Well, what I've long suspected about the hospital in the town where I work is, in fact, true: DNR indeed does mean "Do Not Treat". The EMTs won't even transport someone to the ER if their advanced directive says "comfort measures only", even if they're in obvious DIScomfort. Why? Because some group of high-ranking muckety-mucks has decided that treating the sick is not a 'cost-effective' use of the hospital's services.:angryfire
I couldn't believe it when I read about this in the newspaper. Then I actually heard about it again from the paramedics I called today for a resident who was having severe back pain from an unknown cause. They were very sympathetic, but they told me the order had come down NOT to transport anyone to the ER unless they were, essentially, a full code and had one foot already in the grave. In other words, if a patient is elderly and/or has a DNR order, the hospital won't even 'treat 'em and street 'em' anymore. They won't even LOOK at them.
I am so angry right now I could spit nails. Naturally, I don't believe in using the ER as a primary care provider, but for crying out loud, when one of my residents is desperately ill or in pain and I don't know why---and their PCP isn't responsive to their needs---where else are we supposed to turn for help? And God help you if you're over 65 and on Medicaid.......you can't use the ER, but you also won't be able to find a PCP willing to take you anymore.
The thing that really burns me up is the fact that our Greatest Generation paid into the "system" literally for DECADES, and now when they need help, it's not there for them. In fact, the healthcare conglomerate here in our area treats them like parasites. Unfortunately, the organization is a monopoly, so it's the only game in town. And now it's turned every standard of decency I can think of on its ear: you're welcome to use the ER if you have private insurance and/or are young and 'productive', but if you're elderly, frail, and/or poor, the hell with you.
Yep, this really makes me look forward to old age..........when my body starts failing, I think I'll just walk way, way out into the wilderness and let nature do what it will, as our ancestors used to do when they sensed that their time was near. It beats the heck out of begging for some small share of mercy and being treated like a "useless eater", as one Adolf Hitler used to put it.:angryfire
Well, what I've long suspected about the hospital in the town where I work is, in fact, true: DNR indeed does mean "Do Not Treat". The EMTs won't even transport someone to the ER if their advanced directive says "comfort measures only", even if they're in obvious DIScomfort. Why? Because some group of high-ranking muckety-mucks has decided that treating the sick is not a 'cost-effective' use of the hospital's services.:angryfire
I couldn't believe it when I read about this in the newspaper. Then I actually heard about it again from the paramedics I called today for a resident who was having severe back pain from an unknown cause. They were very sympathetic, but they told me the order had come down NOT to transport anyone to the ER unless they were, essentially, a full code and had one foot already in the grave. In other words, if a patient is elderly and/or has a DNR order, the hospital won't even 'treat 'em and street 'em' anymore. They won't even LOOK at them.
I am so angry right now I could spit nails. Naturally, I don't believe in using the ER as a primary care provider, but for crying out loud, when one of my residents is desperately ill or in pain and I don't know why---and their PCP isn't responsive to their needs---where else are we supposed to turn for help? And God help you if you're over 65 and on Medicaid.......you can't use the ER, but you also won't be able to find a PCP willing to take you anymore.
The thing that really burns me up is the fact that our Greatest Generation paid into the "system" literally for DECADES, and now when they need help, it's not there for them. In fact, the healthcare conglomerate here in our area treats them like parasites. Unfortunately, the organization is a monopoly, so it's the only game in town. And now it's turned every standard of decency I can think of on its ear: you're welcome to use the ER if you have private insurance and/or are young and 'productive', but if you're elderly, frail, and/or poor, the hell with you.
Yep, this really makes me look forward to old age..........when my body starts failing, I think I'll just walk way, way out into the wilderness and let nature do what it will, as our ancestors used to do when they sensed that their time was near. It beats the heck out of begging for some small share of mercy and being treated like a "useless eater", as one Adolf Hitler used to put it.:angryfire
I am sure this is illegal... as an EMT if someone calls us and wants to go to the hospital we can't refuse to take them (at least here in KY). This is a great time for you to advocate for your patients who are being treated this way by telling anyone who will listen... and even some that won't. I wouldn't let it go!
I agree that the media should be tipped off to this little game. I'd write a letter to my local newspaper and make sure every news station in the country got a copy of it. It is outragous to treat anyone that way. What happened to the right to rectract the DNR. In my facility, we have many patients who are DNR's but, we also get orders to DNI and DNH (do not intubate, do not hospitalize) these orders are usually made by the family and doc of a long suffering patient who is obviously not long for this world. It still does not mean that if they have a common cold we do not give them something to relieve their symptoms to make them more comfortable. A hospital refusing to treat any patient is unbelieveable. Start writing those letters!!
Specializes in LTC, assisted living, med-surg, psych.
Thank you, thank you, thank you ALL for your responses!!!
I have a good friend who is a long-term care ombudsman........think I'll give her a call Monday and see what SHE feels about all of this. Yes, and I'll write a letter to the editor of the local paper (who happens to be another friend of mine) and see where that leads. And if none of this works, I'll start working on my state and federal representatives (I don't know them personally, but who cares?).
I woke up this morning still as outraged as I was when I went to bed last night.........as I was when I first learned of this policy. That's usually a good sign that something really IS wrong, that I'm not just overreacting. Thank you all again..........I've got some work to do!
Yep, this really makes me look forward to old age..........when my body starts failing, I think I'll just walk way, way out into the wilderness and let nature do what it will, as our ancestors used to do when they sensed that their time was near. It beats the heck out of begging for some small share of mercy and being treated like a "useless eater", as one Adolf Hitler used to put it.:angryfire
It's no surprise to me at all, and it isn't just the hospital in your town. As one 90+ y/o woman in a nursing home matter-of-factly put it, the world doesn't want you around when you're old.
Even in cultures where old people were held in high regard they are now being seen as burdens. In India there is such a problem with families abandoning their old relatives the government is trying to make it a crime (ergo, the government doesn't want to be burdened with caring for them, either.)
I've thought a lot about getting old and right or wrong I can't help it this is how I feel. It seems there are a few people who can live into their 80's and 90's and lead fairly healthy lives, but most of the time if you live that long it isn't worth it. Not that I believe they should be treated like the health care system treats them, but I'm praying I don't have to get in such a condition where I'm a burden to society. I know they paid into the system their whole lives, we will pay our whole lives into the system and probably get less than what people are getting now. The whole system is so discombobulated who even knows what to do with it? I just know I see a lot of young people who could actually be helped do without while old people who are past the point of help get "treatment". This is like a slap in the face to both aggregates.
I've heard it said when you can't help yourself you can't help others. When I go out now it seems the old people outnumber the young ones, meaning there just aren't enough to even the scale out.
It's incredibly naieve to think the government would not lie and as such there is no doubt in my mind the government could care less about anyone's so-called quality of life. It's all about cost effectiveness and the bottom line. People are no more than cattle, young or old. If you've got the money they've got the time, if not, you can go to you-know-where.
Wow, we're going through the same thing here with Hospice, and from what I hear, the LTC facility in town has the same issues. The primary physicians think that hospice or LTC=do not need to treat anymore, and they can ignore the calls and faxes from the Case Manager and nurses. The ER thinks "They're on hospice (or in the nursing home). So what if they have a perforated bowel and are in pain? They're dying. We're not going to save them, so send 'em home without treating them." I don't send patients often to the ER, but I'm always mad when I do. I need to look the ER doc in the face next time and say it point blank "Hospice does NOT mean do not treat." ARGH.
I am sure this is illegal... as an EMT if someone calls us and wants to go to the hospital we can't refuse to take them (at least here in KY). This is a great time for you to advocate for your patients who are being treated this way by telling anyone who will listen... and even some that won't. I wouldn't let it go!
I had a patient in the early stages of the dying process who the ER actually refused to take back. They prescribed her an ABO and said that was all they could do.
We had to have her transported to another hospital where they agreed to refer her to a bigger hospital 100 miles away where she was placed in a hospice unit and died about a week later.
The hospitals can refuse all kinds of treatment and word it right so no one can prove a thing.
Yes, and I'll write a letter to the editor of the local paper (who happens to be another friend of mine) and see where that leads.
Letter to the editor is good, but I agree with contacting a local TV station. They just love this kind of stuff.
And if the hospital is refusing care to the elderly? Whoa nelly. The Medicare enforcers would smack them to the curb over that. You don't wanna mess with the Feds
Specializes in CNA, Surgical, Pediatrics, SDS, ER.
I work in the ED and we have several patients who come in that are on hospice care or elderly and we treat them. We just had a NH pt who was a DNR her DIL is a nurse at our facility and she just wanted her checked out because she kept going unresponsive. We checked her out and left it up to the family if they wanted us to do any further tx & they refused.
As far as my facility goes we have not refused to take pt's who are DNR, on hospice care, or from the NH. Just because they are DNR does not mean that they can't have adequate pain control or tx. I can see why you are soooo angry. Hospitals do not have the right to refuse care to anybody. :nono:We are there to help care for these people no matter what the circumstances are. I would definatly not give up on this and I would be getting any and all attention to this matter that I could. Your patients do not deserve to be denied treatment and/or comfort at any stage in their life. Good luck to you and thank you for being an outstanding pt advocate!
I'd check with APS, too. Here adult abuse includes failure to provide "the necessities of life, such as food, clothing, shelter, needed medical care, and reasonable financial management."
it's no surprise to me at all, and it isn't just the hospital in your town. as one 90+ y/o woman in a nursing home matter-of-factly put it, the world doesn't want you around when you're old.
it's not just the old that are devalued, but they were the first to be devalued en mass, hence all the nursing home "abuse", which is perpetuated by under staffing due to corporate greed. one nursing home advocate i was in contact with actually heard the elderly being refered to as "useless feeders,"
even in cultures where old people were held in high regard they are now being seen as burdens. in india there is such a problem with families abandoning their old relatives the government is trying to make it a crime (ergo, the government doesn't want to be burdened with caring for them, either.)
i've thought a lot about getting old and right or wrong i can't help it this is how i feel. it seems there are a few people who can live into their 80's and 90's and lead fairly healthy lives, but most of the time if you live that long it isn't worth it. not that i believe they should be treated like the health care system treats them, but i'm praying i don't have to get in such a condition where i'm a burden to society. i know they paid into the system their whole lives, we will pay our whole lives into the system and probably get less than what people are getting now. the whole system is so discombobulated who even knows what to do with it?
this type of thing is proof positive that our current health care system is imploding and real live human beings are being harmed.
i just know i see a lot of young people who could actually be helped do without while old people who are past the point of help get "treatment". this is like a slap in the face to both aggregates.
what has been very disturbing and i have heard it repeated on these very threads here at allnurses by other nurses and even mds ,is an attitude of anger at having to "pay" for the care of people young and old, with chronic disease due to "life style choices", some went so far as to say that we should withhold care from them.
i've heard it said when you can't help yourself you can't help others. when i go out now it seems the old people outnumber the young ones, meaning there just aren't enough to even the scale out.
it's incredibly naieve to think the government would not lie and as such there is no doubt in my mind the government could care less about anyone's so-called quality of life. it's all about cost effectiveness and the bottom line. people are no more than cattle, young or old. if you've got the money they've got the time, if not, you can go to you-know-where.
it is the private hospital eds that are denying care to these patients, not the government. it is all about the almighty dollar and we have been letting the greed of the private insurance companies and hospitals and clinics hold the public hostage to these kind of prices.
no matter age, chronic illness or lifestyle, these folks still feel pain, still breath, still have value if not for any other reason than they are fellow human beings.
here is another source to contact with this issue.
Naturally, I don't believe in using the ER as a primary care provider, but for crying out loud, when one of my residents is desperately ill or in pain and I don't know why---and their PCP isn't responsive to their needs---where else are we supposed to turn for help? And God help you if you're over 65 and on Medicaid.......you can't use the ER, but you also won't be able to find a PCP willing to take you anymore. 
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KyPinkRN
283 Posts
I am sure this is illegal... as an EMT if someone calls us and wants to go to the hospital we can't refuse to take them (at least here in KY). This is a great time for you to advocate for your patients who are being treated this way by telling anyone who will listen... and even some that won't. I wouldn't let it go!