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
Specializes in LTC, assisted living, med-surg, psych.
Guess what? TODAY we finally got X-rays done on this poor lady, and she has an L-3 compression fracture!! No wonder she's been in so much pain!!!
Think I'm going to send a nice little letter to the editor of our local paper and let the public in on what kind of suffering our magnificent health care monopoly allows to happen in the name of "conserving resources".:angryfire:angryfire:angryfire
Guess what? TODAY we finally got X-rays done on this poor lady, and she has an L-3 compression fracture!! No wonder she's been in so much pain!!!
Think I'm going to send a nice little letter to the editor of our local paper and let the public in on what kind of suffering our magnificent health care monopoly allows to happen in the name of "conserving resources".:angryfire:angryfire:angryfire
I couldn't agree more with sending out that letter. I'd like to read it, too.
This makes me think of an old lady in the nursing home who had her left leg amputated and was sent home a couple of days later with 5mg Lortab every 4-6 hrs.
No wonder she was screaming. That doctor was either an idiot or a sadist.
At the LTC facility where I work (MS), DNR comes into effect only if there is need for CPR or other life-sustaining measures. I always send out residents, both Full code and DNR status, for further eval if needed. Sometimes the ER can do more for fx's, pnuemonia, CHF, sepsis,etc than we can. I've had many "DNR" residents come back in excellent shape after a few days in the hospital. Imagine if they were just left at the facility to die. Hospice patients are usually given comfort measures only. Most that I've seen remained comfortable and had passed peacefully.
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. 
VivaLasViejas, ASN, RN
22 Articles; 9,996 Posts
Guess what? TODAY we finally got X-rays done on this poor lady, and she has an L-3 compression fracture!! No wonder she's been in so much pain!!!
Think I'm going to send a nice little letter to the editor of our local paper and let the public in on what kind of suffering our magnificent health care monopoly allows to happen in the name of "conserving resources".:angryfire:angryfire:angryfire