I work on a very busy Tele floor and can have up to 5-6 patients a night. What kills me...is when I have a patient that is DNR. Seriously? Like what is the point? So far, the DNR's are usually on their last leg, disease processed has moved to the final stages, yet you come to the ER with SOB, and admitted to my busy floor, and I have to now treat you as if I would treat one of my patients whose a full code - but, if you suddenly become pulseless, I cannot do anything anyway...grrrrrrrrr. How time consuming - why? I had a patient admitted from HOSPICE onto my floor for SOB - seriously?
Please help me understand you all. I am a new graduate nurse - 3 months - and when I get a DNR patient, I instantly get turned off. Sometimes these are the most time consuming patients with overbearing family members and in my mind I am like, the hospital is for saving lives if something lethal happens, I am not doing anything anyway. sigh.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Thanks for all of the comments!
Ok I'll just delete all my comments delete my account. I can see that this isn't for me :) and thanks for taking up for her. I'm the bad guy so thanks. I'm a good guy and I know it. She called me ignorant and yet you direct your comment to me and point out what I said?
Thanks. I see where I stand
I said your statement that you wouldn't want any of the posters on this thread to be your nurse in real life was ignorant. It is. I didn't say that you were ignorant. Even if I had, it wouldn't have been nearly as nasty as your post.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Thanks for all of the comments!
I said your statement that you wouldn't want any of the posters on this thread to be your nurse in real life was ignorant. It is. I didn't say that you were ignorant. Even if I had, it wouldn't have been nearly as nasty as your post.
Quoting my own post to apologize to cholmes -- I don't know how your post got quoted in my last two replies, but it was. Sorry. I'll figure it out so it does not continue to happen.
I work in Emergency, and it is not at all unusual to receive DNR patients. In my state, we have a POLST registry, which allows people to choose different levels of intervention. They can choose to have chest compressions without intubation, or vice versa (which makes no sense to me, but it is *their wishes*). They can choose to have no resuscitation, but IV fluids and antibiotics. They can decide if they want nutrition via feeding tube or not. Or, they can choose comfort measures only. Sometimes, a person will have a POLST that states DNR- Comfort Measures Only, but upon arrival in the ER, they change their mind. Sometimes, I care for actively dying people in the ER. In the ER, we are not always about the business of saving lives. Some of my most gratifying experiences have been to be the person providing end of life care to the patient and their loved ones (because it is also the family's experience). For me, it is an honor to be that person.
The point is to honor the patient's wishes- to honor their autonomy, and provide the best nursing care possible for their particular set of circumstances, i.e. an individualized plan of care.
Best of luck in your future nursing career- thank you for being open to learning, because without it, we cannot become great nurses. I would rather be cared for by someone who is willing to take their lumps and learn and grow than someone who is set in their way of thinking and allows their biases to be barriers between them and the people they are privileged to care for. Stay open, keep growing, and some day you will be a great nurse.
This does beg the question, "Why is a DNR on tele in the first place?"
Because, as has been stated repeatedly, DNR does not equal Do Not Treat, and you can treat rhythm changes. Maybe the person is not actively dying, and would like their rapid A-Fib controlled.
If the person is actively dying, however, it does not make sense to have them on tele.
This does beg the question, "Why is a DNR on tele in the first place?"
Possibly the patient would like all measures to be taken to recognize and treat an arrhythmia before it results in pulseless arrest. As others have pointed out, just because the patient has chosen to be a DNR in the event they experience cardiac arrest, this does not mean they do not wish to prolong their life short of actually experiencing cardiac arrest. As mentioned above, DNR does not mean "Do not treat."
Ruby Vee, BSN
17 Articles; 14,051 Posts
I said your statement that you wouldn't want any of the posters on this thread to be your nurse in real life was ignorant. It is. I didn't say that you were ignorant. Even if I had, it wouldn't have been nearly as nasty as your post.