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.
I will make this short and sweet. Just because you do not wish to be brought back to life does not mean you wish to suffocate and die painfully at home. I did most of my clinical on telemetry floors as well as my role transition where we had several codes a day, some of which were DNA and some were Full Code. I cared for them all equally. If you do not wish to care for dying people who don't want heroic measures taken but do wish for comfort at the end, as we all do, then you shouldn't be working in acute care, let alone telemetry. Go to a doctors office if you can't be troubled with DNR patients and let someone who actually cares have your job.
Specializes in LTC, assisted living, med-surg, psych.
I'm a DNR. That means if I'm found down, with no respirations and no pulse, I want to be left alone so my soul can go free. BUT---until I reach that point, I want treatment that respects my dignity and keeps me comfortable. And I would hope the nurse taking care of me wouldn't see me as a burden, an inconvenience, or someone who just needs to die. But that's just me.
As others have said, DNR does not equal Do Not Treat. I have DNR patients in the ICU all the time, and it does NOT mean I just pull the curtain and wait for them to die. There is a doctor on my unit who has had nurses removed/fired from the unit for having attitudes such as your own. I would take some time to consider your future path in nursing and maybe brush up on what a DNR truly is.
The vast majority of DNR patients in the world are not actively dying and are receiving treatments for conditions that will resolve or stay stable and they will go on to continue to have quality life after their hospital stay.
However, even patients actively dying deserve quality nursing care to die with dignity, and to have things like pain, nausea, anxiety, and delirium managed, and to not be left laying in their own feces with a mouth bleeding it's so dry and pressure ulcers. They are still humans that people love. To imply that they don't deserve quality nursing care, or that caring for them is a waste of resources is offensive and deeply concerning.
If, somehow, I've missed your point and you're frustrated with futile care in patients with no hope of meaningly recovery, ie, trachs and pegs in 90 year olds with cancer of the everything, that's a whole different ball of wax and I could certainly understand that.
I don't even know what to say. Let me just say this, my dad was a DNR, all I wanted was for his symptoms to be alleviated so I could get him home again. What do you want, for these people to
just be tossed aside to die?
You really need to take a step back and look at what type of nurse you want to be. I so hope you can figure out that being compassionate and empathetic are truly part of being a good nurse. We provide comfort and death with dignity, this is the art of nursing. You have been a nurse for a short time, take a long look at yourself and ask if this is the type of nurse you want to be.
and I hope you are never on the other side of the fence, as one of those annoying family members.
Thank you all for your responses. I needed to read it and you all are right. Sorry, I guess I am just stressed out and so happy to hear the different perspectives. Thank you again for your thoughts. This helped me approach this line of care very differently!!!! Thanks
I had a patient admitted from HOSPICE onto my floor for SOB - seriously?
I figured there would be quite a few posters educating you on what DNR means and why it often doesn't matter to nursing care UNLESS there is an arrest.
As for this statement, if a patient is on hospice at home, symptoms may not be adequately controllable at home and inpatient hospice care in a general acute care facility is warranted. The hospice company may not have a bed in their own inpatient unit, but the patient needs 24/7 nursing care to get the symptoms under control. Although I would question the need for tele monitoring (those monitors can be unwieldy and uncomfortable), admission is absolutely appropriate.
OP, your attitude toward DNR/end of life issues reeks of narcissism and displays an apparent profound lack of life experience. I truly, deeply, sincerely hope that you do not work in a hospital anywhere near myself or my loved ones.
I find it appaling that as a patient and their family are trying to navigate through the end stages of a life, you, as their nurse, are just thinking how pointless and bothersome it is FOR YOU, and how much of a pain in the *** they all are to take up your precious time with nonsense.
Personally, I hold it as a great honor and find it very humbling to be able to witness and share in the last stages of a person's life.
You'd be well served to follow the useful advice of the previous posters and educate yourself on these matters. I don't have much else to add except this....
Remember, when you are at work, caring for patients (no matter the situation), IT IS NOT ABOUT YOU!
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
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.
Deep breathe. OK. Another deep breathe! Maybe now I can answer without accumulating points . . . .
DNR means "Do Not Resuscitate", it does not mean "Do Not Do Anything." The point is to keep the patient as comfortable as possible while nature takes its course. Many of those patients wish fervently to die at home, but when they become short of breath, in a great deal of pain, incontinent or whatever, their families cannot (or will not) care for them and bring them to the hospital. The way in to the hospital is through the ER.
Hospitals are for caring for patients. "Saving lives" is a bonus. Sometimes. Not always. DNR patients are patients and their family members are suffering anticipatory grief, knowing their loved one is about to die and in some cases extreme guilt for reneging on their promise to care for the loved one at home so that the loved one can achieve their wish of dying at home.
I really hope you give these patients better care than your post would indicate. They -- and their "overbearing families" both need and deserve it.
EmpathyInAction
47 Posts
I will make this short and sweet. Just because you do not wish to be brought back to life does not mean you wish to suffocate and die painfully at home. I did most of my clinical on telemetry floors as well as my role transition where we had several codes a day, some of which were DNA and some were Full Code. I cared for them all equally. If you do not wish to care for dying people who don't want heroic measures taken but do wish for comfort at the end, as we all do, then you shouldn't be working in acute care, let alone telemetry. Go to a doctors office if you can't be troubled with DNR patients and let someone who actually cares have your job.