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.
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
That's great and I really hope that in the future, you practice compassionate care for the sake of your patients and their families.
Specializes in public health, women's health, reproductive health.
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 hope you really will approach this line of care very differently. Your original post was alarming, to say the least.
My dad was DNR for 5 years while he battled pancreatic cancer. When he went into remission he decided he didn't want to be DNR anymore and lived for another 10. Thats the point.
People, this nurse has all of 3 months of experience. It is very likely that some of her attitude was picked up from other coworkers who don't know much. Or perhaps it's just the perspective of a very young person, with young'uns' classic immortality, who has no experience with serious illness in herself or someone she knows well. She just don't know jack yet. Let us hope that this discussion may very well have saved her patients from unnecessary suffering from heartless care because it has changed her mind.
OP, come back in a few years and tell us how you're different. You will be, you know.
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
Glad you came back to post this. We all need to vent and ask difficult questions sometimes. The hospice patient probably would have been better served in an inpatient hospice setting for symptom management rather than in a cure-focused acute setting, and you could be an advocate for such patients in the future.
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.
DNR means that a patient doesn't wants any medical interventions done once they have actually DIED. It doesn't mean that they wish to be tortured while they're still alive.
Shortness of breath isn't any less frightening to a person just because they've made a decision not to be brought back from the dead. We always try to alleviate suffering when we can. That's the point of treating someone.
I don't know if it's the stress of being a recent graduate in a very demanding job that has skewed your outlook but trust me, alleviating suffering for a patient who doesn't want their life artificially prolonged is every bit as important, worthwhile and ethically necessary as doing it for someone who does.
OP, I hadn't read the entire thread before responding. I now see that you've made additional posts. I'm glad that you've had a change of heart. Nursing is a challenging job with many ethical aspects, it's not always easy. I applaud the fact that you had the integrity to post again after reading the responses. Good luck to you!
You know how there are "who should be assigned to this patient" questions on the NCLEX? I'm beginning to think that hospice and DNR patients should be cared for by experienced nurses ONLY.
Okay, the OP is not the only one who shares this perception of DNR patients. I have a friend who works Med-Surg. She was complaining about her patient assignment after work one day. If I recall correctly, she had 8 patients while another nurse had 7 patients - one of the other nurse's patients was DNR. My friend went on and on about how the other nurse actually had 6 patients because the DNR patient "didn't count." Remember, nurses are people and people are imperfect. Not everyone thinks the same and everyone doesn't have to. We just have to do our jobs to the best of our abilities.
CCRN2BE
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That's great and I really hope that in the future, you practice compassionate care for the sake of your patients and their families.