Warning-DNR forms are worthless

I'm sorry to hear of your mothers death, that must be very hard for you even though you've probably been saying good bye for a long time now.

I've noticed every time we get a re-admit, we still have to get new code paperwork, even though I would consider the person to be a no code without it.

One facilities DNR is worthless at anothers, same with the Florida DNR that you use at home for EMS, it's worthless in the hospital setting. The Dr. must sign the hospitals DNR to be official.

Legalities.

Hospital policy in our facility is that we need a signed medical order for DNR. The DNR that comes with the patient from the nursing home is not good enough.

yeah, I make sure to stress this to our families of new admits. I work in an LTAC ICU and a lot of our folks will have or be considering DNR. IF they have one already, we must write an order and have them fill out our paperwork. This happens more in our med/surg floor. Our ICU unit has less DNR patients. A lot of them are futile care, it's sad. Where a DNR was meant for patients just like these, the families are against it.

People don't understand DNR orders and think they mean "do not provide care", I have seen families overturn a patients wishes and doctors afraid to challege the patient children. Its all very sad

But haven't some states passed laws that make they much more binding?

And it can vary, even inside a state. The hospital I work at requires a signed MD's order, regardless of all the state DNR forms you may wave. The site I do clinicals at just requires the state form and DOESN'T require the order.

God only knows how many folks who wanted to be DNRs have been brought back.....Go read my article called "The Patient I Failed."

I have been a nurse for 15 years, I have worked in 5 hospitals. All of them require a written DNR order on the chart upon admission even with living will or home DNR papers.

Why? Because the hospitals have been sued many times by family members who decide that mama shouldnt be a DNR. Now that Mama cant speak for herself, the kids decide to speak for her. So why even bother?

Thats why everyone needs a Healthcare Power of Attorney. This person can make all your decisions for you without interference from anyone else even your children/spouse.

I am 35, my daughter is 17. She already knows what i do and do not want regarding end of life. She will make the decisions.

Moral of the story- find you a POA, tell them what you want. POA papers are more binding than DNR papers.

Sounds like the doctor was not paying attention. At our hospital, if the POLST form is on the chart, that is what we follow, doctors order or not.

At my facility, the doctor must write a DNR order for the patient to be a DNR, POLST or no POLST. The POLST is for care outside the hospital. While in the hospital, code status is an MD order for the duration of that hospital stay. Of course, the code status can be modified per the wishes of the patient or their MPOA, but the MD must be the one to write the code status as an order.

And it can vary, even inside a state. The hospital I work at requires a signed MD's order, regardless of all the state DNR forms you may wave. The site I do clinicals at just requires the state form and DOESN'T require the order.

God only knows how many folks who wanted to be DNRs have been brought back.....Go read my article called "The Patient I Failed."

It can vary depending on municipalities as well. There is one smaller community near where I live that has city-run EMS, and they only recognize their own DNR forms. Of course, few who live in the town realize that..........sooo. :angryfire

I don't know if this would stand a legal challenge, but some aggrieved Pt or family member who has watched EMS people code a DNR Pt should take it to court.