What Is a Do Not Resuscitate (DNR) Order and how does it work?


Q: What Is a Do Not Resuscitate (DNR) Order and how does it work?

A: A Do Not Resuscitate Order is a legally binding physician's order for a patient, which is signed by the treating doctor, that no steps will be taken to restart a person's heart when it stops or to get a person breathing again if the patient stops breathing.

A DNR order is normally a result of a person's healthcare directive, which says that he or she does not want measures to be taken to keep the person alive. The decision to not resuscitate a person must be made by the individual, if competent to do so, or by the person's agent for healthcare, on a "living will'" or healthcare directive, if the person is not competent to do so. The patient or agent must ask for such an order.

The signed DNR order is placed in the patient's hospital chart. The family of the patient who does not want to be resuscitated often must remind the doctors and staff in a hospital about the order, because the first thing doctors and nurses want to do is to save someone's life if their patient does stop breathing or their heart ceases to beat.

The DNR order only works if the patient or the patient's family is clear with the doctors about it, and is able to be the patient's advocate in a setting where it is almost automatic that resuscitation will take place. In other settings, such as hospice care (care designed to keep someone comfortable in their last days for a dignified death, rather than trying to fix or save them during their last days),

DNR orders are fully respected without coaching or advocacy by family.

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I have discussed with my mother many times when things are not in an uproar about what she wants done if I walk in her room and find her not breathing or without pulse.I am a retired nurse and DNR did not mean do not treat. If the patient had a fever, that was addressed with specimens taking and appropriate Abx be prescribed,.Pain would be treated and monitored,I explained what was involved in a CODE, showed her an ETT , a PEG tube(for tube feeding) discussed quality of life and what that meant to her,it was a painful discussion,she cried a lot but I tried my best to truthfully answer all her questions.In my experience ,at least where I worked just because someone was a DNR didn't mean we didn't check on them, VS,meds were done,infections treated, pain addressed and treated, the only thing we would not do was push drugs or do CPR,nor would we place an ETT(plastic breathing tube) down the trachea.Thoracentesis would be done if needed as this was seen as a comfort measure to improved breathing so the person didn't struggle to breath.Please talk to your "loved" ones about what they want before something happens in the middle of the night.Not all hospice is alike ,some better than others. My father was on hospice for leukemia, he was still treated with antibiotic for infections,they did everything for him that could be done in an ER except push emergencey cardiac drugs on him of do CPR.He got his wish of being in his own room with his books and his dogs and kept comfortable,and you don't always have to "knock someone out with drugs" to get good pain relief.
to flogo, you must have had a really bad experience.However, you are giving out some really bad information.For one thing, you don't give TPN( food) thru a PICC line, it's to thick, and usually TPN does already have insulin in it as it is such a hi glucose source.You are basically saying every nurse is a potential murderer.Where are you getting your info, from TV murder mysteries?I hope some emotionally vulnerable person doesn't listen to you but instead checks things out for themselves.There are to many people on these forums that don't have a medical background and some half*ssed comments like yours can cause unnecessary grief.I would advise people please check things out for yourselves,talk to you loved ones before they get sick.
My mother was adamant about having a DNR Order in place. I was her DPOA and Healthcare proxy. Last year my mother was in the ICU on a ventilator. It was her intent in the directive not to be hooked up to a ventilator under no circumstances. I had to insist the doctor remove the tube and let nature takes it course. Yes she could have been alive today of I had not honored her wishes. Alive on a ventilator with a trachea in a nursing home for the rest of her life. I allowed my mother to die with dignity and quality of life still intact. It is the individuals right, decide what Healthcare Directive Choice. As long as the wishes are legal. Flogo, if you truely believe your mother was murdered, see a lawuer for a wrongful death suit.