Posted on 03/28/2018 2:41:40 PM PDT by Twotone
Patients beware. When you’re admitted to a hospital, you’re routinely encouraged to sign a DNR, short for Do Not Resuscitate order. Don’t assume it will apply only in extreme circumstances. New research shows having those three letters — DNR — on your chart could put you on course to getting less medical and nursing care throughout your stay. Fewer MRIs and CT scans, fewer medications, even fewer bedside visits from doctors. A DNR could cost you your life.
They even hesitate to put DNR patients in the ICU when they need intensive care.
No wonder patients with DNRs have far worse recovery rates than patients with identical conditions and no DNRs. Women are especially affected.
Hip fracture surgery patients who opt for DNRs reduce their chances of surviving their hospital stay. At Brigham and Women’s Hospital in Boston, researchers found that “mortality was over two times greater” for patients with DNRs than those without them.
DNR means if your heart stops or you can’t breathe, medical staff will let you die naturally, instead of rushing to give you cardiopulmonary resuscitation. Correctly interpreted, a DNR bars just that one procedure, resuscitation. But scientists are discovering that many doctors and nurses take DNR to mean you want end-of-life care only. They misconstrue DNR as Dying Not Recovering.
(Excerpt) Read more at spectator.org ...
While I agree with you, here in Arizona our patients are routinely informed (recommended) that their DNR status is suspended for a specific procedure, eg Cardiac Catheterization/Stent/Balloon Angioplasty. The suspension is noted on the consent. When a guidewire wiggles into the LV and the patient goes into Vtac/fib due to our intervention we will defibrilate them. There are rare cases of chest compressions. We just know we are working with a sick heart at the beginning and try to prep for the worst.
I rather doubt that, because when my father collapsed in a parking lot in Yuma, the ER doc kept trying to bring him back for over 45 minutes, while my mother was in the next room telling them “He’s gone, give it up already!”
She was more distressed by the “ridiculous antics” of the ER team than his death.
He was 75.
No, she’s not cold, she’s a realist, and his wishes were to avoid “heroic attempts”, but of course the medicos know better.
Jerry just needed a pint of Kramer; and a pint of Newman.
Giddyup!
My experience is this...EVERY place I've worked...did not...and continues to be the case....they don't ask the question.."Are you a DNR"?
On one side...I think that question should be asked...Because I've seen what I've seen.
On the other hand....I think...this article is crap.
Look Dummy dead people that stay dead don’t complain about pain because they are dead. Those that survive are not dead to begin with. Sorry if that offends.
But I've preformed CPR...and intubated patients that survived and went on to live productive life's....
All depends on the circumstances...
Good post...........
Funny...gas dr..!!! Ha!!
I have strongly suspected that.
How about you let the adults and professionals practice medicine. Also perhaps you should not raise your voice when you should reinforce your argument. To say your comments are ignorant would be an insult to ignoramus people everywhere. Your expert opinion of assisting in 12 resuscitation as an EMS provider are noted. So whennkt gets to the point in your expert manual that says call a doctor, I will be waiting to provide adult supervision. Or any of my physician colleagues will as well.
How about you let the adults and professionals practice medicine. Also perhaps you should not raise your voice when you should reinforce your argument. To say your comments are ignorant would be an insult to ignoramus people everywhere. Your expert opinion of assisting in 12 resuscitation as an EMS provider are noted. So whennkt gets to the point in your expert manual that says call a doctor, I will be waiting to provide adult supervision. Or any of my physician colleagues will as well.
A DNR might also make you fair game for the organ harvesters, too.
A discussion about DNRs on an Internet forum is full of half truths and suppositions.
Does my 97 year old mother in law want four ribs broken while getting CPR? Because that’s what it means.
Do your homework. Make your decision. Tell your family.
No need to share stories on the inter webs with people who have no idea what they are talking about.
We honor a DNR if we are shown a legal one and are not asked to proceed by a family member.
I work at a hospital. We ask for a health care proxy. Not a DNR. I think people are easily confused.
I do, and I mean it.
I am an EMT, not a paramedic, which is a higher certification. My best guess is that CPR does not hurt because the patient is technically dead when you do it - no heartbeat. Maybe the brain cells linger on some; supposedly hearing is the last sense to go, and I worry more about the casual conversations the patient might hear, as if he doesn’t matter, rather than any pain.
Paramedics (and EMTS, doctors, nurses) are not eager to do CPR on the old old or terminally ill. If the patient fits those categories I always ask, is there a DNR? I remember one elderly woman who had metastasized pancreatic cancer and was on hospice care but there was no DNR because the family didn’t want one. So the cop and I hauled her off the bed to the floor, bared her chest in front of her teenaged grandson, broke her ribs, brought up stomach contents, and I kept thinking, at least she’s gone already. If it was my mother, I would have held her, and told her I loved her.
So far my only CPR save, as in the patient came home from the hospital (return of pulse is common, return home much less so) was when I saved a resident of a group home from CPR. He was conscious when I got there, so I told the staff they could stop compressions...oy.
Then many years later we had DNR...and DNI...meaning do not intubate.
I personally saw a woman intubated against her DNR wishes....because she didn't have a DNI order....Was...IMO very wrong...and she was pissed..!!
When my daughter was getting certified an EMT is the lower of the two. She will be pissed she did two more years of training and gets paid more for running the ALS ambulance.
I give DNR patients the exact same care as those that are not DNR except in the event of cardiopulmonary arrest. All my colleagues in the hospital
do the same. Unless the patient and family specifically direct that they do not want ICU transfers or more aggressive care. I encourage everyone to
have thought out whether they want cpr, resuscitation, and aggressive care prior to a crisis. Having clear well thought out wishes that have been discussed with your loved ones makes a crisis situation much easier on all
Involved
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