What Is a Do Not Resuscitate Order?
A do not resuscitate order (DNR) is a legal order signed by a physician that specifies you do not want to be resuscitated in an emergency, meaning no steps will be taken to restart your heart or restore breathing should you experience cardiac arrest or respiratory arrest. People without DNR orders will be resuscitated my medical teams who are required to resuscitate patients in emergency situations.
What Life-Sustaining Treatments Are Prohibited?
Cardiopulmonary resuscitation (CPR) is the combination of chest compressions and artificial respiration to keep blood circulating throughout the body when the heart has stopped beating.
Transcutaneous Cardiac Pacing (TCP) involves placing pads on a patient’s chest. These pads send electric currents through the chest to stimulate heart contractions or balance irregular heartbeats.
Defibrillation involves an electric shock to a patient’s chest to restore a normal heat beat or if a patient’s heart suddenly stops, it will help it beat again.
Advanced Airway Management involves inserting a tube into a person’s mouth when they are not breathing or are not able to breathe well on their own. Trained personnel then breath through the tube to assist with the patients breathing.
Artificial Ventilation is performed by trained personnel with a device known as an “Ambu bag”, which is used to push air into the lungs when the patient cannot breathe on their own or has stopped breathing.
Who Needs a DNR?
The steps to resuscitate someone often come with risks when used on elderly or very ill patients, that is why DNR orders are very common among hospice patients whose chance of surviving resuscitation is very low. It takes careful consideration, but DNRs can make sense for certain situations.
While many patients want to avoid the health risks following resuscitation, many also have an understanding perspective of death. For some, enacting a DNR order allows them to have a peaceful and dignified death rather than staying in an inevitable state of pain and/or illness after resuscitation. DNR orders enable people to make important medical decisions on their own accord – before their mental cognition declines due to age or illness.
What Are the Steps to Get a DNR?
Step 1: Let your physician and family know
If you decide that a DNR order is right for you, tell your physician and hospice care team. Your physician must follow your wishes or transfer you to a doctor who will carry it out. Your doctor will fill out the form and update your medical records with this information.
Informing your family of your decision is vital. In the event that you are not able to communicate, your family should be able to inform medical personnel of your end-of-life care desires.
Step 2: Implement the DNR Order into Your Advanced Care Directive
An advanced care directive, or a living will, is a legal document that expresses your end-of-life care desires. Your advanced care directive only goes into effect if you are incapacitated and cannot speak for yourself.
Though it is not a requirement, it is strongly suggested that you include your wish to have a DNR order in your advance care directive. By planning ahead, you can avoid making these crucial decisions during stressful emergencies.
Do I Need a DNR to Receive Hospice Services?
Three Oaks Hospice does not require patients to have a DNR. Getting a DNR order is a decision that should be made by the patient and their family members.