Tuesday, December 30, 2008

Full Code versus DNR

I have touched on this subject in some of my previous posts, but I really wanted to go into detail today.

I think that a lot of us do not realize what exactly is the meaning of "Full Code" versus "DNR". My aunt is a nurse and I emailed her for more clarity, however, I have not heard from her as of yet. This is what I have learned through my own research. If I am incorrect in any area please feel free to set me straight.

Before I get into the differences between the two, let me state that a Living Will does not mean "DNR". These are 2 separate items of paperwork. Usually a Living Will only tells the Doctor that you are a "Full Code". Your loved one will be saved no matter the consequences. Please understand that DNR does not mean "Do Not Treat". By having this document misinterpeted, your loved one's care and safety can be compromised!

There are several different code statuses. I have listed them below and what I have been able to learn about them

Full Code - Everything is done for the patient to keep them alive.

DNR - The person has no pulse and is considered dead. No measures are taken to resuscitate.

DNI - Do not intubate.

DNR/Comfort Care - Do not resuscitate and keep patient as comfortable as possible. Nature is allowed to take its course.

If you have a Living Will, your Doctor may write a DNR order without any discussion from you or your loved one. It is very important that you discuss with your loved one's Doctor exactly what they want in regards to their end of life decisions. This is not the time for confusion or family bickering over who wants what.

Please make sure your Doctor understands what your DNR order is! Question whether or not it is appropriate to administer a DNR at this time. Unfortunately, most doctors are less aggressive in their treatments in regards to a DNR patient. You loved one's care should not be compromised because they are a DNR. It is up to you to maintain diligence in observing their care. A broken hip should not usually invoke a DNR order. However, there have been case when less serious injuries than this have become fatal because a DNR order was misinterpreted.

Nursing care is also less aggressive when a person has a DNR order. Nurses are less likely to inform doctors when there is a change is a person's status if they are a DNR.

Some hospitals also have regulations preventing a person with a DNR order from being admitted into and ICU.

In conclusion, you should know what your hospital's regulations are regarding a DNR order. You definitely need to discuss in detail with your loved one's doctor exactly what they want. You need to make sure that all paperwork is in detail and that any nurse physician in question reads and understands what your loved one desires regarding their end of life decisions.

I found most of my information at this site. There is a lot more that I did not post so I highly suggest that you visit this site yourself and make sure that you are making the best most informed decision that is possible for you and your loved one.

I also want to say that I am not of the opinion that doctors or nurses are uncaring or lazy individuals. It is unfortunate that this paperwork is so confusing that inproper care or no care is given. I know from my own experiences with doctors and nurses that they are doing the best they can with the information they have. So if you are able to enlighten yourself and those that treat your loved one, so much the better for all involved.

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