Do not resuscitate Orders
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With increasing client control of decisions at the end stage of terminal illnesses, new issues have arisen for both doctors and nurses. One of those issues involves the "do not resuscitate" order which patients may establish during the end stage process. At the same time, those same patients, or their doctors, may wish to institute surgical procedures for pain relief or symptom management. There is a clear conflict here, since each time an individual undergoes surgical procedures under general anesthetic, there are risks that they will not return to natural breathing through natural processes. Thus, the institution, and individual health care providers involved, place themselves at-risk of lawsuits if they ignore, or follow, the "do not resuscitate" order in this instance. There are other issues involved, including the use of health care resources, but the basic question to be explore in this paper is whether or not patients with such an order should be permitted to undergo surgical procedures with the order still in effect. The first step here is to clarify what the "do not resuscitate" order means. It means that if the patient's heart stops, there will be no efforts to revive that patient. The patient will simply be allowed to die naturally, with no medical intervention. The Royal College of Nursing, along with other professional organizations, noted that these orders are important documents
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citated. Without a formal and official DNR (and even with that), the patient's wishes are likely not to be respected by medical staff, even if the nurse advocates for those wishes.
Haddad (1996) noted a further complication for the nursing staff when the attending physician refuses to accept the patient's wishes and does not write a DNR order. In this situation, the nurse is aware of the patient's clear request not to be resuscitated, but is hampered by the physician's refusal to accept that. The nurse is left with an ethical and legal dilemma, along with a potential job-threatening situation if she ignores a code situation. In other words, she must call a code, even though she knows that the patient has both verbal and written advance directives requesting that there be no resuscitation in specific situations.
There is such a thing as the Patient Self-Determination Act, in effect since 1991. This, theoretically, leaves the right to make decisions about code situation and DNR orders in the hands of the patient, rather than of health care staff. However, this does not take into account the reality of uneven compliance on the part of both hospitals and health care providers. Nurses placed in this situation may feel unet
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Some common words found in the essay are:
College Nursing, Medical Center, , Directive DNR, Self-Determination Act, Journal Nursing, DNR Haddad, Nursing Management, health care, DNR Ethical, Proulx AJ, surgical procedures, health care providers, care providers, aware patient's, call code, journal nursing, write dnr, haddad 1996, american journal, patient's wishes, american journal nursing, patient's request resuscitated, doctors write dnr, ebrahim 2000 resuscitate,
Approximate Word count = 1615
Approximate Pages = 6 (250 words per page)
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