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How do you get a Do Not Resuscitate order?
A patient can talk to her doctor about signing a "Do Not Resuscitate" order. The patient usually must have a chronic condition that is serious enough to interfere with physica…l well-being and quality of life. A DNR can be signed before a crisis or emergency occurs, if a physician believes that a crisis could be expected to occur with a certain patient's health. For example, a patient who had a severe heart attack and by-pass surgery, who then developed blood clots, and as a result of these and other complications is now stuck in bed with chronic shortness of breath and on oxygen might get his physician to sign a DNR. The process of having a doctor sign a DNR includes that the patient must understand the conditions or diseases he has and must not have any other options for a treatment that could result in a cure or improvement. Second, the patient's thinking must not be clouded by depression or brought up because the patient has "given up trying to get well." Instead, the patient must understand and be able to clearly express why he would not want CPR, to be cardio-converted (shocked) if needed, to be intubated if necessary and to be put on a ventilator, or to have any "heroics" that are meant to keep a person's heart beating and lungs functioning. For the most part, a DNR is an "either-or" on most topics, meaning, a person cannot say "Well, they can do general CPR on me but I don't want them sticking a tube down my throat" because once resuscitative efforts begin, the entire goal is to save the person's life. A Living Will can specify "do this but don't do that" but a Living Will primarily tells a patient's wishes after he/she has already been resuscitated. Physicians will often counsel that, "If I sign the DNR, it should remain permanent, meaning, I wouldn't want you to keep changing your mind." Patients can change their minds about a DNR-- but, it is not to anyone's advantage to create a DNR if the patient is not fully committed to the decision she/he is making. Having a DNR one month, then reversing the decision the next month, then asking for the order to be written again, will only confuse medical workers. A signed, dated, and physician co-signed DNR MUST be clearly posted if at home. It will not help if it is only on the doctor's chart, or kept in a lock box. Paramedics must SEE the order or they will do the usual life-saving measures. Every family member should know the DNR exists and, hopefully, agree with the order. (MORE)
