The word DNR is a commonly used phrase in the context of hospitals and one that you might encounter if there is a loved one admitted for a critical illness or surgery. A DNR or a Do Not Resuscitate order is formal medical order written by a doctor. It is a clear instruction that health care providers of a patient consent not to do cardiopulmonary resuscitation (CPR) if a patient's breathing or heart stops during a surgery or post surgery care time in the hospital. The word can conjure different explanations in the minds of people. Here are some guidelines and facts associated with a DNR.
Why is a DNR Important?
Having someone’s life in your hands can be very disconcerting and a matter of great responsibility. Many a times, due to lack of a DNR, care givers make the decision of keeping someone alive on a ventilator knowing that the person may not survive without it. It is an emotional and tough call to make, and the one that can have a massive financial burden. It will help your family take a clear decision in case of an eventuality and assist in moving forward.
What is resuscitation?
Cardiopulmonary resuscitation is the treatment given to someone when his or her blood flow or breathing stops. The idea is to offer efforts such as mouth-to-mouth breathing and pressing on the chest to inject air inside the lung. In some cases electric shocks are administered to restart the heart. Breathing tubes may be used to open the airway apart from the giving oral medication. CPR can be invasive and is a critical life saving process.
Decision Making
Taking a decision in a life saving moment is allowed only to the next of kin in many cases. In the case of critical situations, the doctors look for a DNR, in case it has been drawn up already. It is prudent to create a DNR before a major surgery, taking in consideration the decision-making that it may involve at any stage.
These can be hard choices for you and those who are close to you. There is no hard and fast rule about what you may choose. Ideally, a DNR should be created by the patient. Here are some quick guidelines:
- Know more about your medical condition and what to expect in the future.
- Talk to the doctor about the pros and cons of CPR.
- A DNR can be a part of a hospice care plan, in which case the focus of care here would be to treat symptoms of pain or shortness of breath, and to maintain comfort, instead of life saving.
- If you have a DNR order, you always have the right to change your mind and request CPR.
In case you are unable to make the decision yourself, the next of kin decides in tandem with the doctor on a DNR status, depending on the condition.
Making a DNR
If you decide you want a DNR order, tell your doctor that you need one at the time of visiting the hospital. A qualified doctor can help fill the DNR form. This is clearly communicated on the patient’s medical chart. You can also choose to keep a version in your wallet. Along with a form, one can submit wishes in a living will or health care power of attorney. The next step is extremely crucial. You need to communicate about the DNR to your family. If you do change your mind, talk with your doctor or health care team right away. Also tell your family and caregivers about your decision. Destroy any documents you have that include the DNR order.