What is Do not resuscitate?

Do not resuscitate (DNR) is a medical procedure for patients who are suffering from critical,
untreatable, and irreversible disease where the patient's life is predicted to end. DNR is
considered a sensitive decision for patients and their relatives, as well as physicians.
It is a legally binding order signed by a physician at a patient's request. Its purpose is to let
medical professionals know that the patient does not want to be resuscitated if the patient
suddenly goes into cardiac arrest or stop breathing.
Who can decide for DNR?
A DNR order must be written by a doctor. The doctor will typically explain your options to the
patient and patient’s family, outlining what the DNR entails. With the patient’s consent, the
doctor will create the order for the patient’s request that states that the patient don’t want to
resuscitated if the patient suddenly goes into cardiac arrest or stop breathing.
Why Do People Choose to Have a DNR?
A patient is most likely:

 Resuscitation is unlikely to prolong the patient’s life for very long

 Resuscitation could endanger the patient’s quality of life
 The patient has a terminal illness and does not expect to live for much longer

Can a Family Member Override a DNR?

Doctors are bound to honor a patient’s wishes in the event of a DNR, and no family member has
the authority to override those wishes if the order is in effect at the time of the emergency. It’s
not uncommon for a patient’s family to demand resuscitation when the unconscious patient can’t
speak for themselves, but such demands are seldom heeded if a DNR is in place—though in
the case of an EMS (Emergency Response Services) response outside of the patient’s treating
hospital, the DNR paperwork must be presented in order for the responding professional
responders to honor it.
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Role of the Nurse

 nurses advocate for and play an active role in initiating discussions with patients,
families, and members of the health care team
 care for patients with do not resuscitate orders is no different than the care for any other
patient
 patients with do-not-resuscitate orders must not be abandoned, nor should these orders
lead to any diminishment in quality of care.
 Nurses’ holistic view of patient and family care prepares them to collaborate with the
patient family, and health care team to promote informed decisions.

Scenario
A father, 90 years old was admitted to the telemetry unit. and was diagnosed of possible acute
stroke, coronary artery disease, hypertension, and type II diabetes. The patient signed and
wishes a DNR with his family, he stated “I don’t want any heroic efforts to be carried out on my
behalf, I’ve lived a good life and just wanted to go home to heaven”. But the son of the patient
doesn’t agree and threatens to sue.
*the patient signed it and as for the patient’s wish, given the fact on his current condition. The
physician granted it.
*the patient had a cardiopulmonary arrest, but since the patient has a DNR. The health care
team didn’t do life saving interventions such as CPR to revive the patient.
The son arrived at his father’s death bed. “I can’t believe, that you didn’t revive him. I’m going to
sue this whole hostipal!
Who is in the right position, the health care team who followed the DNR of the patient, or the
son who did not agree on the DNR?