Would you call a code/MET on a pt. who is a complete DNR?

Sorry if this is a stupid question, but I'm a new nurse, freshly graduated.

If I walk into the room of a complete DNR pt and he/she is unresponsive, diaphoretic, breathing is labored, should I call a MET/Code?

Thanks...
Comfort measures only please ... respect the DNR. You have to know what the DNR says about comfort measures as well. Usually O2, suction, and pain meds (morphine for rapid breathing) are the norm but not the standard. Know your patients.

No. I always try to remember this when a pt is DNR. If you find them in a state which would indicate the need for resuscitation, then you do not call a code. So for example if my DNR pt is:ApneicCyanoticUnresponsiveSevere (low)vitalsI know DNR can be tricky, even to me still and I've been a nurse for a while. I've had patients who were possible ICU candidates but were downgraded to med-surg because they were DNR/DNI.I think too often patients that really should be referred to hospice services don't get that priviledge. It's sad to see a patient in terminal state (of whatever disease) have to go through multiple hospitilizations, resuscitation/intubations when it's clear that the patient needs comfort care because it's their last stage of life. Not enough family members are educated about it either. But that's another subject.

I wouldn't call a code, but I would call a rapid response. Just because a person is DNR/DNI doesn't mean they are comfort care.

I would not......but i would treat the symptoms.

I have a hard time differentiating between something that could be treatable...like just a low blood sugar, and something that would require intubation, etc. Now of course if they are pulseless, or agonal breathing (actively dying), i wouldn't call anyone but the gray area is what concerns me. Would it hurt to call a MET/RR and just let them know they are DNR? Or is it pointless?

DNR does not mean do not treat. I would call the MD, call an RRT and see what can be done. Do they need lasix? Apply some o2. Reposition them. Do they need to be NT suctioned? Have they been recieving narcotics and could they use some narcan? Theres a lot of things you can do aside from intubating, starting pressors, etc... that can turn a person around. There is a difference between being a DNR and being on comfort care or hospice geared care.

Quote from 2011nursetobeI have a hard time differentiating between something that could be treatable...like just a low blood sugar, and something that would require intubation, etc. Now of course if they are pulseless, or agonal breathing (actively dying), i wouldn't call anyone but the gray area is what concerns me. Would it hurt to call a MET/RR and just let them know they are DNR? Or is it pointless?

Quote from nursenotamaidDNR does not mean do not treat. I would call the MD, call an RRT and see what can be done. Do they need lasix? Apply some o2. Reposition them. Do they need to be NT suctioned? Have they been recieving narcotics and could they use some narcan? Theres a lot of things you can do aside from intubating, starting pressors, etc... that can turn a person around. There is a difference between being a DNR and being on comfort care or hospice geared care.

So regarding comfort measures...if you give pain medicine to make them comfortable and the patient expires....then what? I've always wondered this...

Quote from melosaurRNSo regarding comfort measures...if you give pain medicine to make them comfortable and the patient expires....then what? I've always wondered this...

When I have a patient who's a DNR, I gently explore the notion of hospice with the patient or their family. Yes we have hospice patients who are still full codes, but if a person is truly endstage COPD, CHF, renal failure, etc., let's have the discussion as to what we can do to help the person to find comfort and peace their last days on earth, not whip them down to an ICU, shove tubes in every opening, and make sure they are physically and mentally miserable just so we buy them a few extra hours or days that will be a horror to them. If the patient is actively dying, then I get the doc to write me an order for comfort care. I'd treat the symptoms with an eye to comfort, acknowledging that we all reach a point where there is no "better" and there is no "cure."Let's do the right thing for the patient, the nurse thing for the patient, which is to make them comfortable and give them the best quality of life, not the longest length of life...

While it's true that many DNR patients are end-stage something ... many are not. It's totally appropriate to explore hospice and end-of-life care but it's also important to recognize when it's not appropriate. It's not a clear-cut either/or situation.