Changing code status to DNR/DNI

4 There is something just so satisfying about locating your 95 year old demented patient's advanced directive in the computer and having the hospitalist change his code status to DNR/DNI... Last edit by Lev <3 on Oct 14, '13
Why is that satisfying?

Quote from kp1987Why is that satisfying?

Quote from BrandonLPN Because no one enjoys shattering the ribcage of the dead body of a 95 year old.

Assuming the 95 y/o still wants it? which i hope if they still have a mind , can say so.I must say I feel relief usually also if pt has advance directives/molst forms.Have had a few aox3 >85 y/o lately.ooops , didnt see "demented" pt - sorry

Quote from kp1987Why is that satisfying?

Quote from kp1987Why is that satisfying?

Quote from jrwestAssuming the 95 y/o still wants it? which i hope if they still have a mind , can say so.I must say I feel relief usually also if pt has advance directives/molst forms.Have had a few aox3 >85 y/o lately.ooops , didnt see "demented" pt - sorry

I agree. I personally wouldn't say I feel satisfied, specifically, but I definitely do feel relieved and less anxious while caring for them.

We get patients from local nursing homes all of the time who are admitted as full codes. . .they are usually about 100 yrs old, dementia, FTT and admitted for either AMS or a fall. . .and when going thru their admission paperwork I find DNR forms! I HATE it. I call the doctors and get them to change the order in the computer but what if something happens during those couple of hours it takes a doctor to do anything? Would I have to jump on their chest??

I applaud nurses advocating for their patients when they are unable to communicate for themselves. It appears from this post that this patient took the time to prepare in advance by putting a legal advance directive together. These documents are legally binding and unfortunately go unnoticed way too often. If a patient chooses to have no cpr and to be kept comfortable then we must abide by this wish. I am a palliative care nurse and ask the all too difficult questions every day, however, when I ask a 96 y.o what their goals are for their care while they are in the hospital it usually comes in the form of "Oh honey, I told the doctor I didn't want to come back here to the hospital. I've had a good life. I just want to be back home with my friends and be comfortable. No one lives forever." POLST forms are used to transfer these wishes into a ACTIONABLE physician order. We may think we are protecting the patient from an uncomfortable topic, and don't wish to cause them distress in facing their own mortality. But believe me you are going to cause them WAY more discomfort, brutality and distress when THE GORRILLA enters the room to perform CPR. So please advocate, investigate and follow thru with patients wishes whether spoken to you or written in a legal document. This is what makes nursing the wonderful profession that it is.

Quote from Lev, BS, RNThere is something just so satisfying about locating your 95 year old demented patient's advanced directive in the computer and having the hospitalist change his code status to DNR/DNI...

Quote from AlphaPigWe get patients from local nursing homes all of the time who are admitted as full codes. . .they are usually about 100 yrs old, dementia, FTT and admitted for either AMS or a fall. . .and when going thru their admission paperwork I find DNR forms! I HATE it. I call the doctors and get them to change the order in the computer but what if something happens during those couple of hours it takes a doctor to do anything? Would I have to jump on their chest??