Question

Lack of do not resuscitation (DNR) orders, impact on frial adult patients.

Please provide reference. Thank you.

Answer 1

Do not resuscitate orders has controversial issues. Ethically, all patients deserve and should receive appropriate nursing interventions , regardless of their resuscitation status. Do not resuscitate is a legal order written by a licensed physician after consulting with patient or his family ,which instructs nurses and other healthcare workers to not perform cardiopulmonary resuscitatie on a patient , when the patientstops breathing or his heart stops beating. A patient may write a living will ,which is a document about patient's wish regarding end of life care . Patients very aged, or having terminal incurable illness, long time bedridden patients may be applicable for DNR when legally accepted.Some patients may lack the knowledge or decisional incapacity regarding DNR , in which a nurse or physician or the care givers can help them to overcome the situation .

Often patients and the families may not have knowledge regarding the DNR policy or there may be lack of opportunities for a favourable patient physician communication or may be the opportunity was neglected. When a clinical syndrome is associated with a poor long-term prognosis and typically present in elderly patients with other chronic conditions , the physicians may talk about end of life care and regarding DNR .

Lack of do not resuscitate orders in weak elderly patients with debilitating diseases may lead to prolong the suffering. Elderly weak, chronically ill patients or with terminal illness have been undergoing many painful and unpleasant treatment and conditions have a gradual decline. Resuscitating them may still worsen their condition and also increase their suffering and provide room to susceptible infections decreasing quality of life.