18 June 2008

Frustration

DNR. Do Not Resuscitate. Let Me Die. To me, these statements seem pretty clear. I would assume they are even more so when you are being cared for in a "skilled nursing" facility. Nurses, LNAs, PCTs, whatever, should understand the technical terminology, and I truly believe that anyone spending weeks and months with terminal patients can understand the logical choice being made to avoid additional hopeless interventions. So, why, oh why do nursing homes call 911 for DNR patients who are dead or dying?

I just don't understand. 1. Patient is terminally ill, does not want any drastic interventions. 2. You have legal paperwork attesting to that request. 3. You are able to assess a patient and understand his condition, as in either circling the drain or already deceased. 4. You call 911 anyway and then yip at us for wanting to hook up the cardiac monitor to have an objective confirmation of death.

Okay, yes, we brought in all the goods to run a full resuscitation because the dispatch was for a seizure, updated en route to cardiac arrest. We'd be doing a piss-poor job if we weren't ready to do everything in our power to save our patient when we get there. But when you hand us the DNR paperwork, explain the patient's condition and the series of events that find a dead guy sitting in a wheelchair next to his bed, we are capable of switching gears. We understand DNR. Neither of us wants to feel like we're assaulting a corpse and disrespecting a patient's memory by performing interventions he wouldn't want. But there are a series of steps required of us before we can leave, just as there are steps required of you. We may not have known this man, but we can perform our duties with respect and until you see us behave otherwise, save your yipping for a more deserving target.

3 comments:

Ellie said...

Lordy. This DNR business is something that really pushes my buttons. At least they had the paperwork and presented it before you (in your words) assaulted a corpse.

manchmedic said...

One of my last calls before I went per diem was for the same thing - 60 year-old male, riddled with cancer, died at home. One of his daughters freaked out and called 911. She told me afterward that she "felt like she had to do something...." I can sort of understand that - however, it seems like in that case it was somewhat dramatic on her part to do this. The poor guy's wife wanted nothing to do with us being there as she had the DNR in her hands when we arrived (which, again, I understand completely), but my question to her was why she allowed her daughter to make the call in the first place if she knew we weren't going to do anything. She couldn't answer me....

Jen said...

I have less issue with panicked family members than I do supposedly "trained professionals" who have a fair number of DNR patients and I would guess at least 1 death a week. These are the people who are supposed to be able to be calm and rational and support the family.