Do Not Resuscitate Order Template

What is a Do Not Resuscitate (DNR) order?

A Do Not Resuscitate order is a legal document that indicates a person's wish not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest or respiratory failure. This order is designed to respect the individual’s preferences regarding end-of-life care and should be discussed with healthcare providers and loved ones.

Who can request a DNR order?

Typically, a DNR order can be requested by a patient, their legal guardian, or a healthcare proxy. In some cases, the healthcare provider may also initiate the discussion, especially if a patient is critically ill and not likely to benefit from resuscitation efforts.

Do I need a DNR order to refuse resuscitation?

No, you do not necessarily need a DNR order to refuse resuscitation. A patient can verbally express their wishes about resuscitation. However, having a written DNR order is beneficial, as it provides clear guidance to emergency medical personnel and healthcare providers in critical situations.

How does a DNR order differ from advance directives?

A DNR order specifically pertains to resuscitation efforts, whereas advance directives cover a broader scope of medical treatment preferences. Advance directives might include decisions about other life-sustaining treatments, like mechanical ventilation or feeding tubes, in addition to resuscitation preferences.

Will a DNR order affect my other medical treatments?

No, having a DNR order in place does not affect the quality of other medical treatments you receive. Healthcare providers will continue to offer all necessary care, except for resuscitation. It is important to clarify your wishes about other treatments in your advance directives if you have specific concerns.

How can I obtain a DNR order?

You can obtain a DNR order through your healthcare provider. They will typically provide you with a specific form to fill out. You may need to have a conversation about your medical condition and treatment wishes, ensuring you fully understand what a DNR means for your care.

Can a DNR order be revoked?

Yes, you can revoke a DNR order at any time. If you change your mind about resuscitation, simply inform your healthcare provider, and they can help you with the process. It is important to communicate any changes to family members and ensure that your new wishes are documented properly.

1. Not Understanding the Form: Many individuals rush through the DNR form without fully understanding its implications. It's crucial to know what a Do Not Resuscitate Order means for your healthcare choices.

2. Inaccurate Information: Some people fail to provide complete or accurate personal information. This includes the patient's name, date of birth, and other identifying details, which are essential for the order to be valid.

3. Omitting Signature: A common oversight is neglecting to sign and date the form. Without a signature, the DNR cannot be legally honored, leaving room for confusion during critical moments.

4. Not Discussing with Healthcare Providers: Failing to communicate the DNR wishes to healthcare providers can create issues. It is essential to have conversations with doctors and loved ones about these choices.

5. Not Keeping Copies Accessible: After completing the DNR form, some individuals forget to make copies. It’s important to keep the form in an accessible location, such as a medical file, to ensure it's readily available when needed.

A Do Not Resuscitate (DNR) Order is a crucial document indicating a person's wishes regarding resuscitation in the event of cardiac arrest. However, it is often accompanied by other important forms and documents that together create a comprehensive plan for medical care. Here are several forms that are commonly used alongside a DNR Order:

• Advance Directive: This document outlines an individual’s preferences for medical treatment when they cannot communicate their wishes. It includes specifics about different medical interventions.
• Health Care Proxy: This form designates a trusted person to make medical decisions on behalf of someone who is unable to do so. It ensures that decisions reflect the individual's values and desires.
• Living Will: A living will specifies what types of medical treatment a person does or does not want in situations where they are terminally ill or permanently unconscious.
• POLST (Physician Orders for Life-Sustaining Treatment): Similar to a DNR Order, this document is a set of medical orders intended for those with serious illnesses, detailing the patient’s preferences for treatment and resuscitation.
• Medical Power of Attorney: This legal document allows individuals to designate someone to make healthcare decisions on their behalf, aligning with their wishes when they are unable to do so.
• Medical Records Release Form: This form permits the sharing of medical information with designated individuals or institutions, which can be crucial for treatment planning.
• Do Not Intubate (DNI) Order: A DNI order indicates that a patient does not wish to be intubated, which is often used in tandem with a DNR order.
• Resuscitation Policy Statement: Many healthcare facilities provide documentation outlining their policies and procedures regarding resuscitation efforts, keeping both patients and families informed.

Understanding these documents is essential for individuals seeking to ensure their medical preferences are respected. Engaging in conversations about end-of-life wishes can provide peace of mind for both the individual and their loved ones. Having the right documents in place fosters clarity and assists healthcare providers in delivering care that aligns with the patient’s values.

A Living Will serves as a document that outlines an individual's preferences for medical treatment in scenarios where they are unable to communicate their wishes. This document often encompasses decisions regarding life-sustaining measures, much like a Do Not Resuscitate Order (DNR). While a DNR specifically addresses the wish to forgo resuscitation efforts during cardiac or respiratory arrest, a Living Will might include broader end-of-life care choices, such as preferences for feeding tubes and ventilators.

A Health Care Proxy is a document that designates an individual to make medical decisions on behalf of another person. This appointed person, typically known as an agent, is entrusted to communicate the principal’s health care preferences to medical providers. Similar to a DNR, a Health Care Proxy ensures that a patient's wishes are honored, especially during critical situations when they cannot express their intentions directly.

An Advance Directive combines elements of a Living Will and a Health Care Proxy. This comprehensive document allows individuals to outline their medical care preferences while also appointing a representative for health decisions. Just like a DNR, it provides clarity about the person’s wishes to medical personnel, ensuring that treatments align with their desires regarding end-of-life care.

When filling out a Do Not Resuscitate (DNR) Order form, it's essential to understand the process and the implications. Here are ten important guidelines—five things to do and five things to avoid.

• Do consult your healthcare provider. Discuss your wishes and concerns before completing the form.
• Do ensure the form is signed and dated. An unsigned form may not be honored.
• Do clearly indicate your preferences. Use plain language so there is no misunderstanding about your wishes.
• Do keep copies of the signed form. Share these copies with your medical team and loved ones.
• Do review the document regularly. Your wishes may change over time, and the form should reflect that.

• Don’t fill out the form hastily. Take your time to understand the implications of your decision.
• Don’t forget to discuss the order with your family. Ensure they understand your wishes and are supportive.
• Don’t assume the form will be honored without discussion. Medical professionals need to know about your DNR preferences ahead of time.
• Don’t store the form in an inaccessible place. Keep it somewhere where it can be easily found when needed.
• Don’t overlook local laws and regulations. Ensure that your form complies with state requirements.

By following these guidelines, you can help ensure your wishes are respected when it matters most.

When it comes to Do Not Resuscitate (DNR) orders, there are several misunderstandings that can lead to confusion and incorrect assumptions. Here’s a breakdown of four common misconceptions:

• DNR orders mean that medical care will not be provided. This is not true. A DNR specifically pertains to cardiopulmonary resuscitation (CPR) and does not indicate that a patient will not receive other forms of medical treatment. Patients with a DNR order will still receive comprehensive medical care, except in situations where resuscitation is appropriate.
• DNR orders are only for end-of-life situations. Many assume that DNR orders are only applicable in the final days or hours of life. However, individuals of any age with serious medical conditions may choose to have a DNR in place as part of their overall healthcare plan, even if they are not in a terminal state.
• A DNR order is permanent once signed. DNR orders can be changed or revoked at any time by the patient or their legally authorized representative. If circumstances change, such as improvement in health or patient preferences, a new order can be issued.
• All healthcare providers respect DNR orders. While most medical professionals follow DNR orders, there can be some confusion in emergency situations. It is essential for individuals with a DNR order to ensure that their wishes are communicated clearly and that family members and caregivers are aware of the order to help avoid potential misunderstandings.

Understanding these common misconceptions can help ensure that individuals make informed decisions regarding their healthcare preferences and goals.

Filling out a Do Not Resuscitate (DNR) Order form can be an important decision for individuals facing serious health issues. Here are some key takeaways to keep in mind:

• Understand Your Wishes: Clearly articulate your preferences regarding medical treatment and resuscitation. This ensures that healthcare providers follow your desires in critical situations.
• Involve Your Healthcare Provider: Discuss your intentions with your doctor. They can offer guidance and help you understand the implications of the DNR order.
• Keep Forms Accessible: Store the DNR order where it can be easily found. Healthcare professionals should be able to locate it quickly in emergencies.
• Review and Update Regularly: Your health status and preferences may change over time. Re-evaluate and update your DNR order as necessary to reflect your current wishes.

By considering these factors, individuals can make informed decisions and ensure their healthcare preferences are honored when it matters most.