In the event of an emergency, a person--especially if elderly--may have specified resuscitation orders for loved ones and others who are responsible for their care. For some states, these orders are divided into two categories, DNR-CC and DNR-CC Arrests. It is important to know the distinction between the two for legal and ethical purposes.
DNR Comfort Care
DNR-Comfort Care law governs do-not-resuscitate situations. Medical providers follow the DNR-CC protocol when no resuscitative actions to maintain life are done. For Comfort Care-DNR, what the health care professional will or will not do is outlined in detail. For example, Ohio's DNR-CC law specifies that the practioner will attempt to clear the airway, give oxygen, improve the position of the patient, treat bleeding, provide support and contact other providers as needed.
DNR Comfort Care Arrest
Medical staff act upon these instructions and steps when a patient experiences a cardiac or respiratory arrest. The things outlined for the healthcare professional include the initiation of the DNR comfort care protocol, provision of any necessary care or treatment appropriate to the patient's needs. Patients needing cardiac monitoring along with a DNR order will only receive comfort care.
Communication of a DNR-CC/DNR-CC-A order
When a DNR order is written, the person filling out the order has the responsibility to fill out the DNR verification form, and file the order in the Physician's Orders in the patient chart. The verification form verifies that the nurse or doctor giving the order is properly credentialed and actually gave the order. When done by phone, the doctor has a responsibility to fill out the DNR form and the nurse must file the form in the patient's chart under the Physician's Orders section.
Legal/Ethical Concerns
When a patient arrives at a hospital with evidence of a DNR-CC or DNR CC-A order written by a physician, the hospital must honor that order. The order could be present as a form, wallet card or bracelet. No one can override a patient's wishes even if a DNR order exists. If the patient cannot make the decision for themselves, a legal guardian or someone with power of attorney may do so. It is important to let loved ones know DNR wishes. A DNR order is a legally binding document and if the patient does not wish differently, it has to be honored.
Tags: comfort care, loved ones, order When, order written, patient chart, Physician Orders