Valid Do Not Resuscitate Order Form

Guidelines on Utilizing Do Not Resuscitate Order

Completing a Do Not Resuscitate (DNR) Order form is a critical step for those who wish to have their preferences known regarding CPR (cardiopulmonary resuscitation) or advanced cardiac life support in the event of a cardiac or respiratory arrest. This document is recognized by healthcare providers and ensures that a patient's wishes are respected. Accuracy and compliance with state laws are paramount when filling out a DNR form, as it is a legally binding document. Below are step-by-step instructions on how to properly fill out the form.

1. Individual Information: Begin by entering the full name of the individual the DNR order is for, their date of birth, and address. This ensures that the order is accurately attributed to the right person.
2. Decision Maker’s Information: If the individual is unable to make health care decisions for themselves, the name, relationship, and contact information of their designated health care proxy or legal guardian should be entered here.
3. Medical Conditions: Detail any significant medical conditions that inform the decision for the DNR order. This might include terminal illnesses or specific wishes related to quality of life considerations.
4. Resuscitation Preferences: Clearly indicate the individual's specific wishes regarding resuscitation. This includes whether they decline CPR, advanced airway management, mechanical ventilation, defibrillation, and the use of resuscitation drugs.
5. Signature of the Individual: The individual, or their proxy if they are not capable, must sign the form to validate it. This affirms that the choices expressed are made voluntarily and with full understanding of their implications.
6. Physician’s Section: A licensed physician must review, agree with, and sign the DNR order, including their name, contact information, and date. Their signature verifies the medical appropriateness of the DNR order based on the individual’s health status and wishes.
7. Witness Verification: If applicable, some states require one or more witnesses to sign the form, certifying that the individual (or their proxy) signed the document willingly. Witnesses cannot be the individual's healthcare provider or an employee of a healthcare facility where the individual is receiving care.
8. Additional State Requirements: Be sure to include any additional information or steps required by the specific state where the DNR order will be executed. This might include notarization or the attachment of specific state forms.

Once the form is completed, it should be placed in a visible location and copies should be provided to the individual’s healthcare proxy, family members, primary care physician, and any healthcare facilities where the individual is receiving care. This ensures that the DNR order is accessible when needed and can be honored by healthcare providers.

1. What is a Do Not Resuscitate Order?

   A Do Not Resuscitate (DNR) Order is a medical directive signed by a physician or authorized healthcare provider that informs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event a patient stops breathing or their heart stops beating. The DNR is intended for individuals who wish to avoid aggressive measures of resuscitation due to terminal illness or a desire for a more natural end-of-life process.

2. Who can request a DNR Order?

   Any competent adult can request a DNR Order based on their healthcare preferences. Additionally, legal guardians or healthcare proxies can request a DNR on behalf of individuals who are unable to make such decisions for themselves due to medical incapacity or minor status.

3. How do I get a DNR Order?

   Obtaining a DNR Order involves a discussion with your healthcare provider about your end-of-life care preferences. If a DNR Order aligns with your wishes, your healthcare provider can draft the order. It is crucial to communicate with family members and healthcare proxies about your decision to ensure your wishes are understood and respected.

4. Is a DNR Order permanent?

   No, a DNR Order is not permanent. Individuals can revise or revoke their DNR Order at any time, as long as they are competent to make such decisions. It is advisable to review and discuss any changes with a healthcare provider and family members.

5. What happens if I don't have a DNR Order?

   If there is no DNR Order in place, medical personnel are typically required to perform CPR and other resuscitative measures in the event of cardiac or respiratory arrest. This includes the use of medications, chest compressions, and mechanical ventilation if necessary.

6. Does a DNR Order affect other treatments?

   A DNR Order specifically addresses the use of CPR and does not impact other forms of medical treatment. Patients with a DNR can still receive medication, nutrition, hydration, and other interventions to provide comfort and manage symptoms unless specified otherwise in an advanced directive.

7. Can a DNR Order be implemented at home?

   Yes, a DNR Order can be implemented in non-hospital settings, including at home. It is important to have the DNR documentation readily available and to inform family members and caregivers of its existence and location to ensure it is honored by emergency medical services (EMS).

8. What is the difference between a DNR and a living will?

   While both a DNR Order and a living will are advance directives, they serve different purposes. A living will provides broad instructions regarding a person's preferences for end-of-life care across various scenarios, whereas a DNR specifically instructs healthcare providers not to perform CPR. It is possible and often recommended to have both documents as part of a comprehensive end-of-life care plan.

9. How does a DNR Order affect the role of healthcare proxies or powers of attorney?

   A DNR Order does not diminish the authority of healthcare proxies or powers of attorney but instead provides clear guidance about the patient’s wishes regarding CPR. It is essential for proxies to understand the patient's desires to advocate effectively for their care preferences in situations not covered by the DNR.

1. Not verifying the patient's identity thoroughly. The form requires accurate patient identification to ensure the DNR is applied correctly. This often involves checking and double-checking patient information against other documents.

2. Failing to secure the required signatures. A valid DNR order must have the signature of the person it concerns (if they are capable) or their legally authorized representative, as well as the signature of a witness in many jurisdictions.

3. Overlooking state-specific requirements. Different states may have unique stipulations for DNR orders, such as the necessity for a physician's signature or specific language that must be included in the document.

4. Misunderstanding the scope of the DNR. Some people mistakenly believe that a DNR order limits all forms of medical intervention. In reality, it specifically addresses the avoidance of cardiopulmonary resuscitation.

5. Forgetting to renew the order. DNR orders can expire. It's important to know and adhere to the renewal schedule, which may vary by state or medical institution policy.

6. Not communicating the existence of the DNR. A DNR order only works if medical professionals are aware of it. Failing to inform healthcare providers or family members about the DNR can lead to unwanted resuscitation efforts.

7. Improper storage or access to the DNR form. After the DNR form is filled out, it must be stored in a location where it can be easily accessed by emergency responders or healthcare providers. An inaccessible DNR form is as good as having no order at all.

By addressing these common errors, individuals and their families can ensure that their wishes regarding resuscitation are clearly documented and respected.

Navigating the landscape of healthcare and end-of-life planning can be both complex and emotionally taxing. A Do Not Resuscitate (DNR) order is just one of many important documents individuals may consider when making plans for their healthcare. Beyond the DNR, there are several other forms and documents that can help ensure a person's wishes are honored and their affairs are in order. Here's a look at some of these key documents, each bearing its own significance in the broader context of medical and estate planning.

• Advanced Directive/Living Will - This document allows individuals to outline their preferences for medical treatment in situations where they might not be able to express their wishes. It covers a range of treatments including the use of ventilators, feeding tubes, and more.
• Healthcare Power of Attorney - Unlike a DNR, which is a directive, a healthcare power of attorney appoints someone else to make medical decisions on behalf of an individual if they are unable to do so themselves.
• Medical Order for Life-Sustaining Treatment (MOLST) - Similar to a DNR, this form provides detailed instructions about specific types of life-sustaining treatment. It is often used by individuals with serious health conditions.
• Last Will and Testament - This essential document outlines how a person's assets and estate will be distributed upon their death. It also may appoint guardians for any minor children.
• Financial Power of Attorney - This grants someone authority to handle financial decisions and transactions on behalf of another person, including paying bills, managing investments, and selling property.
• Trust Documents - Trusts are arrangements where one party holds property for the benefit of another. Trust documents spell out how assets placed in trust should be managed and distributed.
• Organ and Tissue Donation Registration - This allows individuals to register their consent to donate their organs and tissues upon death, and can often be noted on a driver's license or state ID.
• Physician Orders for Scope of Treatment (POST) - This is another form of advance directive that is often for very ill patients, specifying which treatments they do and do not want.
• HIPAA Authorization Form - This form grants permission for healthcare providers to share an individual's health information with designated persons, helping loved ones stay informed about medical conditions and treatments.
• Funeral Pre-Planning Documents - These allow individuals to specify their preferences for funeral and burial arrangements, alleviating the decision-making burden from loved ones during a time of grief.

Together, these documents form a comprehensive plan that addresses a wide range of healthcare and estate planning considerations. By thoughtfully preparing these documents in advance, individuals can provide clear guidance about their personal wishes, ensuring that their healthcare preferences are respected and their estate is managed according to their desires. When considering these documents, it's often advisable to consult with legal and medical professionals to ensure that all forms are correctly prepared and reflect the individual's specific wishes accurately.

• A Living Will - Like a Do Not Resuscitate (DNR) Order, a living will provides instructions regarding medical care a person wishes or does not wish to receive in the event they are unable to communicate their preferences. Both documents are used to guide healthcare professionals and loved ones in making decisions that align with the patient's desires.

• Medical Power of Attorney (POA) - This legal document, similar to a DNR, allows an individual to designate someone else to make healthcare decisions on their behalf should they become incapable of making such decisions themselves. While a Medical POA covers a broader range of decision-making powers, a DNR focuses specifically on the aspect of not undergoing CPR or advanced life support.

• Advance Healthcare Directive - An advance healthcare directive encompasses various types of healthcare instructions, including DNR orders. It's a comprehensive approach that may outline one's treatment preferences in various scenarios, appoint a healthcare agent, and include a living will. Both serve the purpose of guiding healthcare professionals on the care a patient wishes to receive or avoid.

• POLST Form (Physician Orders for Life-Sustaining Treatment) - The POLST form, similar to a DNR, is a doctor's order that specifies the types of medical treatment a patient wishes to have towards the end of life. Both documents are designed to ensure that the patient’s wishes are respected by medical teams, especially in emergency situations or during advanced illness.

• Healthcare Proxy - Similar to a DNR in its purpose of ensuring a patient’s healthcare preferences are honored, a healthcare proxy designates an individual to make healthcare decisions on another person’s behalf. While a DNR provides specific instructions regarding resuscitation, a healthcare proxy has the authority to make broader healthcare decisions.

• Last Will and Testament - Although primarily used for the distribution of assets after death, like a DNR, a last will can reflect personal wishes and instructions. This similarity lies in the preparatory nature of the documents, where individuals make decisions ahead of time to guide others after their incapacity or death.

• Organ Donor Card - An organ donor card indicates a person's consent to have their organs and tissues donated upon their death, similar to how a DNR order indicates a person's wishes regarding life-saving treatment. Both documents communicate critical healthcare decisions that affect what happens to one's body in emergency or end-of-life scenarios.

• Ethical Will - Although not a legal document, an ethical will allows individuals to share their values, wishes, and life’s lessons with their loved ones, akin to how a DNR communicates a person’s preferences regarding end-of-life care. Both serve as tools for expressing important personal decisions and wishes.

When filling out a Do Not Resuscitate (DNR) Order form, understanding the dos and don'ts is crucial. This document is sensitive, with implications for end-of-life care, thus requiring careful and precise input. Below are guidelines to help ensure that the form is filled out correctly, reflecting the wishes of the individual it concerns.

• Double-check that all personal information is accurate, including the full legal name, date of birth, and any identification numbers used by medical institutions.

• Ensure that the form is signed by the required parties. This typically includes the individual the DNR applies to (if able) or their legally authorized representative, and often a witness or a healthcare provider.

• Discuss the DNR order with a healthcare provider to understand its implications fully. This ensures that the decision reflects the individual's wishes and that they understand the nature of a DNR order.

• Keep the DNR order in a location where it can be easily found by healthcare providers. Inform family members, close friends, and caregivers of where the document is stored.

• Review and update the DNR order as necessary. Life circumstances and wishes can change, so it's important to ensure the document reflects current desires.

• Rush through filling out the form without thoroughly understanding each section. Mistakes or unclear wishes can cause unwanted confusion or distress during critical moments.

• Forget to verify state-specific requirements. DNR orders and their processing can vary from state to state, so it's vital to ensure that the form meets all legal stipulations where the individual resides.

• Leave sections incomplete. If a section does not apply, consider marking it as "N/A" (not applicable) instead of leaving it blank, to indicate that it was not overlooked.

• Use ambiguous language. It's important that wishes are stated clearly to prevent misinterpretation.

By following these guidelines, you can help ensure that the DNR order is filled out accurately and effectively, aligning with the individual's preferences for end-of-life care. Remember, the goal is to respect and fulfill the wishes of the person it concerns, making attention to detail of paramount importance.

Do Not Resuscitate (DNR) orders are legal documents that instruct medical personnel not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. There are several misconceptions about DNR orders that can affect decisions made by patients and their families.

• Only for the elderly: A common misconception is that DNR orders are only suitable for elderly patients. In reality, DNR orders are considered based on the patient's overall health condition and personal wishes, regardless of age.

• Signifies giving up: Some believe that choosing a DNR order means giving up on life. However, a DNR is a specific decision about CPR and does not indicate refusal of other types of medical treatment. Patients with a DNR order can still receive medications, surgeries, and other forms of care.

• Permanent and irreversible: Another misconception is that once a DNR order is in place, it cannot be changed. In truth, DNR orders can be rescinded or modified by the patient or their legal representative at any time, based on changing wishes or health conditions.

• Applies to all medical personnel: People often think that a DNR order will be recognized and followed by all healthcare providers. However, it is crucial to discuss and share the DNR order with all healthcare providers involved in the patient's care to ensure it is honored in all settings.

• Automatically includes "Do Not Intubate" (DNI): Many assume that a DNR order also means "Do Not Intubate." DNR orders specifically address CPR and do not automatically include decisions regarding other life-sustaining measures like intubation. These should be discussed separately.

Filling out and using the Do Not Resuscitate (DNR) Order form is an important process for those wishing to make clear their preferences regarding life-saving measures in emergency situations. Here are nine key takeaways regarding this crucial document:

• The DNR order informs medical staff not to perform cardiopulmonary resuscitation (CPR) if a person's breathing stops or if the heart stops beating.

• It must be completed and signed by a licensed healthcare provider. This ensures the order is valid and reflects the patient's current wishes and health status.

• This form is used in a variety of settings, including hospitals, at home, or in long-term care facilities, to make sure the patient's wishes are respected across different healthcare environments.

• The form should be easily accessible and placed in a visible location if the individual is receiving care at home. This ensures that emergency personnel can see and honor the order during a crisis.

• A DNR order can be revoked or modified at any time by the patient or their legal surrogate. It is crucial that any changes are communicated clearly to all involved in the patient's care.

• Discussing the decision with family, close friends, and healthcare providers is recommended. Clear communication can prevent confusion and ensure that everyone understands the individual's wishes.

• Understanding the difference between a DNR and other advance directives, such as living wills or healthcare power of attorney, is important. Each serves a unique role in a person's healthcare planning.

• In some states, specific forms and stickers are provided once a DNR order is completed, which can be placed on an ID bracelet or in a visible area. This helps ensure the orders are followed by first responders.

• Cultural, religious, and personal beliefs can influence the decision to complete a DNR order. Professional guidance from healthcare providers can help individuals navigate these complex considerations.

Understanding these key takeaways can facilitate a smoother process for those considering or implementing a DNR order, helping ensure that their care aligns with their values and wishes.