My mother-in-law has an advanced cancer and she is looking to get a Do not Resuscitate Order that is binding on all health care workers. While looking for information I found that we only need to get the order signed by the doctor and keep it around. However, I am unable to find an order on the internet that I could
print out and fill out with the doctor signing it.
So, does anyone know where I can get a Do not Resuscitate Order blank to print? My mother-in-law is located in Rockdale County, Conyers, Georgia, USA.
One needs to make sure that a DNR order is done right, and that all state laws are obeyed. If the proper regulations & processes are not observed, a DNR order will not be honored by many health professionals.
For example: In Wisconsin, a patient must be certified to be a qualified patient by two physicians, one of whom is the attending doctor. Among other things, a qualified patient is one who is expected to die within 6 months, or one who has a condition which would make attempts at resuscitation futile, or cruel.
Then, the patient (or the patient’s Medical Power of Attorney or Guardian if the patient is not competent) must sign.
And then the signature must be witnessed by two disinterested parties, who also sign the proper forms.
In addition to the esteemed Dr’s comments above please note.
Some EMS agencies cannot honor a DNR without base hospital contact and getting it confirmed by phone. The easy way, if you come in and find your loved one with a DNR not breathing, don’t call 911. In many cases they are required by protocol to initiate rescuitation efforts until the DNR can be confirmed.
Far too easy for people to say DNR and then turn around and file suit because you did not take the proper steps to save the loved one in question and the DNR was not valid/properly executed/existant.
My ex’s mother just passed away and he went through something similar. Depending on where your mother is living, you may also want to file copies of the order with the hospital and nursing home. And, as the previous poster said, if you call 911 they will try to resuscitate. But to be certain of the laws where you live, you can ask an attorney.
Damned straight, and can’t be emphasized enough. Don’t call 911 if you don’t want the crew to resuscitate the patient.
This doesn’t mean that emergency rescue may never be called for a DNR patient. If the terminal patient is in intractable pain and needs help getting it under control, it may be appropriate to transport to a hospital (though hopefully hospice services will already be active, and able to manage such a problem without transport).
Other circumstances can apply too. But if you call 911 for a patient who appears to be pulseless or a non-breather, expect resuscitation to be performed.
I’d say you’re best off checking with your local police department or ambulance service. Protocols vary greatly from state to state and even city to city.
Where I work, my medical director would have my ass (and my paramedic cert) if I worked a DNR patient. If you called 911 and said the patient had a DNR we would respond non-emergent with an ambulance only and the paramedic would pronounce the patient.
After they have expired call 911 and tell them. IF they ask, you may want to say you just found them that way, not that you spent the last 20 minutes watching them die. Remember, this is assuming the person has a DNR in place, and that you, personally, respect and want to honor the persons wishes for the DNR order. No point in getting this mixed up in the legal system when it can be easily avoided. Again, assuming the DNR and that you are okay with the DNR.
I once asked my brother in law (EMT) what he would do if he found DNR tattooed across someones chest, or on a medical alert bracelet, or if the person had written a note. He said it would be ignored and they would go ahead and work on the person anyways. (I beleive he took my question to mean that a physical DNR order wasn’t present).
Would it make sense to file it with your local emergency responders (ie fire deparment). That way if they came across you collopsed in a shopping center or in a car accident, or badly burnt from a house fire that they would leave you? Bascially what I mean is, let’s say you have a DNR because you are in the final stages of cancer, death will be within the next month or so. Will the EMTs honor the DNR if they are called out for an unrelated reason (ie, house fire, car accident (assume someone else was driving)), or does the DNR only hold up if the death is due to the disease for which you have the DNR for? Does that even make sense? If the answer is yes, would it make sense to file a copy of the DNR with the fire deparment so they know to let you die?
My Grandmother had a DNR for a few years. All of her Doctors had copies, and there was one on the Fridge. Can’t have too many copies of a DNR lying around.
Just like you can’t not talk to your family about how you feel about organ donation NOW.
Tell them what you want, don’t make them decide after that fly ball hits you right on the temple and you die nicely in the ER with a perfect, healthy young body.
(Many hospitals don’t feel comfortable honoring the ‘organ donor’ indication on your driver’s license without the permission of family.)
If there’s a local hospice organization (and there almost certainly is), they’re the experts. Even if she isn’t a hospice patient they’ll probably be happy to let you know what the local requirements are.
A DNR tattoo would not be honored. Some jurisdictions have DNR braclets available, those would be honored. A note would be tough, because it would be hard to determine it’s authenticity, which is something we’re not trained or equipped to do.
Generally, we’ll try to determine what the patient’s wishes would be and honor them.
A DNR would be valid for all causes- we don’t determine the cause of death, we just verify that they are, in fact, dead. Unfortunately, I’m not aware of anywhere that has a mechanism for having a DNR on file. In this case, an official bracelet would be your best bet.
Sorry I’m not linking you directly to the right page, but try this. Follow the link that says “HEALTH”, then the link that says “LIVING WILLS AND DURABLE POWERS OF ATTORNEY”, then “END OF LIFE/DO NOT RESUSCITATE ORDER.”
As said above, this varies greatly state to state. In NY State, Paramedics cannot pronounce without calling Medical Control and describing in detail the patient. A BLS ( Basic Life Support ) ambulance that has EMT’s but no Paramedics would not be allowed to pronounce under any circumstances. And then yeah, DNR or not, if they show up at the door, they will start working the patient.
In New York, once CPR and similar treatments are initiated, it is against the law to stop them until IN the E.R. and then only after the treatment has been taken over by E.R. staff. Then, the Dr. may instruct the team to cease, and pronounce.
Thank y’all for all your answers. I will forward this information to my Mother-In-Law. I will ask her to ask her doctor if he has any DNR order blanks to fill out there. Don’t know why I didn’t think of that first… Probably because she just asked me to look on the Internet for her.
I do have one question for y’all though, everyone that has been mentioning the DNR order braclets, I was wondering where I might be able to order something like that for her? Is there a place that supplies them that I can order it? Or is it something I would have to have the Doctor place the order for? Do I need a script for it, or will they just send me one? I guess that is more then one question. Oh well.
This website has a summary of DNR information for many states. I can verify that the Colorado information is accurate. Unfortunately, the info for Georgia is listed as pending and I can’t seem to find anything else.