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DNR – Ethics

Student Name

Course Title

Institution

Instructors Name

Date
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DNR – Ethics

When doing my nursing practice, I have encountered cases that question the do-not-

resuscitate (DNR) ethics. Like a certified nursing assistant (CNA) in the case study, I tried

saving a patient's life without knowing they had signed the DNR order. As a registered nurse

tried to stop me, there came an ethical dilemma whereby we disagreed on whether to follow the

DNR order or not. The patient's relatives did not know what their patient's last wish was, and

following the rules of the DNR, ethics one is supposed to respect the patient's wish. The DNR

order is significant because it puts the patient in charge of their end-of-life choices (Oh, & Lee,

2017). The patient has signed the DNR order relieves any pressure the family might have of the

patient's decision to end their life. 

           When studying my course, I realized why a patient wants a DNR order; in most cases,

there are usually older adults and are fully decided that they don't need to be resuscitated if there

is an emergency. However, as a nurse, one should be very careful to make sure the patient's

decision has been documented in their medical report, and that other staff members who are

concerned with the patient are well informed (Pettersson et al., 2018). At times a

Cardiopulmonary resuscitation (CPR) may be administered even though the patient had signed a

DNR order. For example, where the medical team realizes the patient's condition can improve. 

           According to the DNR ethics, a DNR order cannot be signed if a patient is healthy, and

the nurses will for sure resuscitate the patient. When a patient has a DNR order, they are not

restricted to receive medical assistance such as the administration of oxygen, placed in a

comfortable position, provided with emotional support, bleeding controlling, and therapy is still

meant to be provided. In some cases, there is a DNR full code whereby a patient's heartbeat and

breath stopped even after resuscitation procedures were provided to help keep them alive
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(Robinson et al., 2017). The DNR orders stand ethically and legally as it states the physician will

take no steps to restart their heart or restore their breathing if the patient gets a cardiac arrest. 

Family and patient's discussion about DNR

           To discuss a DNR with the patient's family, some steps provide the best way to

communicate and make them understand the patient's decision (Pettersson et al., 2018). As a

nurse, I first initiated a discussion that was very supportive to the patient before moving on to the

family with one of the situations I experienced. Secondly, I clarified the prognosis question that

the patient had. I asked the patient to clearly document and identify their end–of–life goals and

made sure the family was comfortable and supportive to the patient. Lastly, we discussed the

patient's treatment plan and how it would be facilitated. 

           In cases where the patient is dying, there is a particular way to communicate without

feeling sorry as a nurse to the patient (Pettersson et al., 2018). In a case where I handled a dying

patient, I applied the following tips while talking to the patient. First, I decided to follow the lead

of the dying patient. Secondly, I made it clear that I knew the patient's end was nearing. Thirdly

when dealing with the patient's regrets, I used words such as "forgive me please." Fourthly, I

freed myself from any hard feelings by replying to me, "I forgive you." Lastly, I appreciated my

patient's legacy by ending with a "thank you."

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References

Oh, Y. J., & Lee, E. M. (2017). Convergence awareness and ethical attitudes about DNR of

nursing students. Journal of the Korea Convergence Society, 8(2), 63-72.

Pettersson, M., Hedström, M., & Höglund, A. T. (2018). Ethical competence in DNR decisions–

a qualitative study of Swedish physicians and nurses working in hematology and

oncology care. BMC medical ethics, 19(1), 1-12.

Robinson, E. M., Cadge, W., Zollfrank, A. A., Cremens, M. C., & Courtwright, A. M. (2017).

After the DNR: surrogates who persist in requesting cardiopulmonary

resuscitation. Hastings Center Report, 47(1), 10-19.