DNR - Ethics

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DNR – Ethics
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DNR - ETHICS 2
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
DNR - ETHICS 3
(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."

DNR - ETHICS 4
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.

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1

patient's decision to end their life.

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

Family and patient's discussion about DNR

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

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

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

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

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

After the DNR: surrogates who persist in requesting cardiopulmonary

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

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