Do Not Resuscitate (DNR) Orders – Definition & Detailed Explanation – Palliative Care Services Glossary

What is a Do Not Resuscitate (DNR) order?

A Do Not Resuscitate (DNR) order is a medical directive that instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) in the event that a patient’s heart stops beating or they stop breathing. This order is typically put in place for patients who are terminally ill or have a poor prognosis and do not wish to undergo aggressive life-saving measures.

Who can make a DNR order?

A DNR order can be requested by the patient themselves, or by their legal guardian or healthcare proxy if the patient is unable to make decisions for themselves. In some cases, a physician may also recommend a DNR order based on the patient’s medical condition and prognosis.

When is a DNR order appropriate?

A DNR order is typically considered appropriate for patients who have a terminal illness, advanced age, or multiple comorbidities that make the likelihood of successful resuscitation very low. It is important for patients and their healthcare providers to have open and honest discussions about the patient’s wishes regarding end-of-life care to determine if a DNR order is appropriate.

How is a DNR order communicated and documented?

A DNR order is usually communicated verbally to the healthcare team by the patient, their legal guardian, or their healthcare proxy. It is also documented in the patient’s medical record and a DNR bracelet or necklace may be provided to the patient to alert emergency responders of their wishes.

What are the implications of a DNR order for palliative care patients?

For palliative care patients, a DNR order can provide peace of mind knowing that they will not be subjected to invasive and potentially futile life-saving measures at the end of their life. It allows them to focus on quality of life and comfort care, rather than aggressive medical interventions.

What are the alternatives to a DNR order?

For patients who do not wish to have a DNR order in place, there are alternatives to consider. These may include a Do Not Intubate (DNI) order, which instructs healthcare providers not to place a breathing tube in the patient’s airway, or a Full Code order, which indicates that the patient wishes to receive all available life-saving measures in the event of a cardiac arrest. It is important for patients to discuss their wishes with their healthcare providers and loved ones to ensure that their end-of-life care preferences are respected.