What is a DNR and Why is it Important?

DNR and POLST Instructions: What you need to know

A DNR, or Do Not Resuscitate, is a medical directive that instructs medical staff not to perform any form of resuscitation if a patient has stopped breathing or heartbeat. The State of Washington has clear guidelines for how emergency medical providers can proceed when faced with an illness or injury where the person has signed a DNR type directive. These directives are typically made with input from the patient’s next of kin. It’s a form that specifies the patient’s wishes regarding end-of-life care and can be transferred from one health care setting to another.

DNRs are important for two reasons. First, they allow patients to make medical decisions when they are calm and conscious. Second, a DNR can only be reversed with the patient’s consent. However, in some cases a guardian or healthcare agent can request that the order be reversed.

While DNRs are generally respected by hospitals and other medical providers, some medical personnel might choose not to honor these requests. Emergency medical responders often call emergency care teams to stabilize a patient, and they might not be aware of a DNR. Therefore, it’s important to communicate your wishes to medical staff and keep a copy of your DNR paperwork handy.  In the State of Washington this paperwork is called a Portable Orders for Life Sustaining Treatment or POLST. 

A DNR is an order that you can make to health care providers if you no longer have the capacity to make those decisions. While this order is not binding, it may be a good idea to discuss your wishes with your family or physician prior to a medical emergency. You may also want to consult with an attorney at Orbitwills.com if you are unsure about your wishes.

A DNR/POLST order is a document that is written by a doctor. He or she will explain your options and enter the order into your medical record. Once it’s in the medical record, it will be visible to any medical professionals. You can even request that CPR be discontinued if you’re in a terminal condition. However, in this case, there’s no guarantee that CPR will be performed and you could suffer permanent brain damage if the treatment doesn’t work. Although DNRs are generally used in hospitals, it’s also a good idea to have a DNR form in nursing homes.

If you’re a health care provider, it’s crucial that you respect the wishes of your patients. In addition to the legal protection provided by the DNR, you can also benefit from your state’s Good Samaritan Law. This law protects laypersons who provide life-saving assistance in good faith, but it won’t protect you from liability if you fail to follow the rules.

If you’re concerned about your health, it’s important to have your DNR order with you at all times and make sure your family and friends are aware of your decision.  It’s important to post it prominently in the home. Emergency medical teams may look for it near a bed or on a refrigerator. While Washington doesn’t require patients to wear a DNR or POLST medical bracelet it’s a good way of letting people know your desires in case of emergency.