Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.
Today, I want to focus on why you should never consent to a DNR or Do Not Resuscitate order. In some jurisdictions like in Australia, it’s also called an NFR, Not for Resuscitation order. At the end of the day, the meaning is the same. It means that in the event of a cardiac arrest, or if the heart stops, that intensive care teams do not resuscitate and do not start CPR. And in this quick tip video, I want to focus on why you should never give consent to that.
So when a lot of patients go in intensive care and they’re critically ill, they’re probably at their most vulnerable state in their lives ever. A lot of intensive care teams want to suggest, or even coerce families into consenting to a DNR or do not resuscitate order.
Now, what does that mean? It means that if your loved one’s heart was to stop either during cardiac arrest or any other event, they would not commence CPR and they would basically let your loved one die. And the argument of intensive care teams is often around, “oh, well, you got to crack some ribs and it wouldn’t be conducive. And even if they do survive, they won’t have any quality of life”.
Well, I agree that if you do start CPR, there may well be the chance of cracking some ribs. That is a reality of CPR. The question is though, what do you want and your family? And what does your loved one want? If your loved one has an advanced care directive, if it’s documented in a living will, that they want everything done, including CPR, then a DNR is ruled out.
Now, assuming that your loved one is in intensive care and can’t make their own decisions, you probably have to make the decision for your loved one. And that decision should be not to consent to a DNR, and why is that?
Well, when you consent to a DNR, it’s almost like you are consenting to not do everything that can be done to save your loved one’s life. Now, the goal in intensive care should always be to let your loved one, make the decision. And if, for example, they’re having a cardiac arrest and they’re not getting CPR and they will die, well, they can’t make their own decision. What if they get treatment, hopefully get better, come out of an induced coma, get off the ventilator, then they can make their own decision, whether want CPR or not, that would be the much better alternatives. And it’s not up to intensive care teams to make decisions on you or your loved one’s behalf.
Now, the other thing is this, once you’ve consented to a DNR, intensive care teams, won’t put their best foot forward. I’ve seen it so many times. It’s like once you’ve consented to a DNR, there are many other things, many other treatment options that are often falling by the wayside as well. Simply because, your loved one is deemed often as a “hopeless case”. And they won’t get everything that is on offer in intensive care for them. I’ve seen it many, many times. And unfortunately, this is just a reality and it’s one way for intensive care units to manage beds, staff, equipment and other resources, because the demand for intensive care beds is so high. And there’s simply not enough staff in intensive care to look after all patients that are in need of intensive care.
So it comes with really undesired effects if you consent to a DNR, such as your loved one won’t get best care and treatment because you’ve given in into what the intensive care team wants to manage their agenda, to get their agenda. And that’s something you should never do. Use your own discretion, use your own judgment and do what you know your loved one wants or would decide for themselves if they could make the decision for themselves. And disclaimer here, if you had a discussion with your loved one before they’re going into ICU and they don’t want CPR, then you should also respect their wishes, of course. It’s about respecting you’re loved one’s wishes and it’s about doing what’s right for them and doing what’s right for you and your family.
That is my quick tip for today.
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This is Patrik Hutzel from intensivecarehotline.com, and I’ll talk to you in a few days.