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Posted

No, I was referring to the NH not having their shit together, creating the confusion that lead to this guy's care turning into a cluster fark. They'd had him all this time, never put his bracelet on, and lost it. That's about like losing his meds and never giving them to him. That DNR is "care". They had a duty to provide, and the failed. This just has negligence and neglect written all over it.

Do you agree or disagree with the rest of my post????

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Posted

This is what gets me everytime, except for in a NH. If the person has a DNR, do not call EMS! It's not complicated, if a person wants to die and has signed up to do it, dont call us!

Posted
This is what gets me everytime, except for in a NH. If the person has a DNR, do not call EMS! It's not complicated, if a person wants to die and has signed up to do it, dont call us!

Well, a DNR is not the same as "Do Not Treat." There are legitmate reasons for someone to have a DNR and either need emergency treatment (problems not relating to why they have a DNR. Hypoglycemia could be one example) or transport to a hospital for further care. Granted, the latter should be arranged though means other than the 911 system, but the reasons are there.

Posted

Well, a DNR is not the same as "Do Not Treat." There are legitmate reasons for someone to have a DNR and either need emergency treatment (problems not relating to why they have a DNR. Hypoglycemia could be one example) or transport to a hospital for further care. Granted, the latter should be arranged though means other than the 911 system, but the reasons are there.

terro ......its not that simple i work in a nursing home as well as EMS and I know how things work so before you go off the deep end on stuff like that maybe you should take the time to investigate the reasons behind it.

JP i agree with you on the DNR and the DO NOT TREAT.... there is a difference and people that think just because people have a DNR shouldnt be treated need their heads checked. Once again there are many conditions and circumstances that need treatment and comfort measures for the patient. Some people need to look outside the box and see things as they are and not the way they think they should be.

terr

Posted

...and at least around here, there are varying levels to the DNR--

--no CPR

--no heroic measures (like defib)

--no advanced care/no life--prolonging measures (like vents)

--transport to hospital for comfort measures only

etc etc. That's the one thing that I've noticed around here: where other things may be lacking, the DNR is usually produced...usually first!

This man had a DNR, fair enough. But unless the DNR was specific on what it said, it might be hard to prove a breach by the wife since he technically wasn't dead yet when he was intubated...hence the intubation was part of a 'save' procedure, not a 'resuscitation' event. As to the NH losing the bracelet however...I can smell money from here...

Brat :angel8:

Posted

My understanding was that wife wanted everything done so she is the one that voided the DNR even if it had been available.

As far as calling all to often familys and nursing homes freak out and call. Many times they have still honor the DNR. Sometimes as mentioned they want them taken to hospital for more aggressive pain measures. I also know that I have gone to confirm death many times.

Posted

That is correct Spenac - she voided it as she is his POA - so now that he couldn't tell anyone what to do, she took over. She wanted the other kids to have time to get there so that they could say goodbye... He was dying at an inconvenient time... so regardless of the fact that he had talked about his options and come to a decision.. he got tubed, paralyzed and sedated...

Posted

I hate when family ignores wishes. It is a selfish response made in a moment of fear. Sadly they allow emotion to override even what they know is best.

Posted
That is correct Spenac - she voided it as she is his POA - so now that he couldn't tell anyone what to do, she took over. She wanted the other kids to have time to get there so that they could say goodbye... He was dying at an inconvenient time... so regardless of the fact that he had talked about his options and come to a decision.. he got tubed, paralyzed and sedated...

Did you read my post??? if he was suppose to die right then or before he got tubed then he would have. It would not have mattered if he was awake and told you no he did not want to be intubated. If her POA was active it is what she wants. Someone please correct me if I am wrong.

Ok here is my deal, we are not gods, we do not make choices for our patients. If that is what she wanted and she was at peace with that then who cares. He probly did not know what was going on. He was paralyzed and sedated. Most people do not know they are on the vent if sedated correctly. I may not have liked doing it but I would have.

Are you the one that has to deal with the kids hating you because they did not get there in time and you done nothing to make sure they had a chance to say goodbye. Are you the one that will for the rest of your life have to wonder if you made the right choice about it. If that is what made her feel at peace and keep peace in her family then who cares. Like i said i bet he had no idea what was going on if he was that far into a end stage cancer stage.

Posted

JP has it right IMHO. You ( read we ) have to treat the patient. a DNR means Do Not Resuscitate. My interpretation of that is, they would have to code or be DOA not to do anything.

In this case, the DNR was misplaced :roll:, so unless the pt. is dead, you have an obligation to treat them.

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