Discussing A DNR

A great article on discussing a DNR with patients.

von Guten - Discussing Do-Not-Resuscitate Status

Here are the main points:

1) Establish an appropriate setting for the discussion. Ensure comfort and privacy.
2) Ask the patient and family what they understand about their current health situation.
3) Find out what they expect will happen and how they want things to be if they are ill.
4) Discuss a DNR order, including context. Specifically use the word “die.”
Say: “If you should die despite all of our efforts, do you want us to use heroic measures to bring you back?”
OR “How do you want things to be when you die?”
Do Not Say: “Well, if your heart and lungs were to stop, would you want us to use shocks to start your heart and put you on a breathing machine?”
5) Respond to emotions sympathetically, which can be silently offering tissues.
6) Establish and implement the plan depending on your judgment and institution policies.