Printable Do Not Resuscitate Order Document Make My Do Not Resuscitate Order Online

Printable Do Not Resuscitate Order Document

A Do Not Resuscitate (DNR) Order is a legal document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. This order indicates that a person does not want to receive cardiopulmonary resuscitation (CPR) or other life-saving measures if their heart stops beating or they stop breathing. Understanding the implications and processes surrounding a DNR Order is crucial for patients, families, and healthcare providers alike.

Do Not Resuscitate Order for Specific US States

Form Sample

Do Not Resuscitate Order

This Do Not Resuscitate Order is executed in accordance with the relevant laws of the state of [State Name].

Patient Information:

  • Name: [Patient Name]
  • Date of Birth: [Date of Birth]
  • Medical Record Number: [Medical Record Number]

Emergency Contact:

  • Name: [Emergency Contact Name]
  • Relationship: [Relationship to Patient]
  • Phone Number: [Phone Number]

This order is intended to communicate the patient's wishes regarding resuscitation in the event of cardiac arrest or respiratory failure. The patient does not wish to receive cardiopulmonary resuscitation (CPR), advanced airway management, or any resuscitation measures.

The following healthcare providers are authorized to respect this order:

  1. [Healthcare Provider Name]
  2. [Healthcare Provider Name]

Patient/Authorized Representative Signature:

[Signature]

Date: [Date]

Witness Signature:

[Witness Signature]

Date: [Date]

This Do Not Resuscitate Order should be placed prominently in the patient's medical record and a copy provided to all relevant healthcare providers.

Misconceptions

Understanding a Do Not Resuscitate (DNR) order is crucial for patients, families, and healthcare providers. However, several misconceptions often cloud the conversation. Here are six common misunderstandings about DNR orders:

  • DNR means no medical care at all. Many people believe that having a DNR means a patient will receive no medical care. In reality, a DNR only applies to specific situations involving cardiopulmonary resuscitation (CPR). Patients will still receive other forms of medical treatment and comfort care.
  • DNR orders are permanent and cannot be changed. Some think that once a DNR is in place, it cannot be altered. This is not true. Patients or their healthcare proxies can change or revoke a DNR order at any time, reflecting their current wishes.
  • DNR orders are only for terminally ill patients. While many associate DNR orders with terminal illness, they can be appropriate for anyone who wishes to avoid resuscitation in certain situations, regardless of their overall health status.
  • Having a DNR means giving up hope. A common belief is that requesting a DNR indicates a lack of hope for recovery. In truth, it can be a thoughtful decision that aligns with a person's values and preferences regarding end-of-life care.
  • Emergency responders will ignore a DNR. Some worry that emergency medical personnel will not respect a DNR order. However, trained responders are legally required to honor a valid DNR in the field, ensuring that the patient's wishes are respected.
  • DNR orders are only for elderly patients. There is a misconception that DNR orders are exclusively for older adults. In reality, individuals of any age can have a DNR if they choose to forgo resuscitation in the event of a cardiac arrest.

Understanding these misconceptions can empower individuals to make informed decisions about their healthcare preferences. Open discussions with healthcare providers can clarify any uncertainties surrounding DNR orders.

Key takeaways

Filling out a Do Not Resuscitate (DNR) Order form is an important decision for many individuals and their families. Here are some key takeaways to keep in mind:

  • The DNR Order clearly states your wishes regarding resuscitation in case of cardiac arrest.
  • This form should be filled out in consultation with your healthcare provider to ensure it meets your needs.
  • Make sure to sign and date the form for it to be valid.
  • Keep copies of the DNR Order in easily accessible places, like your medical records or with a trusted family member.
  • Inform your healthcare team about your DNR status to ensure they respect your wishes.
  • Review and update the DNR Order as your health status or preferences change.
  • Discuss your decision with loved ones to help them understand your choices.
  • Know that you can revoke the DNR Order at any time if you change your mind.

Understanding these points can help ensure that your wishes are honored and can provide peace of mind for you and your family.

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