Free  Do Not Resuscitate Order Template for Washington Make My Do Not Resuscitate Order Online

Free Do Not Resuscitate Order Template for Washington

A Washington Do Not Resuscitate Order (DNR) form is a legal document that allows individuals to refuse resuscitation efforts in the event of a medical emergency. This form is particularly important for those with serious health conditions who wish to make their end-of-life care preferences clear. Understanding the DNR process can help ensure that personal wishes are respected during critical moments.

Form Sample

Washington Do Not Resuscitate Order

This Do Not Resuscitate (DNR) Order is created in accordance with Washington State laws regarding advanced directives and patient rights.

Patient Information:

  • Name: __________________________
  • Date of Birth: __________________
  • Address: ________________________

Health Care Provider Information:

  • Provider Name: __________________
  • Provider Phone Number: __________

Decision Maker (if applicable):

  • Name: __________________________
  • Relationship to Patient: __________
  • Contact Number: _________________

This DNR Order indicates that the patient does not wish to receive cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) in the event of cardiac arrest or respiratory failure.

Effective Date: ___________________

Signature of Patient or Decision Maker:

____________________________________

Date: ______________________________

Signature of Health Care Provider:

____________________________________

Date: ______________________________

Please keep a copy of this order in a readily accessible location. Inform family members and healthcare providers about the existence of this DNR Order.

Misconceptions

Misconceptions about the Washington Do Not Resuscitate (DNR) Order form can lead to confusion and distress for patients and their families. Here are ten common misconceptions explained:

  1. A DNR means no medical care at all. This is false. A DNR only specifies that a person does not want to receive cardiopulmonary resuscitation (CPR) in the event of cardiac arrest. Other medical treatments can still be provided.
  2. Having a DNR means I am giving up on life. Many people believe that requesting a DNR signifies a desire to end their life. In reality, it is a personal choice about the type of medical interventions one wishes to receive during a critical situation.
  3. DNR orders are only for terminally ill patients. This is a misconception. While many people with terminal illnesses choose to have a DNR, anyone can request one based on their personal health care preferences.
  4. A DNR is a legally binding document in all situations. While a DNR is a legal order, its enforceability can depend on the specific circumstances and the healthcare setting. It is crucial to discuss it with healthcare providers to ensure understanding.
  5. Once I have a DNR, I cannot change my mind. This is not true. Individuals can revoke or modify their DNR orders at any time. It is important to communicate any changes to healthcare providers.
  6. All medical staff will know about my DNR. Unfortunately, this is not always the case. It is vital to ensure that the DNR is properly documented and communicated to all relevant medical personnel.
  7. A DNR is only necessary in a hospital setting. This misconception overlooks that DNR orders can be applicable in various settings, including at home or in long-term care facilities. It is essential to discuss the order with all caregivers.
  8. I can just verbally express my wishes for a DNR. While verbal communication is important, a formal DNR order is required for legal enforcement. Written documentation is necessary to ensure that wishes are respected.
  9. Having a DNR means I will not receive pain relief or comfort care. This is incorrect. Patients with a DNR are still entitled to receive pain management and comfort care, regardless of their resuscitation preferences.
  10. DNR orders are the same as advance directives. Although related, DNR orders and advance directives are not the same. An advance directive encompasses a broader range of healthcare decisions, while a DNR specifically addresses resuscitation preferences.

Key takeaways

Understanding the Washington Do Not Resuscitate (DNR) Order form is crucial for individuals who wish to make their healthcare preferences clear. Here are some key takeaways to consider:

  • The DNR Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) in the event of cardiac arrest.
  • It is important to have a conversation with healthcare providers about your wishes before filling out the form.
  • The form must be signed by a physician, ensuring that your decision is informed and legally recognized.
  • Individuals can complete the DNR Order form for themselves or for someone they are legally authorized to represent.
  • Once completed, keep copies of the DNR Order in easily accessible places, such as with your medical records or in your home.
  • Inform family members and caregivers about the existence of the DNR Order to avoid confusion during emergencies.
  • The DNR Order can be revoked at any time, and it’s advisable to inform your healthcare provider of any changes.
  • Make sure to review the form periodically to ensure that it still reflects your current wishes and health status.
  • In Washington, a DNR Order is recognized by all healthcare facilities and emergency medical services, providing peace of mind regarding your preferences.

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