Do Not Resuscitate (DNR)
What is a do-not-resuscitate (DNR) order?
A do-not-resuscitate (DNR) order is a medical directive signed by a doctor that informs healthcare providers a patient does not want cardiopulmonary resuscitation (CPR) in the event his or her breathing stops or heart stops beating. This order is specific only for CPR and does not have instructions for other treatments.
DNRs are generally created before emergencies, allowing patients to choose if they want CPR in an emergency. They are often a part of hospice care plans since the focus of hospice shifts from prolonging life to treating symptoms and maintaining comfort.
Creating a DNR order involves speaking to a doctor and healthcare team. If in a hospital, the doctor will write the DNR order in the medical record. For those in at-home or non-hospital settings, the doctor can provide instructions on how to receive a bracelet, wallet card, or other DNR documents.
What role do DNRs play in healthcare?
DNR orders are a common element of advanced planning, especially for those with a lower chance of survival should the heart stop beating.
There are many reasons why someone may seek a DNR, such as the increased risk of the following after cardiac arrest:
- heart damage
- brain damage
- internal bleeding
- lung injury
- broken ribs
For many people, the risk of harm and pain from CPR is higher than the potential benefits. Additionally, some people may not want to be on life support at the end of their life, and the DNR is a way for them to help prevent that.
It is also important to note that a DNR order can be reversed, and those with a DNR can always change their mind and request CPR.