Just Learned Mom Has a DNR

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@CatholicSooner
I don’t think anyone here is saying that CPR is evil or unnecessary.
What is being said is that people need to be aware of what these types of procedures really are, how invasive some can be and that, in some cases, they are futile attempts to prolong an “exsistence”, not a life.

Most people who have DNR orders are elderly or have chronic illnesses. Attempting to do CPR on an elderly person often causes more harm than good when it comes to prolonged suffering and pain.

This is why it is so important to talk to your parents and other loved ones about what their wishes are.
If you can’t follow their wishes, do not become their health care proxy or POA.
And also remember, this is not a “once and done” thing. I have advanced directives (living will) and a health care proxy. We meet once a year and discuss things again, change what might need changing and make sure that everyone is still on the same page. The way I look at it, it is the best gift I can give my family.
 
CilladeRoma said:
This is why it is so important to talk to your parents and other loved ones about what their wishes are.
If you can’t follow their wishes, do not become their health care proxy or POA.
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My mom did this over a decade ago, probably close to two decades ago in the form of a living will. Her and my step-dad have named me their proxy trusting that I will make the right decision if the time comes. They also know that my EMT training will kick in and that gives me a little more know how on the right time according to them.

I also know what they want after they are dead, which is not to be buried. They want to be cremated.
 
@lonegreywolf20

Are your parents Catholic? What will you do with the ashes?
 
They are, although like me, non-practicing.

Haven’t thought that far yet on what I will do with them.
 
Allie1 said:
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CatholicSooner:
My whole point was that people in this thread are making CPR and defib seem like it is evil when in fact is saves thousands if not millions of lifes a year.
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Im an ICU nurse. Its not that CPR and defribrillation is an evil. But, I do think that it is an injustice to do it on people who have expressly stated that they do not want it.

Broken ribs lead to pneumothorax’s and chest tubes. Which are extremely painful.
When someone has a pulse after cpr, it does not mean that they are out of danger by any means. They may still be in shock whick means that they probably will need to be started on high dosages of vasoprssors to perfuse their core organs and brain. These types of medications can lead to lack of blood flow to your limbs, and I have indeed seen people need to have portions of their hands and feet amputated from these drugs.
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no argument from me on this
 
Those months we spent in the Zoll Lifevest were not fun times!!
 
I don’t think that is what my mom wants to have happen. We technically have two burial plots, one for me and one for my mom that my grandparents bought, but I think she either has sold or will sell hers. I plan on being buried as it will be with my grandparents.

The honorable thing to do is to honor my mom’s wishes on what she wants done with her ashes. To do anything else is dishonorable. My step-dad I believe wants me to go bluefishing with my friends on a party boat in NJ and spread his ashes. I have to check into the laws on that one.
 
I imagine not.

We had a patient a couple years ago when I was working an ALS shift. She had to go to a different hospital because one of her pacemaker leads had dislodged. She was supposed to go by medivac, but there were sever storms in the area, so they ended up getting grounded at the sending hospital. This was a lights and sirens call to a hospital 1 1/2 hours away, plus have to add time for the torrential downpours. Midway through the trip I hear the patient scream. She had pacer pads on her because she had bradycardia off and on. Those pads we’re connected to the Philips monitor, but my medic was about to do that when she yelled. thirty seconds later, she yelled again. My medic was at a loss because he wasn’t doing anything to her that would cause that. She was finally able to get out that she was being shocked.

The dislodged lead was touching her heart and was shocking her because it saw a shock-able rhythm. I was already doing 80 in a storm, he asked me to speed it up more as we were still a good 35 minutes away.

When we got to the receiving hospital we learned that the sending hospital should have put a magnet on the pacemaker to shut it down. Neither one of us knew we could do that.
 
Poor lady!

There are also ICD devices, a combo pacemaker internal defibrillator. Yes, they save lives, however, there can also be ICD storms where the person receives shock after shock. It is hell to watch.
 
I can tell you, it wasn’t fun to hear! I felt so bad for my medic. He was sitting on the bench seat looking through the protocol book trying to figure out how to help her.

Afterwards, he said give me a code any day, I know how to work that!
 
One time DH’s icd fired at home, the POP was so loud it woke me from a dead sleep. He would weep and scream from the pain.
 
And here, I am a baby when it comes to needles. I am relatively fine with blood being drawn from me, but nothing sub-q or intramuscular or I freak out.

Again, that is when it’s happening to me. I can do it all day long to others… lol.
 
There are a lot of complex medical horror stories on this thread. But what puzzles me is this:
When faced with complex and variable medical decisions, those who know most about it–the physicians, nurses, EMT’s, and medical personnel, take a step back, pause, and leave the decisions to laypeople–patient and family.

They expect these laypeople to have foreseen all these possibilities months or years ago, and to have made a pre-emptive decision about what to do about events they cannot predict and have little knowledge of. In this situation, do this. In another situation, do that. They defer to the judgment of a POA with no medical training, a spouse or relative, to make serious decisions about medical matters.

Why not exercise some medical judgment? Is this futile ? Will it do more harm than good? Have we done all that we reasonably can? Is it time to let go?

I somewhat resent the fact that doctors can not make their own medical decisions, but expect patients to tell them what to do.
 
Actually, it’s a law that we have to at least gain informed consent in order to treat, which means that we need to ask them if they want this done, or that done. Otherwise it can be construed as battery on someone. Especially when it comes to children. We have to get permission from the parents to treat. We will generally lay out what we will do and if that doesn’t work, what our next option is. Each step of the way, we have to gain consent. There is an implied consent, but that is when the patient is unconscious and/or has an altered mental status.

That is why it’s a good thing that there are DNRs and living wills.
 
It is imperative for us to be informed, to then work with our physicians. Informed consent is vital.
 
Apparantly it’s vital because witihout it, docs make treat my body as a punching bag. What percentage of patients are knowledgeable enough about medicine to give truly informed consent?
 
Our healthcare is primarily our responsibility. We need to be pro-active, ask questions and do research on our own, as well as consult with healthcare professionals, on what the best suited to our needs.
Why would we expect someone else to make the most important decisions about our life and death when all the know of us is information on a medical chart?
 
So we need to be our own physicians.

When my brother in law was rushed to the ER after being discharged from a cancer treatment center, the physician asked “Do you want us to make him comfortable or to do everything possible?” His children immediately began to say “Do everything possible!” I asked the doc, “What’s his prognosis?”

The doc replied, “Oh, he’s not going to make it. He’s got tumors here, here, here, and here. He won’t last long.”

He was sent to a hospice, where he died one day later. What was the point of even asking the question?

When my wife was dying, the doc did not ask for a DNR. He said, “Your wife is dying. We’ll put her in this room, where you can be with her for a few minutes.”
 
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JimG said:
What was the point of even asking the question?
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They still have to ask what the family’s wishes are.

We in the medical field don’t have carte blanche power. We are still bound by laws, standard operating guidelines/procedures and the family still gets a say.
JimG said:
Apparantly it’s vital because witihout it, docs make treat my body as a punching bag.
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I find the above offensive of as a medical field worker. We don’t want to treat anyone like a punching bag. That is not the intention of what we do that are life saving measures. If you code on us and we do not have a DNR, we are going to do what we can to bring you back to life. That is what we are trained to do. We’re not out to purposely hurt anyone.
JimG said:
So we need to be our own physicians.
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A thousand times yes! You are your own best advocate while you are able to be that advocate. After that, if you cannot make your own decisions, then family is your next best advocate. I also advocate for my patients. We are trained and expected to do that as well.
 
Can speak to the importance of these orders for older people from experience with the older generation in my extended family. I’m just a layman telling what I know about: there are Advanced Health Care Directive forms. which have more than just the DNR part, they also have sections dealing with the degree of care desired for those who are breathing and have pulses, they’re just out.

For example, there is the part about the degree of medical care to be rendered if the patient is not conscious but breathing with a pulse. One checkbox essentially says “do everything possible”. all “extraordinary” means to render care and keep that person going no matter what. The next checkbox essentially says “ordinary” care and the last checkbox essentially says “no care, just pain-free maintenance”. Which I think of as essentially hospice without saying so.

What I was told is that most persons check “ordinary” care, but the problem they run into is that the cut and dried checkbox on a piece of paper doesn’t resemble real life that much. Because in in real life, there are shades of meaning between ordinary care and extraordinary care so distinguishing the point at which “ordinary” became “extraordinary” is often a matter of debate and interpretation. Not to mention easily subject to family infighting as described above.

Hence this requires at least some discussion and agreement with the kids as to what that looks like and how much should be done. For example, the senior might say, I’m ok with IV fluids, but I don’t want a feeding tube at all, then these are the kinds of topics to be put out there so the family has some idea what their loved one wants.

The Catholic Church does not require “extraordinary” care. There is a fair amount more discussion if one wants to search for it, just saying Catholics are not required to check the box for “extraordinary” care.

Catholics can be cremated and get the funeral Mass treatment. But their ashes must be interred at a cemetery or the local parish is supposed to refuse to do the Mass without an indication as to the final destination of the ashes. Which is typically the contract one has signed with the cemetery. No scattering the ashes or splitting them up or any of that is allowed.
 
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