What do you think of a "Do Not Resuscitate" order in the classroom?

[gardenswithkids]

…A reasonable compromise is that the DNR not apply during the time she is on school property or on school transportation (if she uses a bus, for instance)…

That seems a reasonable compromise. If a child has a cardiac or respiratory arrest and the paramedics are called, the child will either: a) recover following the arrest (full or partial recovery) or b) not recover.

If the child does not recover a) the child dies after an effort is made to save her life* or* b) the child may be hospitalized, likely in critical condition, leaving the parents and doctors to decide *in the hospital *what medical treatmenst are appropriate. If a child partially recovers and is released from the hospital, it is time to again evaluate if the child is healthy enough to attend school–again knowing the school will not honor DNR orders. If the child fully recovers to where she was prior to the arrest, she resumes her normal life.

DNR orders at a school carry another possibility that no one has mentioned yet. What if a special needs child does NOT have DNR orders, but there is some confussion about the matter and a child whose family desires resitation doesn’t receive it at a critical time? Some examples of how this confussion may occur: Sometimes people have similar names, sometimes signs are added or removed from children’s chairs by other children playing pranks, a regular nurse or teacher may be absent when a medical emergency takes place, non-medical school staff may mistakenly assume DNR protocol is the norm for other special needs students at the school, etc., etc…

Beyond the issue of asking if DNR orders are ever appropriate for a child whose well enough to attend school, I think that schools would be wise to steer clear of accepting DNR orders for the safety of the other children at that school. DNR orders in schools may pose a threat to lives of other children–especially for those with special needs.

 

[4Horsemen]

I have to agree.

A reasonable compromise is that the DNR not apply during the time she is on school property or on school transportation (if she uses a bus, for instance).

I would think that the school district would be within good legal standing to not allow her to go to school with a DNR in effect. What would keep the school district from getting sued if the parents “changed their minds” if the girl goes critical and dies as a result of non-action on thte part of school district employees?

You might think they’d be protected, but stranger things have happened. And, what about the parents of the other kids suing the school district if their kid(s) were “emotionally scarred”, legitimately or not, by having to watch a classmate die without intervention?

A good lawyer, a sympathetic jury, and the school district forks over a blank check…

.

I agree that schools should not allow the DNR protocol on their campuses or in transportation vehicles, first of all, due to the moral/social issues as previously mentioned, and, second, due to the horrendous legal issues as your post delineated. Yes, mistakes can be made. Also, different school districts may have different policies on DNR orders, and substitute teachers may not be aware of change of policy from one school to another, or, due to human error, make a mistake. True, the other parents of students in the classroom who might witness a classmate in a dying situation (even though the child may live through it) may certainly be traumatized. Psycologists would be needed. Lawsuits would abound. School districts should wise up and set policies on this issue that forbid DNR orders. I think most posters agree with that assessment.

For Life,
4Horsemen

 

[4Horsemen]

DNR orders at a school carry another possibility that no one has mentioned yet. What if a special needs child does NOT have DNR orders, but there is some confussion about the matter and a child whose family desires resitation doesn’t receive it at a critical time? Some examples of how this confussion may occur: Sometimes people have similar names, sometimes signs are added or removed from children’s chairs by other children playing pranks, a regular nurse or teacher may be absent when a medical emergency takes place, non-medical school staff may mistakenly assume DNR protocol is the norm for other special needs students at the school, etc., etc…

Beyond the issue of asking if DNR orders are ever appropriate for a child whose well enough to attend school, I think that schools would be wise to steer clear of accepting DNR orders for the safety of the other children at that school. DNR orders in schools may pose a threat to lives of other children–especially for those with special needs.

Well said.
4Horsemen

 

[Jesus_123]

… A reasonable compromise is that the DNR not apply during the time she is on school property or on school transportation (if she uses a bus, for instance).

… I would think that the school district would be within good legal standing to not allow her to go to school with a DNR in effect.

I agree one hundred percent . . . *but I would also add that *. . . the school should require a licensed physician’s authorization that the child is well enough to attend school . . . thus keeping the DNR with all its ramifications . . . *morally, medically and legally *. . . where it belongs - in the hands of the parents and their medical providers as the responsible parties . . . And I also completely support 4Horseman’s contention that the classroom is no place for a child who has been classified as being in a medical state/condition where . . . death is “imminent” . . ."

Parable of the Good Samaritan
****Luke 10:29b-37 :bible1: ****

“… And who is my neighbour? And Jesus answering, said: A certain man went down from Jerusalem to Jericho, and fell among robbers, who also stripped him, and having wounded him went away, leaving him half dead. And it chanced, that a certain priest went down the same way: and seeing him, passed by. In like manner also a Levite, when he was near the place and saw him, passed by. But a certain Samaritan being on his journey, came near him; and seeing him, was moved with compassion. And going up to him, bound up his wounds, pouring in oil and wine: and setting him upon his own beast, brought him to an inn, and took care of him. And the next day he took out two pence, and gave to the host, and said: Take care of him; and whatsoever thou shalt spend over and above, I, at my return, will repay thee. Which of these three, in thy opinion, was neighbour to him that fell among the robbers? But he said: He that shewed mercy to him. And Jesus said to him: Go, and do thou in like manner.“

Just some thoughts:

Forcing cooperation and compliance with a medical DNR order in an essentially NON-MEDICAL ENVIRONMENT/FACILITY . . . such as a school . . . to my soul . . . is an attempt to force the personnel in the facility . . . the majority of whom are non-medical personnel . . . to “pass-by-pass-by” a person in great distress . . . and it appears to be an attempt to force them not to “compassionately take care of the person in great distress” to the best of their ability . . .

Nurses . . . while licensed medical personnel . . . work under authority . . . and are . . . by the very limitation of the scope of their medical training . . . not medically qualified to make diagnoses and prescribe treatment such as a licensed physician is qualified and authorized to make . . .
. . .

The lack of a licensed physician’s diagnosis in the individual’s immediate/imminent medical crisis creates an unknown medical diagnostic situation . . . calling for the patient to receive complete emergency care until a licensed physician is able to assess the medical situation in its reality . . . and diagnose the immediate individual medical emergency . . . and prescribe treatment for same . . .

:yyeess:. . . . . . :curtsey: . . . :ballspin: . . . shaw: . . . :kiss4you: . . . :thankyou:

God bless the children!

. . . all for Jesus+​

 

[Friar_David_O.Carm]

Just some thoughts:

• Forcing cooperation and compliance with a medical DNR order in an essentially NON-MEDICAL ENVIRONMENT/FACILITY . . . such as a school . . . to my soul . . . is an attempt to force the personnel in the facility . . . the majority of whom are non-medical personnel . . . to “pass-by-pass-by” a person in great distress . . . and it appears to be an attempt to force them not to “compassionately take care of the person in great distress” to the best of their ability . . .

I do not agree with this statement. If a DNR is properly in place then it is not compassionate to go against it. It is the opposite of compassion to not follow a DNR order and to render care. I can see someone doing this to make themselves feel good but it is not the right thing to do.

• Nurses . . . while licensed medical personnel . . . work under authority . . . and are . . . by the very limitation of the scope of their medical training . . . not medically qualified to make diagnoses and prescribe treatment such as a licensed physician is qualified and authorized to make . . .
  . . .

• The lack of a licensed physician’s diagnosis in the individual’s immediate/imminent medical situation creates an unknown medical diagnostic situation . . . calling for the patient to receive complete emergency care until a licensed physician is able to assess the medical situation in its reality . . . and diagnose the immediate individual medical emergency . . .

As a former paramedic your thoughts on this are off.

A DNR is in force for all medical personnel if that person knows of its existence. A nurse is trained enough to know when a DNR is to be followed, it does not take a physician to judge this.

Also, a DNR is in effect everywhere. There is no compromise as has been suggested that it would not be in effect at school. A DNR would not be binding upon a teacher or other non-medical personnel but once a nurse or paramedic arrived and was informed of the DNR, unless that DNR is resciended by a family member, it is in effect and all extraordinary methods (or what ever is stated in the actual DNR) would cease under the supervision of the medical professional in charge of the scene (nurse or paramedic).

Yes it is tragic, but it is the law. While some might view this as immoral, it is not, that is if the DNR is properly put into place. If the DNR is properly used then it is immoral not to honor it.

My question is what was raised by others, how sick was this child and was school the right place for her to be.

One more thing, DNR’s are not just for the hospital.

 

[Jesus_123]

As a former paramedic your thoughts on this are off.

A DNR is in force for all medical personnel if that person knows of its existence. A nurse is trained enough to know when a DNR is to be followed, it does not take a physician to judge this.

Also, a DNR is in effect everywhere. There is no compromise as has been suggested that it would not be in effect at school. A DNR would not be binding upon a teacher or other non-medical personnel but once a nurse or paramedic arrived and was informed of the DNR, unless that DNR is resciended by a family member, it is in effect and all extraordinary methods (or what ever is stated in the actual DNR) would cease under the supervision of the medical professional in charge of the scene (nurse or paramedic).

Yes it is tragic, but it is the law. While some might view this as immoral, it is not, that is if the DNR is properly put into place. If the DNR is properly used then it is immoral not to honor it.

My question is what was raised by others, how sick was this child and was school the right place for her to be.

One more thing, DNR’s are not just for the hospital.

Again . . . we are dealing . . . specifically . . . with compliance or non-compliance with DNR orders**. . . by non-medical facilities** . . . in this thread . . . And . . . actually . . . legally . . . there is considerable latitude all around the United States in enforcement of medical DNR’s . . . quoted below is a policy with complete legal references from the Willmar, Minnesota Department of Education as an example . . . wherein . . . as a school system . . . they categorically refuse to enforce DNR’s . . . throughout their school system . . . and they are just one of many . . . which is the exact solution Newbie2 recommended in the above referenced posts . . .

willmar.k12.mn.us/node/1129

533 - DNR-DNI Orders
Submitted by superadmin on March 18, 2008 - 11:56pm

Purpose

The school district recognizes that it is serving students with complex health needs. The school district also recognizes that school district staff may be confronted with requests to withhold emergency care of a student in the event of a life-threatening situation at school or school activities or be presented with Do Not Resuscitate/Do Not Intubate (DNR-DNI) orders. The purpose of this policy is to provide guidance to school district staff and parents or guardians in these situations.

General Statement of Policy

1. The primary mission of the school district is education. DNR-DNI Orders are medical documents. School district staff will not accept or honor requests to withhold emergency care or DNR-DNI orders. The school district will not convey such orders to emergency medical personnel.

1. School district staff will provide reasonable emergency care and assistance when a student is undergoing a medical emergency during school or school activities.

1. School district staff will activate emergency medical services (911) as soon as possible when a student is undergoing a medical emergency during school or school activities.

1. The parent/guardian will be notified of the emergency as soon as possible.

1. Notwithstanding this school district policy, IEP and § Section 504 teams must develop individualized medical emergency care plans for students when appropriate in accordance with state and federal law.

1. Parents/guardians who request that emergency care be withheld for their child or who present DNR-DNI Orders, shall be advised of and shall be given a copy of this policy.

Legal References:
29 U.S.C. § 794 et seq. (§ Section 504 of the Rehabilitation Act of 1973)
42 U.S.C. §§ 12101-12213 (Americans with Disabilities Act)

Cross References:
(MSBA Model Policy #518)
Adopted: October 24, 2001 Revised: July 14, 2003 Revised: July 12, 2004

As far as a nurse implementing a DNR order . . . when the nurse is working for a non-medical facility . . . she is working under the authority of those non-medical employers . . . and is subject to their protocol/policies as developed for their particular institution . . . and would be required to agree to follow said protocol/policy . . . or she would not be hired . . . and under “Good Samaritan” law . . . a medical professional is protected in the administration of emergency care in a medical crisis . . . and in many states would be in personal legal jeopardy if they did not administer such care . . .

The morality of various types of DNR orders was discussed earlier on this thread . . . and while each of us has a right to our own opinions . . . as a devout Catholic . . . I have **grave reservations **about the morality of some types of DNR’s . . .
"In the Lord I put my trust …"
Psalm 10:1a
:bible1:

. . . all for Jesus+
​

 

[Newbie2]

Are there DNR medical alert tags? (Seems like a contradiction in terms)

Say the kid has a crisis and emergency personel arrive on the scene. Are they going to take the word of a teacher or administrator that a DNR is in place, especially when there may not be time to run to the file cabinet and pull out an “official” copy?

How do emergency personel handle this sort of thing?

How about when it’s in a home? How do the emergency people determine if, say, a spouse is telling the truth when they say the other person has a DNR (I know, they wouldn’t have called emergency in the first place…but what if Aunt Millie goes into cardiac arrest, and her nephew calls 911. Medical personel get there, and Uncle Mike says no, she has a DNR. What do they do?

Just curious. I would assume that the default when there is a question is to try to save a life.

 

[Friar_David_O.Carm]

As far as a nurse implementing a DNR order . . . when the nurse is working for a non-medical facility . . . she is working under the authority of those non-medical employers . . . and is subject to their protocol/policies as developed for their particular institution . . . and would be required to agree to follow said protocol/policy . . . or she would not be hired . . . and under “Good Samaritan” law . . . a medical professional is protected in the administration of emergency care in a medical crisis . . . and in many states would be in personal legal jeopardy if they did not administer such care . . .

Only people without a duty to respond are covered by the “Good Samaritan” laws. A nurse working at an institution has a duty to respond.

While it is correct that a nurse working at a non-medical facility is working under the authority of non-medical personnel they are still medical personnel and must follow all directives. A DNR is issued with the knowledge and authority of a physician so it is binding upon all medical personnel.

Even if not, when the paramedics arrive they take control of the medical care of the patient and must enforce any standing DNR that they are made aware of.

 

[Friar_David_O.Carm]

Are there DNR medical alert tags? (Seems like a contradiction in terms)

Say the kid has a crisis and emergency personel arrive on the scene. Are they going to take the word of a teacher or administrator that a DNR is in place, especially when there may not be time to run to the file cabinet and pull out an “official” copy?

How do emergency personel handle this sort of thing?

An actual copy of the paper DNR must be present and handed to the emergency personnel.

How about when it’s in a home? How do the emergency people determine if, say, a spouse is telling the truth when they say the other person has a DNR (I know, they wouldn’t have called emergency in the first place…but what if Aunt Millie goes into cardiac arrest, and her nephew calls 911. Medical personel get there, and Uncle Mike says no, she has a DNR. What do they do?

Again, an actual physical copy of the DNR must be present in an emergency situation. At a medical facility a copy will be kept in the patient’s medical chart.

Just curious. I would assume that the default when there is a question is to try to save a life.

When in doubt emergency personnel treat the patient as if no DNR is in effect.

 

[gardenswithkids]

… If a DNR is properly in place then it is not compassionate to go against it. It is the opposite of compassion to not follow a DNR order and to render care …

We are discussing the situation of a young child. It is not the patient who requested the DNR–it is the parents or care-givers. Situations can arise where parents or care-givers decide to fore-go medical treatment their own convenience rather than out of compassion for the disabled person. (Please note that I don’t intend to imply that was the situation in this particular case;however, I think we would be naive to ignore the possibility it can happen.)

Parents do not always have authority to decide to forego or stop medical treatment for their children. In another case recently an arrest warrent was issued for a mother who fled a state with her teenage son who had court orders to receive chemo-therapy. Different case, different situation, but it shows that sometimes the state wants to have a say in the medical treatment for children.

… As a former paramedic your thoughts on this are off.

A DNR is in force for all medical personnel if that person knows of its existence. A nurse is trained enough to know when a DNR is to be followed, it does not take a physician to judge this.

Also, a DNR is in effect everywhere. There is no compromise as has been suggested that it would not be in effect at school. …

If parent and care-giver have the authority to decide DNR for a minor child, then they also have the authority to revoke the DNR. Schools have a sort-of substitute parental authority over the children in their care. The term “en loco parentis” meaning “instead of a parent” or “in place of a parent” is used in the US to refer to the authority schools have over children in their care. Notice also the term “alma-mater”, used to refer to schools, includes the word “mater” which is Latin for mother. Because the schools do have some legal authority over children in their care, I believe that schools are within their rights to go against DNR orders for a minor child in their care.

As a homeschooler, I am well aware that schools have some authority over the children in their care. I’m very reluctant to place my own young children under the authority of state schools where things can happen to my children that I disagree with. Fortunately in America, parents have the right to homeschool. I know of homeschoolers with special needs children who decided to homeschool for the sake of their children’s health to limit exposure to infection and because of severe allergies. I realize that not every parents wants to homeschool, but if parents strongly disagree with some aspect of a school policy–such as a school’s decison not to accept DNR orders, there are alternative forms of education. Perhaps another compromise that could be reached with parents who want DNR for their minor child is some type of educational help at home.

 

[Friar_David_O.Carm]

We are discussing the situation of a young child. It is not the patient who requested the DNR–it is the parents or care-givers. Situations can arise where parents or care-givers decide to fore-go medical treatment their own convenience rather than out of compassion for the disabled person. (Please note that I don’t intend to imply that was the situation in this particular case;however, I think we would be naive to ignore the possibility it can happen.)

This does not matter. The DNR is for the patient. The parents, as being the healthcare proxy can request a DNR and if the patient’s physician agrees it is in force as if the patient requested it. It is not for us to judge why the DNR was put into place.

Parents do not always have authority to decide to forego or stop medical treatment for their children. In another case recently an arrest warrent was issued for a mother who fled a state with her teenage son who had court orders to receive chemo-therapy. Different case, different situation, but it shows that sometimes the state wants to have a say in the medical treatment for children.

A DNR is in place and is in effect until a court of law says otherwise, such as in the case you mention. It is not for us to decide if a DNR is relevant or not.

If parent and care-giver have the authority to decide DNR for a minor child, then they also have the authority to revoke the DNR. Schools have a sort-of substitute parental authority over the children in their care. The term “en loco parentis” meaning “instead of a parent” or “in place of a parent” is used in the US to refer to the authority schools have over children in their care. Notice also the term “alma-mater”, used to refer to schools, includes the word “mater” which is Latin for mother. Because the schools do have some legal authority over children in their care, I believe that schools are within their rights to go against DNR orders for a minor child in their care.

Schools do not have the power to circumvent the parents’ wishes. They are not the parent. When a parent is not there and there is no physcial DNR present then a school administer can request treatment but that is only until the proper caregiver, in this case a parent, can be contacted.

In this case a physical copy of the DNR was in place so the school could not change this.

As a homeschooler, I am well aware that schools have some authority over the children in their care. I’m very reluctant to place my own young children under the authority of state schools where things can happen to my children that I disagree with. Fortunately in America, parents have the right to homeschool. I know of homeschoolers with special needs children who decided to homeschool for the sake of their children’s health to limit exposure to infection and because of severe allergies. I realize that not every parents wants to homeschool, but if parents strongly disagree with some aspect of a school policy–such as a school’s decison not to accept DNR orders, there are alternative forms of education. Perhaps another compromise that could be reached with parents who want DNR for their minor child is some type of educational help at home.

That may be but as a former paramedic I am well versed in DNRs, we were trained on them becuase of the legal implications involved.

The only people capable of countermanding a DNR are the patient if they are competent, which a minor child is not (legally speaking), the healthcare proxy (if one is in place), the legal guardian of a minor child (in this case the parents), or the next of kin if the patient is competent but unconscious.

The school does act as a temporary legal guardian but this is why a physical DNR order must be present as it shows the wishes of the patient (or those who make the medical decisions for the patient).

A court may also countermand a DNR order but this will only happen after a hearing and a new legal guardian or healthcare proxy is put into place.

 

[4Horsemen]

I do not agree with this statement. If a DNR is properly in place then it is not compassionate to go against it. It is the opposite of compassion to not follow a DNR order and to render care. I can see someone doing this to make themselves feel good but it is not the right thing to do.

As a former paramedic your thoughts on this are off.

A DNR is in force for all medical personnel if that person knows of its existence. A nurse is trained enough to know when a DNR is to be followed, it does not take a physician to judge this.

Also, a DNR is in effect everywhere. There is no compromise as has been suggested that it would not be in effect at school. A DNR would not be binding upon a teacher or other non-medical personnel but once a nurse or paramedic arrived and was informed of the DNR, unless that DNR is resciended by a family member, it is in effect and all extraordinary methods (or what ever is stated in the actual DNR) would cease under the supervision of the medical professional in charge of the scene (nurse or paramedic).

Yes it is tragic, but it is the law. While some might view this as immoral, it is not, that is if the DNR is properly put into place. If the DNR is properly used then it is immoral not to honor it.

My question is what was raised by others, how sick was this child and was school the right place for her to be.

One more thing, DNR’s are not just for the hospital.

You said “when the DNR is properly put into place.” What are the conditions for a DNR oder to be “properly into place”, if you will?

I read an article from the American Academy of Pediatrics that there may be some difficulty for medical personel at schools to determine when to rescue a child in the face of an emergency. For example, although the child is severely ill with a DNR instruction, she could be merely choking on some food or mucous lodged in her throat. Note this paragraph from AAP website:

"While competent adults have legislated alternative means to refuse unwanted medical care, including advance directives, the options for children have remained less well defined. Only a few states explicitly authorize emergency medical services (EMS) to apply advance directives to children. Although lacking explicit authorization, existing statutes generally do not prohibit extensions of DNR orders for children to out-of-hospital situations. In contrast, the school officials may be worried that a DNR order could be misinterpreted by medically untrained staff, resulting in harm to a child, or they may worry that personnel would feel bound not to respond to an easily reversible condition, such as a mucous plug in a child with a tracheostomy. Administrators have concerns about their personnel responding to circumstances not anticipated by a DNR order, such as when a child chokes on food or is injured. Officials are understandably concerned that they and/or the school or school district could be held liable if personnel failed to act in a way that might have prevented an untoward death. "

You said the DNR orders follow the child everywhere. I would think that if the child went to school and back in a school bus, or let’s say on a fieldtrip, there could be an emergency issue that would require medical personnel on hand. I suppose the state (taxpayer money) would have to pay for each and every possible emergency situation.

You wondered just how sick this second-grader was. She had already had an episode in the school when in 2007 she stopped breathing during a class. School nurses followed the DNR order, and she was not intubated–an “invasive procedure that Katie’s parents thought would only prolong the inevitable,” according to the article in the Chicago Tribune 5/28 about her death. The original article can be found as mentioned in the OP at www.chicagotribune.com/DNR.

In any case, my opinion is that we’re opening up a can of worms when DRN orders go along with a child in school. Below is the website of AAP:

aappolicy.aappublications.org/cgi/content/full/pediatrics%3B105/4/878#Conclusion

God bless,
4Horsemen

 

[Jesus_123]

. . . :nope: . . .
A DNR is issued with the knowledge and authority of a physician
so it is binding upon all medical personnel.

(The blue coloration, centering of text, and the disagreement icons in the above quote are my edits . . .)

Gardenswithkids has made some excellent observations in the above post . . . and . . . again . . . this thread deals with . . . non-medical organizations . . . and compliance or non-compliance with DNR orders . . . *medical organizations have quite different policies/protocols and responsibilities in such matters . . . *

There is apparently . . . considerable leeway . . . in the laws in place regarding this matter which allows **. . . non-medical organizations . . . **such as schools, businesses, airlines, etc. . . . to implement a general doctrine known as “informed consent” . . .

:coffeeread:Informed consent is a legal condition whereby a person can be said to have given consent based upon a clear appreciation and understanding of the facts, implications and future consequences of an action. In order to give informed consent, the individual concerned must have adequate reasoning faculties and be in possession of all relevant facts at the time consent is given. - Wickipedia

The school referenced in the post you quoted from . . . having formulated a policy . . . **as a non-medical organization **. . . as to how they wish to conduct business in relation to medical DNR’s . . . responsibly informs the parents/guardians re their individual policy **not to honor or implement DNR’s-DNI’s . . . If **the parents . . . having received such information from the school in question . . . decide to place their child in that school environment with full knowledge that the DNR-DNI’s will not be honored or implemented should a medical crisis occur . . . then they are accepting. . . by their actions as the child’s parents/guardians. . . and giving informed consent re the school’s policy that their child’s DNR-DNI is **not in effect when the child is within the parameters of the school’s authority . . . and the school nurse is bound by . . . her non-medical employer’s **. . . policies . . . if she has accepted employment under such circumstances as laid out in school policy relating to DNRs . . . below are some other quotes in relation to this matter . . .

Quote from the Princeton City School District, Cinncinati, Ohio’s “A Parent’s Guide to Your Elementary School”

princeton.k12.oh.us/pdf/Elementary_Handbook.pdf

**:coffeereadO NOT RESUSCITATE (DNR) ORDERS

There is no requirement in the law** that a school or school personnel comply with a DNR order. In addition, the uncertainties and risks associated with compliance with DNR orders make such compliance inappropriate for the schools. Accordingly, DNR orders shall not be accepted, honored, or followed by any employee of the Princeton City School District. School district employees who are health care providers, as part of their duties and in lieu of compliance with a DNR order, shall … This shall not be construed as a denial of rights under section 504 of the Rehabilitation Act of 1973 or the Individuals With Disabilities Education Improvement Act (IDEIA).

A quote from the New York Association of School Nurses website . . .

nysasn.org/legislation1.html

:coffeeread:Legislative News…

The legislative agenda is focused on providing (name removed by moderator)ut on laws that impact our students’ health and school nursing practice. Our goals include achieving a mandate for school nurses in every school building. NYSASN participates in legislative education with lawmakers to voice our position that each school building should have a school nurse on site full-time. In June, our delegation will join NYSUT’s Healthcare Professionals Council advocating for a school nurse in every school, as well as nursing-related bills attending to safe staffing and ending mandatory overtime. …

DNR Bills:
A885: . . . healthcare practitioner shall not comply with DNR order pertaining to student where school board has adopted a policy not to honor such orders.

I do apologize for inadvertantly misleading you all re “Good Samaritan” law . . .

:coffeeread:**Good Samaritan laws in the United States **are laws or acts protecting from liability those who choose to aid others who are injured or ill. … Such laws generally do not apply to medical professionals’ or career emergency responders’ on-the-job conduct … - Wickipedia

:choocho: . . . . . . :egyptian:

God bless the children!

. . . all for Jesus+​

 

[Jesus_123]

**

DIVINE MERCY PRAYERS**
Eternal Father . . . I offer You the Body and Blood . . . Soul and Divinity . . . of Your dearly beloved Son . . . our Lord Jesus Christ . . . in atonement for our sins . . . and those of the whole world . . . For the sake of His sorrowful Passion . . . have mercy on us and on the whole world . . .

Holy God, Holy Mighty One, Holy Immortal One,
have mercy on us and on the whole world . . .

In 1933, God gave St. Faustina a striking vision of His Mercy, Sister tells us:

“I saw a great light, with God the Father in the midst of it. Between this light and the earth I saw Jesus nailed to the Cross and in such a way that God, wanting to look upon the earth, had to look through Our Lord’s wounds and I understood that God blessed the earth for the sake of Jesus.”

 

[Friar_David_O.Carm]

Ok, while a school might chose not to follow a DNR order the first responders and paramedics will do so when they arrive and take over the care of the patient.

A DNR order that is put in place is assumed to be proper. The only recourse is to challenge it in court.

It is not the job of emergency responders to judge the validity of a DNR order.

 

[Jesus_123]

The Lord led me to use all the . . . “food for thought” . . . we all have experienced in reflection on 4Horseman’s above referenced topic . . . for the reflection I prepared today for our Benedictine Spirituality Forum . . . it seemed to fit right in with what we are studying right now . . . I wanted to thank you all for all the great and varied perspectives expressed . . . I learned volumes . . . !

---

God’s Chosen Plans . . . . . . for His Cherished Children***

---

A number of years back my home church . . . *located in another state *. . . as it grew in size . . . had begun purchasing houses and land around the church in expectation of expansion . . . and . . . *very unexpectably *. . . the Lord blessed our young family with an opportunity to rent one of the homes . . . *one with a fantastic fireplace :clapping: which marvelous extra blessing I just loved . . . * and we moved in just a day or so before my youngest son was to enter the first grade . . . The day we moved in there came a knock at the side door and . . . *lo and behold *. . . the principal of our church’s school had come calling . . . bringing with her . . . *the plight *. . . that one of her teachers had suddenly been unable to come on board . . . *and offering me her job *. . . I had completely surrendered and consecrated my life into the Lord’s service when I was very young . . . *just in the eighth grade *. . . and singing had become the main gift in the Spirit God used for His Glory for many years thereafter . . . but . . . **God’s plans **. . . for all of us . . . unfold . . . ***day-by-day-by-day ***. . . and this was a really . . . astonishing day . . . in the life of our little family . . .

I absolutely loved being a mother to my three wonderful young sons . . . :yup: . . . and it’s equally delightful being a grandmother . . . . . . but to be successful as a mom . . . or a successful grandmom . . . or a successful teacher of children . . . the process of keeping family, home and school life . . . healthy . . . peaceful . . . and . . . harmonious . . . of necessity must involve both . . . love . . . and . . . discipline . . . being . . . firm . . . but . . . kind . . . Mine is a very ***gentled ***soul before my God . . .

Sacred Scripture teaches . . . "Train up a child in the way he should go: and when he is old, he will not depart from it." (Proverbs 22:6) . . . The training of a child can . . . at times . . . be very difficult on the . . . adult . . . involved as well as the child/children . . . whether in a family or a school environment . . and . . . sometimes . . . on the more serious occassions . . . one can experience the grieving of the whole group involved over its imperfections when the discipline of love is necessary to be carried out for one of its members . . . The Fourth Degree of Humility isn’t easy by any stretch of the imagination . . . but it is absolutely necessary . . . *and very much used of the Lord . . . in the training of all our souls . . . childrens and adults . . . *

+:compcoff: The fourth degree of humility is, that, if hard and distasteful things are commanded, nay, even though injuries are inflicted, he accept them with patience and even temper, and not grow weary or give up, but hold out, as the Scripture saith: “He that shall persevere unto the end shall be saved” (Mt 10:22). And again: “Let thy heart take courage, and wait thou for the Lord” (Ps 26[27]:14). …** - from The Holy Rule of St. Benedict - Chapter 7 - June 2nd Reflection**

Keeping the faith . . .

*God’s sweetest blessings . . . *

. . . all for Jesus+
. . . thank you Holy Mother Mary+
. . . thank you Holy Mother Church+​

forums.catholic-questions.org/group.php?groupid=35

 

[4Horsemen]

Ok, while a school might chose not to follow a DNR order the first responders and paramedics will do so when they arrive and take over the care of the patient.

A DNR order that is put in place is assumed to be proper. The only recourse is to challenge it in court.

It is not the job of emergency responders to judge the validity of a DNR order.

Being on an emergency response team, it is necessary and required of you to follow the DNR order, not to judge its validity. It was always my presumption that a DNR order is issued to patients who are in the dying process. From the article about Katie, it wasn’t absolutely a certainty that she was in the dying process although she did go through it to some extent and would, most likely, have died without extraordinary measures. While some may say that she should be brought back indefinately, others will agree that she has been through traumatic suffering and that medical personnel were keeping her from the natural course of dying. My hope for children like Katie is that when God calls, we know how much of the treatment is necessary and how much is over the top, so to speak. Nonetheless, I would hope that these children would not have the misfortune of dying apart from their loved ones and before an audience of children in a classroom. Thank you for your perspective as a professional.

God bless,
4Horsemen

 

[4Horsemen]

The Lord led me to use all the . . . “food for thought” . . . we all have experienced in reflection on 4Horseman’s above referenced topic . . . for the reflection I prepared today for our Benedictine Spirituality Forum . . . it seemed to fit right in with what we are studying right now . . . I wanted to thank you all for all the great and varied perspectives expressed . . . I learned volumes . . . !

forums.catholic-questions.org/group.php?groupid=35

You certainly have a heart for the children! You’ve added much to the discussion with your colorful way of expressing your thoughts and emotions. Thank you for your reflection prepared for the Benedictine Spirituality Forum. I checked the link. I noticed a picture of the medal of St. Benedict which I wear with my scapular.

As for the topic of this thread, we may have discussed the issue inside out, but there could be others out there with different experiences as teachers or parents. The more we can learn and reflect on moral/ethical issues such as this, the better for society. We know that euthanasia is wrong as well as physician-assisted suicide which is now legal in two states, Oregon and Washington. We need to be on the lookout in our own states and work to protect human life at all stages. That includes the handicapped, like dear Katie and other “terminal” (aren’t we all??? ) cases of children in school. I believe you made a reference to respect for life in another post. Let us continue to work and pray as you said (in Latin no less!!!).

God bless,
4Horsemen

 

[Jea9]

Being on an emergency response team, it is necessary and required of you to follow the DNR order, not to judge its validity. It was always my presumption that a DNR order is issued to patients who are in the dying process. From the article about Katie, it wasn’t absolutely a certainty that she was in the dying process although she did go through it to some extent and would, most likely, have died without extraordinary measures. While some may say that she should be brought back indefinately, others will agree that she has been through traumatic suffering and that medical personnel were keeping her from the natural course of dying. My hope for children like Katie is that when God calls, we know how much of the treatment is necessary and how much is over the top, so to speak. Nonetheless, I would hope that these children would not have the misfortune of dying apart from their loved ones and before an audience of children in a classroom. Thank you for your perspective as a professional.

God bless,
4Horsemen

DNRs are also issued when the after-effects of ‘saving the life’ will make the person’s life extremely unbearable (extraordinary means such as a ventilator). It could be that Katie’s body was so frail that any attempt at chest compressions would break ribs in such a way that her already (possibly) deteriorated breathing muscles would be so injured that she would not be able to breathe on her own. I have no idea if this was the case with Katie. I know that many people live long, full lives with CP. There are also many people with CP where the diaphragm and other accessory breathing muscles become so spasmodic that they are unable to breathe without great trouble. Add a couple of broken ribs to that? No thank you.

I worked in a hospital where we had a lady that just came off of the ventilator (I’m in physical therapy) and she was extremely thin due to being anorexic her whole life. Her family and she decided that they could attempt resucitation but could not perform chest compressions because of her frailty. They decided that this would be too unbearable and potentially put her back on a ventilator and unable to breathe on her own. They did not want to be back in a situation where they had to decide whether or not to unplug the ventilator and see if she made it.

 

[cknick]

I’m a little uncomfortable with it–especially given this child’s age when the DNR order was given. (They wrote these orders when she was in second grade.) The article you posted did a nice job of pointing out the complexities of such situations. If any child is that sick, plus prone to infection and so close to death that the family and doctors think DNR order appropriate, I seriously question if school is right place for her. As the article mentions, DNR orders are more commonly found in hospitals and nursing homes, not schools.

Good point. Sometimes parents will use schools as respite, when the children should be home. It is justified by the mandate that that all children are required and entitled to receive an education, however, in this case, it wasn’t appropriate.