Do-Not-Not-Resuscitate Order And Pediatric Oncology Patients

Most cultures value life and bringing persons back from the dead is a popular subject of many fictional books. However, as technology evolves and the story of Frankenstein reborn with a bolt of lighting has come true with the external or implanted defibrillators, the natural process of death slows as much of society gains the knowledge to live longer than nature intended. The Red Cross Association taught many organizations like the girl and boy scouts the methods of mouth-to-mouth resuscitation and Cardiopulmonary resuscitation or CPR, a manual manipulation of the heart, as life saving methods for drowning, electrocution or heart attacks. First aid for laypersons to save lives as well as

The aim of this dissertation is to critically explore the concept of Family Witnessed Resuscitation and to evaluate the literature available concerning this subject. This in turn will allow the author to identify if this practice should be implemented in their clinical work setting and make recommendations for practice.

Management of the acutely ill adult is a complex and perplexed procedure. It requires underpinning knowledge of the pathophysiology of the disease currently affecting the patient, as well as ensuring that professionals are equipped to deal with the development of a rapid deterioration. The National Institute for Clinical Excellence (2007) explain that patients are sometimes inadequately treated due to staff not acting in a sufficient time manner, and so a systematic assessment of the patient recommended by the Resuscitation Council (2006) should initially be followed (Jevon, 2009).

The National Institute of Mental Health (NIMH) has published a fact sheet of statistics on suicide in the United States. In 2007, it is reported that suicide was the tenth leading cause of death. Furthermore, for every suicide committed, eleven were attempted. A total of 34,598 deaths occurred from suicide with an overall rate of 11.3 suicide deaths per 100,000 people. (NIMH, 2010). Risk factors were also noted on this report and listed “depression and other mental disorders, or a substance abuse disorder (often in combination with other mental disorders). More than ninety percent of people who die by suicide have these risk factors (NIMH, 2010).”

Original research related to sedation management occurred in the year 2000 by Kress, Pohlman, O ' Connor, and Hall. Their findings served as a landmark study and initiated the impetus related to improving our sedation practices. According to Kress et al. (2000), daily interruption of sedation led to a decrease in the number of days on the ventilator in the intensive care unit. Several studies since this time have focused on the influence of sedation protocols, and outcomes. This paper will review the synthesis of the discovered studies and highlight the noted contraindications and inconsistencies. Also, explanations including a preliminary conclusion will be discussed.

A status of do resuscitate in those critically ill patients may result in a slow code. A slow code is a situation where the nursing staff decides to do less than the standard set forth by advanced life support algorithms and the nurse practice act and allow the patient to die instead of possibly sustaining life. The legal implications include falsification of documents and breaching the standard of care set forth by the nurse practice act. The ethical issues include malfeasance, dishonesty, and taking on the role of deciding who has a chance to live during a life

I will methodically analyze all parts of the study to assess the validity of the article, by contrasting and comparing the information provided, with previous literature. I will try to make sure that recommendations provided by the authors are congruous with nursing practice and beneficial to the advancement of it. I will as much as possible provide in depth detail of previous studies on the same topic that either support or contradict the analysis provided by this study and its authors.

A “do not resuscitate” order is a complex, ethical and moral dilemma. From a medical personnel point of view, when his/her patient is put into a situation where death is highly likely or already reached, they will do whatever is necessary to make you survive in that moment. But that doesn’t mean that you will continue to survive long term. Sometimes when a doctor “saves” you in that instance its only for an allotted time, maybe even a couple of hours, sometimes they break your ribs in order to make sure you survive a couple of more

The descriptive statistics were used to evaluate the occurrence of rehospitalization within 30 days (readmission return to emergency department) and discharge outcomes (length of the stay and discharge time). Table 2 on page 252 presents the number and percentage of patients readmitted within 30 days from both groups; this descriptive statistic is also presented in the Figure on page 252. The mean length of stay and standard deviation are included in the same table. In addition, the inferential statistics, such as the t test, the Chi square (2), and logistic regression (odds ratio) were used. The t test was used to analyze interval or ratio data, for example: the length of stay or time of discharge. The Chi square (2) test was used to analyze nominal/categorical data, for example: to assess the relationship between the readmission to the hospital (or ER) and the type of medical team the patient had (with or without the NP). The authors considered a p value below 0.05 as a significant. In addition, the odds ratio was calculated using the logistic regression to

Physician orders for life sustaining treatment (POLST) came about in 1995. This document is utilized by healthcare providers for patients’ preferences concerning their care, cardiopulmonary resuscitation (CPR), and hospital transfer. This document is important if the patient is continuing care across many

Some people in the public, and especially RNs and nursing students, know exactly what a DNR is. They know that this means once a person experiences a cardiac and/or respiratory arrest, they are not to be resuscitated. In a policy from IU Health North Hospital (2016), the following treatments are to be withheld in the case of a respiratory and/or cardiac arrest when the patient has a signed DNR: chest compressions, start of ventilation support, endotracheal intubation, electrical countershock, cardiac pacing externally, and/or bolus administration containing antiarrhythmic, vasopressors, or inotropes. There is an exceptions section to the policy that states that “DNR orders are generally suspended in anesthetizing locations” (IU Health North Hospital, 2016, p. 4). It is noted that any existing directives need to be discussed with the patient when possible. It is important to view all aspects to this ethical issue to be able to see the entire picture of it. This includes looking at what is currently done, the opinions of patients and physicians, along with looking at policies from the American Society of Anesthesiologists along with the American College of Surgeons.

The articles demonstrate that more protocols should be in place to begin mobilization of the Intensive Care Unit patient. The current practices are based upon physician orders, early mobilization is often overlooked for a variety

A Do not resuscitate (DNR) order is a legal document written by a licensed physician, which is developed in consultation with the patient, surrogate decision maker, and attending physician. This document indicates whether the patient will receive resuscitative care, cardiopulmonary resuscitation (CPR), or advanced medical directives, in the setting of cardiac and/or respiratory arrest. A DNR can also be referred as a no code when identifying a patient’s resuscitation status. If a patient has an existing DNR it allows the resuscitation team, taking care of the patient, to either withhold or stop any resuscitation measures, and therefore respect the patient’s wishes. Historically, DNR orders did not become active in the care of patients until 1974, when it was identified that patients who received CPR, and survived, had significant morbidities (Braddock & Derbenwick-Clark, 2014). Braddock and Derbenwick-Clark further noted, the American Heart Association (AHA) recommended that physicians, in consultation with the patient, family, and or surrogate, place on the patients chart when CPR was not indicated. This documentation is now what we refer to as the DNR order and has become the standard to allow autonomous respect for patients, and their families, to make informed medical decisions. Therefore, the purpose of this paper is to discuss the legal aspects, ethical issues, and the application surrounding the DNR order.

Patients that need intensive care are more than likely to decline in health do to the substitute not know how to care for the patient. Nurses

Furthering nursing research is essential, as it forms the basis for evidence-based practice in healthcare today. With this in mind, developing the skills to critically appraise research articles is of the utmost importance in order to determine the relevance of research findings for clinical practice. As I pursue a doctorate degree in nursing practice, I am reminded of the necessity of these skills. Thus, in the following paragraphs, I will reflect on the research goals I developed at the beginning of the Critique and Design of Nursing Research course, and will discuss my views on the role of the graduate nurse in regard to