Printable Do Not Resuscitate Order Template

One common mistake made when filling out the Do Not Resuscitate (DNR) order form is not ensuring that the patient's name is spelled correctly. Accuracy is paramount because any discrepancy in the patient's name can lead to confusion and potentially delay the implementation of their wishes during critical moments. This could result in unwanted medical interventions that go against the patient's preferences.

Another error often encountered is neglecting to date the form. The date provides essential information regarding the recency and relevance of the directive. Without this, healthcare providers may question the validity of the DNR order, which could lead to unnecessary confusion or disputes among family members or between the healthcare team and the patient's advocates.

Moreover, some people mistakenly believe that a DNR order doesn't need to be signed by a witness or a healthcare provider. However, the presence of these signatures authenticates the document, ensuring that the patient's decision was made voluntarily and with an understanding of the consequences. Lack of proper authorization may invalidate the document, undermining the patient's autonomy.

Additionally, failing to communicate and share the DNR order with family members and healthcare providers is a significant oversight. If the document is not readily accessible or if key individuals are unaware of its existence, the patient's wishes may not be honored in an emergency situation. Discussing and distributing copies of the DNR order can ensure everyone involved understands the patient's preferences.

Not checking state-specific requirements is another frequent oversight. Each state may have different laws and forms for DNR orders. Assuming that a generic DNR form will be universally accepted could lead to non-compliance issues, and, as a result, the DNR order may not be legally recognized or respected.

Some individuals mistakenly fill out a DNR order thinking it covers all forms of medical intervention. In reality, a DNR order specifically addresses the non-initiation of cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. Other life-sustaining treatments such as mechanical ventilation, feeding tubes, or antibiotics require separate directives. Misunderstanding the scope of a DNR can create uncertainties about the patient's wishes concerning other medical treatments.

Finally, neglecting to review and update the DNR order is a critical mistake. As a person's health status or personal preferences change, so too might their wishes regarding resuscitation and other treatments. Regularly revisiting and, if necessary, revising the DNR order ensures that it remains an accurate reflection of the patient's current choices, thereby guiding healthcare providers in aligning their actions with the patient's desires.

When the time comes to make important health care decisions, many people choose to prepare documents that clearly state their wishes. One such document is the Do Not Resuscitate (DNR) order. This form is vital for those who wish to withhold CPR (cardiopulmonary resuscitation) in the event their heart stops or they stop breathing. However, a DNR is just one part of a comprehensive approach to end-of-life planning. Several other forms and documents often accompany a DNR to ensure that all aspects of a person's health care and personal wishes are clearly understood and respected.

• Living Will - A living will, unlike a DNR, provides broader directives about a person’s health care preferences, including the types of life-sustaining treatments they would or would not want if they're unable to make decisions for themselves.
• Power of Attorney for Health Care - This document designates a person, often called a health care proxy or agent, to make medical decisions on behalf of the individual if they are incapable of doing so themselves. It’s crucial for ensuring that someone trusted can make decisions aligned with the patient’s values and wishes.
• Physician Orders for Life-Sustaining Treatment (POLST) - Similar to a DNR, yet more comprehensive, a POLST form provides specific instructions for health care providers about other life-sustaining treatments besides CPR, such as intubation or feeding tubes, based on the patient's current health status.
• Medical Orders for Scope of Treatment (MOST) - This is another form similar to POLST, used in some states, that outlines a range of treatment options, from full intervention to comfort care only, based on the patient’s wishes.
• Advance Directive - Serving as an umbrella term, an advance directive can include a living will and a power of attorney for health care. It's a comprehensive document that details the types of medical care a person wants at the end of their life or if they're not able to communicate their desires.

Together, these documents create a framework that ensures individuals' health care wishes are known, respected, and followed. By taking the time to complete these forms and discuss them with loved ones and health care providers, individuals can have peace of mind knowing that their preferences will be honored during critical times. It’s all about maintaining dignity, control, and comfort at the end of life.

A Living Will is closely related to a Do Not Resuscitate (DNR) Order in that it communicates a person's wishes regarding medical treatment when they're unable to make decisions for themselves. While a DNR specifically addresses the use of CPR or advanced cardiac life support, a Living Will can provide instructions on a range of treatments, including life support, hydration, and feeding methods. Both documents are proactive steps to ensure an individual's healthcare preferences are known and respected.

A Medical Power of Attorney (Healthcare Proxy) document resembles a DNR Order as it appoints someone to make healthcare decisions on behalf of an individual if they become incapacitated. The fundamental similarity lies in their purpose to honor the healthcare preferences of the individual. However, whereas a DNR is a direct instruction not to perform CPR, a Medical Power of Attorney encompasses a broader range of medical decisions and does not necessarily include instructions regarding resuscitation.

An Advance Directive is another document similar to a DNR in its function to guide medical care when an individual cannot communicate their wishes. It combines elements of both a Living Will and a Medical Power of Attorney, covering an individual’s treatment preferences and appointing a decision-maker. Like a DNR, it is a key part of planning for end-of-life care, though it is more comprehensive in scope.

The Physician Orders for Life-Sustaining Treatment (POLST) form mirrors the intent of a DNR by providing specific instructions regarding a range of life-sustaining treatments, including resuscitation. Signed by both the patient and their physician, the POLST form is recognized in many states and is effective immediately upon completion. It is designed for seriously ill or frail individuals for whom health care professionals would not be surprised if they died within a year.

A Patient Designation of Another to Consent form shares the purpose of ensuring a person's medical care preferences are upheld, similar to a DNR. By designating another person to make healthcare decisions, this document functions similarly to a Medical Power of Attorney, yet it is more limited in scope focusing on consent for general medical procedures rather than end-of-life decisions. It's a safeguard for scenarios where an individual's decision-making capacity is in question.

Emergency Medical Information forms, which provide critical health care instructions and information to emergency responders, have similarities to a DNR. These forms can include a DNR order or specify conditions like allergies, medications, and chronic conditions, ensuring that first responders can provide appropriate care. The key similarity lies in their role in informing immediate medical treatment based on the patient's conditions and preferences.

A HIPAA Authorization Form, while primarily focused on privacy, indirectly relates to a DNR by controlling access to one’s medical records and sharing information about their health status. By specifying who can receive health information, it can ensure that healthcare proxies or family members are informed about the patient's wishes, including DNR status, which is crucial for making informed decisions on the patient’s behalf.

An Organ and Tissue Donation Form is connected to a DNR in the context of end-of-life planning. While a DNR focuses on the refusal of life-sustaining treatments, the donation form specifies an individual's intentions regarding the donation of organs and tissues after death. Both forms address an individual's wishes for what happens to their body, one during potential life-saving situations, and the other post-mortem.

Last Will and Testament documents, though traditionally focused on the distribution of assets and the care of dependents, indirectly tie to the concept of a DNR through the broader scope of end-of-life planning. They facilitate expressions of a person's wishes upon death, including funeral arrangements and, in some cases, may reflect on the person’s health care preferences. Both serve to ensure that an individual’s wishes are respected and followed in critical moments.

When filling out the Do Not Resuscitate (DNR) Order form, there are specific steps to follow and pitfalls to avoid. These guidelines ensure the intentions are clear and legally recognized. Following these do’s and don’ts will help in accurately completing the form.

Do's:

1. Read the entire form carefully before filling it out to understand every section completely.
2. Ensure that the patient's name, date of birth, and other personal information are correctly spelled and filled in.
3. Discuss the DNR order with family members and the healthcare power of attorney to ensure they understand the patient's wishes.
4. Have the DNR order signed by the required parties, which typically include the patient or their legal representative and the attending physician.
5. Consult with a healthcare provider to make sure the form reflects the patient’s current medical condition and wishes accurately.
6. Keep the original DNR order in an easily accessible place at home, and consider giving copies to relevant family members.
7. Provide a copy of the completed DNR form to the patient’s healthcare provider to include it in their medical record.
8. Review and update the DNR order as the patient’s health condition changes or at regular intervals to ensure it reflects current wishes.
9. Use clear and decisive language to prevent any possible ambiguity regarding the patient’s wishes.
10. Ensure that any modifications or revocations of the DNR order are properly documented, signed, and witnessed as required.

Don'ts:

• Don't leave any required sections of the form blank.
• Don't use unclear or vague language that could lead to misinterpretation of the patient’s wishes.
• Don't forget to notify and provide updated copies to all relevant parties if the DNR order is modified or revoked.
• Don't fail to discuss the implications of a DNR order with the patient (if able) and their family to ensure they fully understand the decision.
• Don't assume that the DNR is universally understood and will be honored in all settings without providing proper documented evidence.
• Don't overlook state-specific requirements or forms that might be necessary in addition to the standard DNR form.
• Don't keep the DNR order in a place where it is difficult for emergency personnel to find in a time of need.
• Don't neglect to review and update the form regularly or as the patient’s health condition evolves.
• Don't hesitate to seek legal advice if there are any uncertainties about how to properly complete or implement the DNR order.
• Don't disregard the necessity of a witness or notary signature if it is required by the state’s law.

Do Not Resuscitate (DNR) Orders are surrounded by a wide range of misconceptions. These misunderstandings can affect decisions and emotional responses related to end-of-life care. Here, we aim to clarify the most common misconceptions to foster a better understanding of DNR Orders.

• Misconception #1: DNR means no medical treatment. A DNR order specifically addresses the issue of not performing CPR if a person's heart stops or they stop breathing. It does not mean the person will be denied other types of medical treatment.
• Misconception #2: DNR orders are permanent and cannot be changed. DNR orders can be revoked or modified at any time by the person or their legally authorized representative.
• Misconception #3: Only elderly people need DNR orders. Individuals of any age with serious health conditions may consider a DNR order. It's based on health status, not age.
• Misconception #4: DNR means "do not treat." DNR orders only apply to CPR, not to other treatments such as antibiotics, pain medicine, or nutrition.
• Misconception #5: A DNR order must be initiated by the patient. While a patient can request a DNR order, it can also be suggested by a healthcare professional or initiated by a healthcare proxy or family member if the patient is unable to make their own decisions.
• Misconception #6: DNR orders are only for people with terminal illnesses. While often associated with terminal illness, DNR orders are also relevant for people with significant health conditions where CPR would not provide a meaningful benefit or might even cause harm.
• Misconception #7: DNR orders are the same in every state. The requirements and procedures to establish a DNR order can vary significantly from one state to another. It is important to understand and follow your state's specific guidelines.
• Misconception #8: DNR orders mean you will die alone. A DNR order doesn't affect the presence of loved ones or medical staff at the time of passing. It solely pertains to the medical interventions used.
• Misconception #9: If you have a DNR, you can't be admitted to the hospital. People with DNR orders are admitted to the hospital for various reasons. The DNR order specifically guides actions in the event of a cardiac or respiratory arrest, not general care or hospital admission.
• Misconception #10: DNR orders take away hope. A DNR order is a personal and medical decision that reflects a patient's values and desires for their end-of-life care. It does not signify giving up but respects an individual's wishes regarding the nature of their care.

Understanding the facts about Do Not Resuscitate orders is crucial for making informed decisions about end-of-life care. It ensures that the care aligns with personal values and medical realities, all while preserving dignity and respect for the individual’s choices.

A Do Not Resuscitate (DNR) Order form is a critical document in managing one's end-of-life care preferences. Here are six key takeaways about filling out and using this form:

• Consult with a healthcare provider: It's important to discuss your health status, understand the implications of a DNR order, and ensure it aligns with your wishes for end-of-life care.
• Clear expression of wishes: A DNR Order form allows individuals to make their wishes known regarding not receiving cardiopulmonary resuscitation (CPR) in the event of a cardiac or respiratory arrest.
• Legal validity: To ensure the DNR Order is legally valid, it must be properly filled out, signed, and, in many states, witnessed or notarized. The requirements can vary, so it's crucial to be familiar with specific state laws.
• Accessibility: Once completed, the DNR Order should be kept in an easily accessible place. Inform family members, caregivers, and potentially even local emergency services of its existence and location.
• Review and updates: Life circumstances and health conditions change. As such, it's important to review the DNR Order periodically and update it if your wishes or health situation changes.
• Impact on other medical treatments: Understanding that a DNR Order specifically pertains to not receiving CPR is important. It does not affect other forms of medical treatment. You can still receive treatments for pain relief, infection, or other preferences unless stated otherwise in an Advance Healthcare Directive.