The Misunderstanding of DNR

DNR stands for “do not resuscitate,” which refers to the act of performing CPR on a patient. Although this seems to be clear, it is often misunderstood and poorly complied with by many doctors and hospitals around the world. So, how exactly is it misunderstood, and how can doctors better comply with this order?

In Memorial Hospital, DNR was misconceived by the doctors on the staff. When Hurricane Katrina struck in New Orleans, the hospital lost power, causing an immediate evacuation of the patients in this unexpected moment of terror. Throughout this experience, the doctors used triage, a system in which doctors decide the order of treatment for a large number of patients based on the urgency of their illness. However, when the doctors grouped the patients into three distinct groups according to their urgency, they placed those with DNR orders with the patients who were the sickest. Personally, I disagree with this action because I do not believe DNR should play a role in this decision. DNR does not have anything to do with the condition of the patient, which is solely what the grouping should be based upon. However, the hospital’s medical department chairman had other ideas: “He said that patients with D.N.R. orders had terminal or irreversible conditions, and at Memorial he believed they should go last because they would have had the ‘least to lose’ compared with other patients if calamity struck” (Fink). Thus, the doctors treated those with DNR orders as if they did not have the same level of desire to live as those who do not have DNR orders. Having a DNR does not necessarily mean that one does not want to live and has provided his or her consent to be euthanized. Rather, it means they do not wish to go on life support or experience a painful recovery. I believe doctors can better comply with DNR orders by completely disregarding it when it comes to triage systems. The fact that one’s medical records has these three letters on it should not imply anything whatsoever. Research has shown that the quality of care for those who have DNR orders significantly decreases, which is wrong, in my opinion. If doctors receive more training and gain more skills in understanding the true meaning of DNR, I believe they will be better equipped to handle triage situations similar to this in the future.

4 thoughts on “The Misunderstanding of DNR

  1. Lexi, I agree with you that DNR (do not resuscitate) is an area that doctors can improve in their decision making when crisis hits. The people who have this DNR on there profile are not saying that they want to die. The point of the DNR is that these people would rather pass away peacefully instead of being hooked up to a bunch of machines for the rest of their lives. However, with that being said doctors in a time of panic and terror have to have a plan. There needs to be some type thought and effort into their response. Even though, most of of us probably do not like to admit it, but there are going to be people who are on the shorter side of the straw in a time of crisis. A doctor’s job is to save people and they have to use their judgement in particular decisions. Trying to evacuate these patients might have been a worse choice for the patients. One of the doctors, Pou, describes the situation. “He said he thought they appeared close to death and would not have survived an evacuation” (Fink). Although it is unfortunate that these scenarios occur, we have to believe that these doctors did their best in trying to save as many people as they could. For if we do not believe them, then the whole hospital system will be broken.

  2. I agree that the impact of the three letters, D.N.R, was much greater than it should have been in the case of the decisions about who to save first in the hospital in New Orleans. I totally agree that just because the patient has a D.N.R on their medical record, it doesn’t mean they don’t want to be saved if they are not in near death situations where they will be in pain the rest of their lives and I think that was definitely a misinterpretation on the doctors part. For this reason I understand the controversiality of the decisions made by the doctors on this day and I think there are better strategies for ranking those to be saved first versus last.

    I think the most compelling part of your argument is that there should be a better understanding of what D.N.R means across the board. I also think that not only should the doctors understand, but the patients should have had the right to understand that by signing to have a D.N.R, in the case of an emergency like an evacuation, they would be placed into the last group to be saved no matter their status of illness. I think that choosing to let others be saved before yourself should be a whole separate indication on their medical records from a D.N.R which states that when in a situation in which “a patient whose heartbeat or breathing has stopped should not be revived.” We saw the issue with the lack of distinction with Wilda’s daughter. She had wished that the doctors would have made it clear that by choosing a D.N.R she was giving up her spot to be rescued even in a situation where her heart hadn’t stopped beating and she was still breathing. These two indications, not wanting to be saved when your body stops functioning and being rescued last in an evacuation would be very different from one another and I think that hospitals across the board should clarify what is meant by certain phrases so that everyone is on the same page.

  3. خزّاناتِ الأليافِ الزُّجاجيّةِ: تتسعُ تلك الخزّاناتِ من 50 جالوناً إلى 50.000 جالوناً، وتُستخدم لتطبيقاتِ ما تحت الأرضِ. خزّاناتِ البولي ايثيلين: تكون تلك الخزّاناتِ فوق الأرضِ. خزّاناتِ البولي بروبلين: تُعتبرُ تلك الخّزاناتِ من أكثرِ الخزّاناتِ شيوعاًظن وتمتازُ بأنها اقتصاديّةً للتّخزينِ فوق الأرضِ، وبالإضافة لذلك فإنّ حجمها يتراوحُ ما بين 12 جالوناً إلى 15.000 جالوناً، وهذه الخزّاناتِ متينةٍ وخفيفةِ الوزنٍ وطويلةِ الأمدِ. خزّاناتِ البولي ايثيلين في الأرضِ: تُعتبرُ تلك الخزّاناتِ أكثرُ كثافةً، وتمتازُ بأنّها خفيفةِ الوزنِ وتأتي بأحجامٍ عديدةٍ، وتوفرُ تكاملاً أكثرُ سلاسةٍ. خزاناتِ الخشبِ: تُستخدمُ هذهِ الخزّاناتِ في تخزينِ مياهِ الأمطارِ فوق الأرضِ، وكانت سابقاً مصنوعةٍ من الخشبِ الأحمرِ، وأمّا بالوقتِ الحاليّ فهي مصنوعةٌ من الصنوبرِ أو الأرزِ أو السّرو وملفوفةٍ بكابلات الصُّلبِ، ومُبطنة ببطانةٍ بلاستيكيّةٍ، وبالإضافةِ لذلك فإنّ هذهِ الخزّاناتِ تتّسعُ من 700 إلى 37.000 جالونٍ، ويوجدُ خزّاناتٍ مُخصّصةٍ تصلُ سعتها إلى 1.5 مليون جالونٍ. الخزّاناتِ المعدنيةِ: تُعتبر هذهِ الخزّاناتٍ خفيفةِ الوزنِ وسهلةِ النّقلِ، وإنّ مُعظم تلك الخزّاناتِ تتكونُ من الصُّلبِ المُجلفنِ المُغطّى بالزِّنكِ السّاخنِ لمقاومةِ التّاَكلِ.

    شركة عزل خزانات بالمدينة المنورة

  4. The subject of DNR has interested me since childhood. I also dreamed of becoming a doctor as a child. Now, I think I’m on the right way to realize my goal. I study at a university of medicine. It’s so hard and nothing else to add, but I love it so much that I can’t give up because of any obstacles. So I was already taught about the do-not-resuscitate order, which left me thinking a lot about the role of a doctor. Some doctors cannot accept this order. I also had some dilemmas on it. The epic point is that I get a homework on DNR. So I decided to consult this source for help. The APA paper writing service brought clarity to my mind and made me understand and be sure that patients receiving such orders have terminal or irreversible conditions. However, it is difficult to perceive such things. Then the ideas I received from the professionals guided my mind to take a concrete and fair view of DNR. I also got an A on my APA paper because my professor liked the work I submitted and said I have a great future in medicine.