ans this pls.tnx..?!
Question:
the patient has cardiopulmonary arrest and refuses resuscitation. the patient is competent. and the doctor refuses to write a "do not resuscitate order" tha nurses are concerned over what is right to do if the patient has a cardiopulmonary arrest.
Answers:
this is a tricky one, is this an NCLEX question? do you know the answer? or did you just make this scenario up?
I don't know, I have never had a question like this before. I will try to find out.
Other Answers:
consult the patient's family members
If the patient is capacitated to understand the situation and make a decision, that decision has to be respected. There is no legal recourse to consult the family members. If the patient verbally expressed a preference against resucitation, that's the end of the story. It's not only unethical to contradict them, it's illegal.
A patient in cardiopulmonary arrest cannot refuse treatment because he is in cardiopulmonary arrest.
Before the patient codes the nurse should consult her supervisor so that the hospital's legal and ethics staff may be involved.
The physician's refusal to write a DNR may be something that needs to be taken up with the medical staff committee and that is the responsibilty of the legal & ethics departments as well as the chief of staff.
However if there is any ambuguity a nurse should code using the implied consent of the unconscious patient.
Without a DNR order, we have to resuscitate. If a family member with power of attorney is close by, he/she can call off the resuscitation and the doctor will have to respect this decision. IF advanced directives are located in the chart, we still have to resuscitate {{{IF}}} the doctor has NOT written the DNR order. That order has to be written by the doctor and usually is if the patient was competent when the AD was written. Usually the doctor will write the order. What has happened where I work is the start of resuscitation, while someone calls the pt's physician to get direction. The advanced directives from the pt were in the chart but there was no Dr's order. Most often this happens when the doctor "forgot" to write the DNR order.
Answers: