Exclusion of nurses from do-not resuscitate (DNR) decisions
Nurses play a vital role in the process of making do-not resuscitate (DNR) orders, but findings from a number of studies suggest that they have very limited involvement in the decision making. People are uncertain about the abilities of nurses to initiate discussions with patients and their families regarding DNR orders as stated by Hosaka et al., 1999 and Sulmasy et al., 2008, in their studies. Such an order instructs medical staff and nurses to refrain from performing Cardiopulmonary Resuscitation (CPR) on the patient in the event of cardiovascular or respiratory arrest. They are a significant part of contemporary medical practice but more often than not, nurses who are responsible for patients with a DNR order are often excluded from participation in the DNR decision, yet the same nurses may be required to provide care at the time of DNR implementation. While there are many who insist that such decisions should be taken by physicians only, there are many others who feel that nurses must be involved in the planning and implementation resuscitation decisions, a position also supported by the American Nurses Association (ANA). Some believe that nurses should be excluded from DNR decisions due to the perception that, they do not have the requisite experience and also their responsibilities should be restricted to nursing alone. On the other hand, as stated by Edmond, 2008, there are others like me who think that most physicians support the view nurses should be involved in DNR decisions, and that nurses often know their patients better than anyone else and also seem sufficiently confident and agreeable about this task. The question then arises as to whether these reasons are enough to either include or exclude nurses from DNR discussions and decisions. My belief is that nurses should be involved in all the stages of resuscitation decisions, to help improve DNR dilemmas.
Many argue that nurses...