What You Need to Know About Hospital Policies on DNR Orders
In the midst of the over-flooding news about COVID-19, there have been recent discussions concerning hospital policies regarding Do Not Resuscitate Orders (hereinafter referred to as “DNR orders”).
Understanding DNR Orders
Brigham Health describes DNR orders as, written instructions from a physician telling health care providers not to perform Cardiopulmonary Resuscitation (CPR). CPR uses mouth-to-mouth or machine breathing and chest compressions to restore the work of the heart and lungs when someone’s heart or breathing has stopped. It is an emergency rescue technique that was developed to save the life of people who are generally in good health. If you do not have a DNR orders, health care providers will begin CPR in an emergency.
CPR and COVID-19
COVID-19 is spread by:
coming into close contact with an already infected person;
respiratory droplets when an infected person coughs, sneezes or talks;
touching a surface that has the virus on it and touching your mouth, nose and eyes.
To perform CPR to COVID-19 patients, medical professionals literally expose themselves to potentially contracting the virus. “The concerns are not just about health-care workers getting sick but also about them potentially carrying the virus to other patients in the hospital.”
Northwestern Memorial Hospital in Chicago has been discussing a do-not-resuscitate policy for infected patients, regardless of the wishes of the patient or their family members.
Atrium Health in the Carolinas, Geisinger in Pennsylvania and regional Kaiser Permanente networks are looking at guidelines that would allow doctors to override the wishes of the coronavirus patient or family members on a case-by-case basis due to the risk to doctors and nurses, or a shortage of protective equipment, but would stop short of imposing a do-not-resuscitate order on every coronavirus patient.
Lewis Kaplan, president of the Society of Critical Care Medicine and a University of Pennsylvania surgeon described the new protocols are part of a larger rationing of lifesaving procedures and equipment including ventilators that is quickly becoming a reality here as in other parts of the world battling the virus.
George Washington University Hospital Officials are having similar conversations, but for now will continue to resuscitate COVID-19 patients using modified procedures, such as putting plastic sheeting over the patient to create a barrier.
The University of Washington Medical Center in Seattle is dealing with the problem by severely limiting the number of responders to a contagious patient in cardiac or respiratory arrest.
Hospital Policies and Medical Malpractice
Though there have not been any official changes to hospital policies regarding COVID-19 and DNR orders, one must wonder what actions are medical professionals taking on the ground level, when supplies are low, fear is running rampant, and there is no end in sight.
What should I do if I suspect CPR was not performed on my loved one?
Should you believe that life saving measures were not taken to save someone you love who may be a COVID-19 patient, here are some options to consider:
Ensure hospital documentation does not reflect DNR orders unless it is the patient’s wishes;
Notify a Hospital Official about the alleged failure to save;
Notify The Illinois Department of Financial and Professional Regulation;