Original Research: Nurses' Perspectives on Caring for Patients with Do-Not-Resuscitate Orders

Area of Science:

• Nursing
• Medical Ethics
• Patient Care

Background:

• Misinterpretation of do-not-resuscitate (DNR) orders as "do not treat" is well-documented.
• Limited research exists on nurses' perspectives regarding DNR orders.

Purpose of the Study:

• To explore nurses' perspectives on the meaning and interpretation of DNR orders.
• To examine how DNR designations influence the care of hospitalized adult patients.

Main Methods:

• Mixed-methods study involving a case study survey and open-ended interviews.
• Direct care nurses responded to a case study on prioritizing care for DNR patients.
• Interviews were conducted, audio-recorded, transcribed, and analyzed.

Main Results:

• Nurses frequently prioritized palliative care for DNR patients, irrespective of existing care plans.
• Analysis revealed common, varying interpretations of DNR orders among nurses, leading to unintended consequences.
• Perceived variances in understanding among healthcare teams, patients, and families were reported, causing care shifts and tension.

Conclusions:

• Nurses can address DNR misconceptions through practice, education, advocacy, policy, and research.
• Improving understanding of DNR orders is essential for consistent and appropriate patient care.