DNR stands for do not resuscitate, or do not provide measures that will revive someone's heart if it has stopped beating. The DNR paperwork is commonly called "The MOST" (Medical Order for Scope of Treatment).
The MOST form is essential because it tells medical providers what you would like done if your heart stops. By default, or without a doctor signed MOST form, the medical team will do everything they can to restart your heart. Everything includes CPR, medications, and advanced airway.
You can make the order more detailed to your own specific preferences. For example, you may say YES to chest compressions, but NO to medications or intubation. There are medical, religious, spiritual, personal reasons to be Full code, DNR or partial DNR; you just need to decide what is right for you.
Tips For Filling Out a MOST Form or DNR
Your preferences around treatment may change over time, so it is important to know that you can change or rescind your DNR any time until your heart stops.
You should keep copies in places where it can be reached easily in an emergency. Examples include the refrigerator door, a glove box, or a purse.
One way to let providers know to look for a MOST form is to wear a medical bracelet that says DNR. The bracelet itself does not count as the Medical DNR order, but it does let people know you have one and they should look for it before providing treatments.
People other than you should know where your MOST form is.
Medical providers are used to seeing a green MOST form, so be sure to print it on green paper, so people can quickly locate it when it’s needed.
You can obtain a MOST form at your Doctor’s office and fill it out with them.
Once you understand what a MOST form is and why it is important, you will need to fill the form out, making decisions that are informed and true to your wishes and beliefs around death and dying.
Understanding CPR
There are things about CPR that every Nurse and Doctor wish their patients understood.
CPR is brutal. The medical team will crack and break your ribs to pump the heart enough to pump your blood to the organs that need oxygen to survive.
If resuscitation is successful, and we restart your heart, organs that haven’t received a good supply of oxygen for 4 minutes start to shut down and the damage to those organs (including the brain) can be permanent.
Patients who are younger and healthier are more likely to survive and make a full recovery.
Often we have to perform CPR again within hours or days.
CPR is the best method we have for restarting someone's heart.
It is vital to understand the whole picture and what each choice means.
Allow a Natural Death
On a final note, the term Do Not Resuscitate sounds like providers are withholding care from their patients. This is not how we want “end of life” to be perceived for any one. A person deserves the best care up to and through the end of life. There is a movement to switch from “Do Not Resuscitate” to “Allow a Natural Death”. The new term better illustrates the goals around a DNR for a person. For example, the goal is never to end life or prevent comfort measures of treatments for symptom management, but instead allot a more comfortable and dignified passing for a patient.