Thank you so much. Great work. I received full credit for my portion of this group assignment. Please continue to keep up the great work and help me as much as possible.
I will pay for the following article Identify a researchable problem in long term care using practical examples and citing from literature. The problem refers to whether a patient’s DNR status should deny them emergency treatment. The work is to be 2 pages with three to five sources, with in-text citations and a reference page. Whether a patients DNR status should deny them emergency treatment? A patient’s Do-not-resuscitate (DNR) status is meant to prohibit the health careprofessionals including doctors and nurses to attempt any emergency treatment like cardiopulmonary resuscitation (CPR) even if physical health status becomes dangerous and the heart rate dwindles. Like euthanasia and prohibition of blood transfusion for Jehovah’s witnesses, the DNR request has also attracted much controversy in the healthcare field. It is not just a request, but a legal order on behalf of the patient to stop the medical personnel from performing an emergency procedure like CPR on him/her even if cardiac arrest is likely otherwise. A DNR does not become an obstacle in the way of most medical treatments like dialysis, surgery, chemotherapy etc. However, any emergency procedure which would consist of intubation or CPR is not allowed and patients with DNR status are denied that.
Though each state in the US has differing rules and regulations, both CPR and advanced life support are not performed if there is an explicit DNR request confirmed by law. It is considered important that “a full discussion of the DNR order should be undertaken” (Norman, 2010) before advancing to surgery. But the way things are done is different in the prehospital settings and in many US states, a DNR order is not followed during the period when a patient is being transferred to the hospital from the site of trauma. Prehospital medical personnel in such cases starts resuscitation measures and does not deny a patient proper cardiac life support based on intubation and CPR. In contrast to Canada and US where DNRs are respected in healthcare setups by doctors and nurses, it is claimed by a Jordanian medical student that there is no concept of DNRs in Jordan and rest of the Middle East and also the family is denied the right to observe resuscitation in the OR. It is always tried to save a patient’s life even if emergency measures taken antagonize the patient’s will (Yousef, cited in Jimenez, 2009). There are some conditions specified by the US law when a patient’s DNR status should not deny them emergency treatment. This is when, among other conditions, there is sufficient evidence suggesting cancellation of the DNR order. Also, when a patient him/herself wishes for resuscitative or emergency measures or he/she is not in a state to make a conscious decision and it is requested by a family member to initiate emergency procedures, the DNR form is ignored (New York Department of Health, 1999). However, if a patient shows a DNR personally or a family member presents it and it is absolutely valid, no chest compressions or ventilation procedures are allowed. Even if the patient is choking on something and breathing stops consequently, a DNR form suggests that still “ventilation should not be assisted” (New York Department of Health, 1999).
Concluding, DNR documents are not respected worldwide on equal basis because in the Middle East and most of Asia, physicians and nurses attempt to save the patients’ lives regardless of their personal wishes or legal orders. Full responsibility is on the doctor’s shoulders to operate in a patient’s best interests and CPR or intubation is included whenever necessary because saving a life is considered most important. More importance is attached to DNRs in the US and Canada where patients are denied emergency treatments if a valid DNR form is presented.
Jimenez, M. (2009, Aug 19). Mideast med-school camp: divided by conflict, united by profession. THE GLOBE AND MAIL. Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/mideast-med-school-camp-divided-by-conflict-united-by-profession/article4282750/
New York Department of Health. (1999). Frequently Asked Questions re: DNR’s. Retrieved from http://www.health.ny.gov/professionals/ems/policy/99-10.htm
Norman, G.V. (2010, Oct 22). Do-Not-Resuscitate Orders during Anesthesia and Urgent Procedures. Retrieved from http://depts.washington.edu/bioethx/topics/dnrau.
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