Advance directives, Do not Resuscitate question for nurses.?

PATIENT, NOT CLIENT. Lawyers have clients. We have patients.

Your job is to call the physician, IMHO. There may be issues that have not been discussed with you, or interventions that do not constitute resuscitation but that may be indicated. Also, only physicians can pronounce a patient dead.

For God's sake, get past the client thing. Patients.

Client is actually the preferred term to patient. Patient is considered to be somewhat derogatory - client is a gentle reminder that the person is a customer of our services. Patient is also considered paternalistic. I'm sure people still do use the term patient, but I think client is a bit more respectful.

Doctors are not the only ones who can pronounce. I'm sure it may vary from state to state, but RNs can often pronounce, as well.

Yes, privacy would be a good thing at this point. Definitely getting the charge nurse involved would be helpful. The family should be notified. If your scenario describes the client as a DNR, I wouldn't second guess it. However, it's good practice to verify code status when coming on shift in "real life" - there should be signed paperwork in the chart. This way if something does happen, you're not scrambling around trying to figure out what to do/not do.

I'm not a nurse, but I would tell the news to my superior nurse/or attending physician. The physician has better knowledge of the clinical chart and hopefully knows about the DNR order and the head nurse has more clinical experience and would be able to take care of affairs calmly without showing a scene.

If you're not 100% this person signed it, better warn people above you who will take the appropriate case of action instead of leaving someone alone and by accident confused the patient that's in arrest with someone else that signed the DNR. Better to seem clumsy asking help from your superiors for everything than to kill someone (even if it isn't intentional).

Draw the curtain and close the patient's eyes, if they are open. the patient may be moved onto the bed. Notify the patient's physician. If he/she is unavailable, often another physician available within the hospital will be brought in to pronounce the patient dead. The family is then notified, and the patient is prepared for viewing by the family, if they wish to come to say their goodbyes, as they often do. Once the family has come and gone, the patient is prepared for the morgue, or in some cases to be immediately transported by a funeral service.

If the patient is DNR then you need to contact the doctor as he/she is the one that has to pronounce the patient dead and do the subsequent paperwork and notification of the family. The charge nurse should also be alerted as he/she can help you contact the doctor and then help contact the family and involve pastoral care or social work.

I dont think nurses make that decision, but they do make decisions about the urgency of treatment and that is called Triage. A person requiring resuscitation would be given the highest priority by a nurse, a doctor would make the decision of when to pronounce.