To code or not to code??

Something that is surprising and interesting about nurses is how we react to our patients not being a DNR.  This was came up one day that I worked last week.  I was getting morning report on a 90 something year old patient who had been sent down to ICU three different times in the past two weeks or so because she isn’t getting enough oxygen to her body.  Her O2 stats keep steadily dropping no matter how much oxygen we pump into her lungs.  Surprisingly she was not a DNR.  I was flabbergasted.  Now, don’t get me wrong, I think everyone has the right to decide if they want to be resuscitated or not.  But, coding someone is rough.  Bones break, lungs can collapse.  Very few patients ever leave the hospital after needing CPR, at least at her age and state of health.  She was VERY sick and was going down hill.  At the time she was so out of breath she couldn’t even speak.  I would guess she weighed around 80 pounds, if that.  I’m not sure if it was her wishes to be coded, her families, or if her doctor refused to write the order.

The ironic thing was every other patient I had that day was a DNR, and all of them were in much better shape than her.  The only saving grace was that her family was always with her, and hopefully they would have told us to stop if we had started working on her.

I was very upset about her code status and was dreading getting out on the floor to start working.  It would have broken my heart if I would have had to code her and feel her ribs break under my hands while I did compressions.  Thankfully she made it through the shift with no incident.  The last I heard of her she was back down in ICU.