The Effect of a “Do Not Resuscitate” (DNR) Status on Patient Care: A Descriptive Survey on the Perceptions of ICU and Medical/Surgical Nurses

Authors

  • Joria Rainbolt Clemente Irvine Medical Center
  • Patrick Hess, DNP, RN-BC, CEN Orange County-Irvine Medical Center
  • Cyr Oca, BSN, RN Orange County-Irvine Medical Center, Southern California
  • Mary Raphael, MSN, RN, CCRN-K, CNML Orange County-Irvine Medical Center
  • Regina M. Valdez, MA Kaiser Permanente, Southern California
  • Felicia Cohn, PhD, HEC-C Orange County-Irvine Medical Center, Southern California
  • June Rondinelli, PhD, RN, CNS Kaiser Permanente, Southern California https://orcid.org/0000-0002-9448-3060

DOI:

https://doi.org/10.29173/ijcc62

Keywords:

Do not resuscitate, DNR, nurses' perceptions, resuscitation orders

Abstract

Background: Nursing research literature demonstrates a persistent concern regarding how nurses interpret “Do Not Resuscitate” (DNR) code status.

Aim: The aim of this study was to assess nurses’ perceptions of the effect of a DNR code status on patient care.

Methods: This study was a cross-sectional, descriptive survey offered to all clinical nurses in the Medical, Surgical, Telemetry, Critical Care, and Emergency Departments within one urban community hospital in Southern California, USA.  Descriptive statistics were used for demographic data and individual question analysis, which included frequency and percentages for categorical variables in addition to means with standard deviation for continuous data. Open- ended questions received content analysis.

Results: This study resulted in a convenience sample of 120 registered nurses (RNs). Greater than 95% of nurses who completed the survey agreed that nursing care should continue until patient death.  Yet when asked about physiologic, demographic, chronic, or cognitive status, participants answered with varying degrees of certainty about the care that should be provided.

Conclusions: Further research is needed to explore the inconsistency in nurses’ understanding of the care provided to a patient with DNR status. There may be opportunities to improve consistency in practice with education or protocols to outline optimal care of a patient with DNR orders.  

 

Author Biographies

Joria Rainbolt Clemente, Irvine Medical Center

Clinical Nurse Specialist at Orange County-Irvine Medical Center, Southern California.

Patrick Hess, DNP, RN-BC, CEN , Orange County-Irvine Medical Center

Clinical Informatics Specialist II, Orange County-Irvine Medical Center, Southern California

Cyr Oca, BSN, RN , Orange County-Irvine Medical Center, Southern California

Nurse for Mary Care, Orange County-Irvine Medical Center, Southern California

Mary Raphael, MSN, RN, CCRN-K, CNML , Orange County-Irvine Medical Center

Assistant Department Administrator, Critical Care Department, Orange County-Irvine Medical Center,  Southern California

Regina M. Valdez, MA, Kaiser Permanente, Southern California

Senior Research Analyst, Regional Nursing Research Program, Kaiser Permanente, Southern California

Felicia Cohn, PhD, HEC-C, Orange County-Irvine Medical Center, Southern California

Medical Bioethics Director, Orange County-Irvine Medical Center, Southern California

June Rondinelli, PhD, RN, CNS, Kaiser Permanente, Southern California

Nurse Scientist and the Regional Nursing Research Program Director (retired), Kaiser Permanente, Southern California Region

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Published

2023-07-27

How to Cite

Rainbolt Clemente, J., Hess, P., Oca, C., Raphael, M., Valdez, R., Cohn, F., & Rondinelli, J. (2023). The Effect of a “Do Not Resuscitate” (DNR) Status on Patient Care: A Descriptive Survey on the Perceptions of ICU and Medical/Surgical Nurses. International Journal of Critical Care, 17(2), 39–53. https://doi.org/10.29173/ijcc62