Clients often ask me, “What is a DNR and do I need one?” A DNR, which is short for Do Not Resuscitate Order, is a form that was developed by the Florida Department of Health to signify that a person does not want to be resuscitated if he or she goes into respiratory or cardiac arrest, i.e. he or she does not want to have CPR performed. The DNR Form is important because paramedics and EMS personnel are required by law to resuscitate a patient to the point that the vital signs are stabilized before transporting the patient to the hospital or before the patient is released from the Emergency Room to another bed in the hospital. The paramedic or EMS personnel must still perform CPR, even if the patient has a living will.
To be valid, the DNR form must be printed on yellow paper and have the words “Do Not Resuscitate Order” printed in black on the top of the form. The Department of Health Form 1896 may be used or it may be copied and duplicated, as long as the content of the form is not altered and it is on yellow paper. The DNR form can be signed by the patient, health care surrogate, health care proxy, court-appointed guardian, or a person acting under a Durable Power of Attorney. In addition, the DNR form must be signed by the patient’s physician. DNR forms are generally signed when the patient is suffering from a terminal condition, end-stage condition, or is in a persistent vegetative state.
There is also a patient identification devise that is a miniature version of the Form 1896. At the bottom of Form 1896, there is an area that can be perforated or cut out, laminated, then hole-punched and place on a chain to be worn by the patient. Use of patient identification devise is voluntary and is intended to be a convenient way for the DNR form to follow the patient.
The DNR desire will only be honored if the paramedic and/or EMS personnel know that the patient has a DNR form and can inspect it. So, it is important to keep the DNR form in a place where the paramedic or emergency technician will know to look. Although the law does not state a place where the DNR form must be, some common placements would include on the patient’s refrigerator, the bedroom door, the wall by the bed and the bed post.
DNR forms are honored in doctor offices, hospitals, hospices, adult family care homes, ER departments, nursing homes, assisted living facilities, home health agencies, and at home. DNR forms from other states will not be honored in Florida.
DNR forms may be revoked by the patient, if signed by the patient, or by the patient’s health care surrogate, health care proxy, durable power of attorney, or guardian. The DNR form can be revoked by a written statement, or physically destroyed, or by the failure to present it, or by verbally expressing the contrary intent.
So, if you or a loved-one are suffering from a terminal condition, an end-stage condition, or in a persistent vegetative state, talk to your doctor about whether it is time to sign a DNR or if you even want one.
At Osterhout & Mckinney, we help clients and their families with end of life decisions. Call us at (239) 939-4888.