Biomaterial Database

Deciding not to resuscitate. Responsibilities of physicians and nurses--a proposal. 1997

R Löfmark, and T Nilstun

Department of Medicine, Länssjukhuset, Gävle, Sweden.

After discussing the decision with the staff, physicians should investigate the conditions for a do-not-resuscitate (DNR) order, make the decision, and inform the patient and the family. But, according to the present and other studies, they are not taking the full responsibility for these tasks. Nurses are supposed to participate in the discussions with the physicians prior to a DNR decision, but not to make the decision or to inform the patient and the family. Physicians and nurses have different opinions about their legitimate roles when DNR orders are initiated and made. However, 8% of the nurses in the present study state that they have made a DNR decision and 37% declare that the nurse should do so. We propose a model where the skills of the responsible physician (to make the diagnosis and prognosis) and the skills of the responsible nurse (to communicate with the patients by virtue of their close relationship) are combined. Accordingly, future guidelines should stress the joint responsibility of physicians and nurses to investigate the conditions precedent for a DNR order, to make the DNR decision, and to inform the patients and the family.

UI	MeSH Term	Description	Entries
D007400	Interprofessional Relations	The reciprocal interaction of two or more professional individuals.	Etiquette, Medical,Medical Etiquette,Relations, Interprofessional
D007587	Job Description	Statement of the position requirements, qualifications for the position, wage range, and any special conditions expected of the employee.	Position Description,Description, Job,Description, Position,Descriptions, Job,Descriptions, Position,Job Descriptions,Position Descriptions
D008505	Medical Staff, Hospital	Professional medical personnel approved to provide care to patients in a hospital.	Attending Physicians, Hospital,Hospital Medical Staff,Physicians, Junior,Registrars, Hospital,Attending Physician, Hospital,Hospital Attending Physician,Hospital Attending Physicians,Hospital Medical Staffs,Medical Staffs, Hospital,Hospital Registrar,Hospital Registrars,Junior Physician,Junior Physicians,Physician, Junior,Registrar, Hospital,Staff, Hospital Medical,Staffs, Hospital Medical
D009741	Nursing Staff, Hospital	Personnel who provide nursing service to patients in a hospital.	Hospital Nursing Staff,Hospital Nursing Staffs,Nursing Staffs, Hospital,Staff, Hospital Nursing,Staffs, Hospital Nursing
D011361	Professional Competence	The capability to perform the duties of one's profession generally, or to perform a particular professional task, with skill of an acceptable quality.	Competence, Professional,Generalization of Expertise,Technical Expertise,Expertise Generalization,Expertise, Technical
D011795	Surveys and Questionnaires	Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions.	Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003657	Decision Making	The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.	Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012941	Social Responsibility	The obligations and accountability assumed in carrying out actions or ideas on behalf of others.	Obligation, Social,Responsibility, Social,Accountability,Communitarianism,Future Generations,Obligations to Society,Social Accountability,Accountability, Social,Future Generation,Generation, Future,Generations, Future,Obligations, Social,Responsibilities, Social,Social Obligation,Social Obligations,Social Responsibilities,Society, Obligations to
D013548	Sweden	Country in northern Europe, bordering the Baltic Sea, between Finland and Norway. The capital is Stockholm.