Nurses Save Lives. What Happens When There’s a DNR?

When a Florida nurse discovered that a 68-year-old patient under her care was unresponsive, her years of training and practical experience kicked in, and she immediately began performing CPR. But what had seemed on the face of it a straightforward reaction to a straightforward problem almost cost the nurse her professional license.

Her mistake? The patient had an active Do Not Resuscitate (DNR) order. The state’s Department of Health filed a complaint but, after an investigation and negotiation, the nurse reached a settlement agreement with the Florida Board of Nursing: if she pays a $50 administrative fine and $4,207 in investigative costs, and completes ten hours of education in critical thinking and nursing law and ethics, she’ll be able to keep her license and carry on as before.

This nurse wasn’t the first to find herself at the crossroads between her training and the legal weight of a DNR, and she won’t be the last. The LLF National Law Firm’s Professional License Defense Team understands how fraught and complicated the moment at that crossroads can be — and what’s at stake for a nurse’s career — and we’re committed to ensuring each nurse’s case is allowed the due process and intelligent consideration it deserves. If you’ve been accused of violating a DNR, call us today at (888) 535-3686 or send us a message.

For Nurses, the DNR Is a Conundrum

It’s almost a paradox: nurses are trained to save lives, but if there’s a DNR, they’re supposed to stand by and let their patients die. When their training prevails in the split-second a nurse has to make this decision, they can, on the one hand, feel proud to have performed their duty of care, and on the other, face potentially career-ending repercussions.

To complicate matters is the fact that DNR orders can sometimes be a little fuzzy:

• Is DNR valid and complete?
• Is the DNR still current?
• Is a family member with medical power of attorney on the scene demanding CPR in spite of the DNR?
• Is it a facility DNR or an out-of-hospital directive?

If it’s a facility DNR, the order usually only applies if the patient is on the premises and it’s included in their medical file. Out-of-hospital directives apply in any setting, but they might not be in the patient’s file or otherwise available to the nurse, who, after all, is not likely to have time in that moment to go looking for it.

The Consequences of Giving CPR to a DNR Patient

Nurses who perform CPR on DNR patients can be accused of violating patient autonomy, failing to follow orders, and even professional misconduct. In response to a complaint, a state licensing board is likely to investigate to determine whether the nurse followed established protocols and whether the DNR was available and accessible at the time. The question the board wants to answer is this: Was the nurse’s decision to perform CPR on a DNR patient reasonable under the circumstances?

What the agreement between the Florida nurse and the state licensing board demonstrates is that, with the right approach, nurses can help the board understand what really happened in the moment of the decision. The Professional License Defense Team at the LLF National Law Firm knows how achieve the best possible outcome for any nurse whose license is in peril. Call us at (888) 535-3686 or send us a message online.