Nurses' perspectives concerning do-not-resuscitate (DNR) orders.
The purpose of this study was to investigate the views of the nursing staff concerning do-not-resuscitate (DNR) orders at the Tokai University Hospital where a controversial incident occurred several years ago. A 'Questionnaire on DNR Orders' was circulated and the anonymous answers were collected two weeks later. The questionnaire was returned by 706 of 780 (90.5%) nurses from every ward/specialty, which revealed that 87% of the nurses felt that DNRs were occasionally necessary, with more than 40% of the nurses answering that they took part in DNR. Further, 36% of the nurses stated that patient consent was indispensable, and 64% thought that the patient's family and physician could decide DNR in the event the patient was physically unable to give consent. Moreover, 66% of the nurses expected the establishment of a DNR order sheet to be formulated as a matter of hospital policy; only 5% of the nurses thought that such an order sheet would not be necessary. Comparing these results with a previous study polling physicians at the Tokai University Hospital, nurses are more likely than physicians to think that patient consent is indispensable, and want the establishment of a standardized DNR order sheet as hospital policy. There is, in fact, a "tacit understanding" between physicians and patients' families in medical practice in Japan. However, DNR is definitely a medical decision. Therefore it should be clearly stated in a standardized format, although such a procedure presently seems unlikely, in view of the Japanese traditional value system.
Hosaka
T
T
Department of: Psychiatry and Behaviroal Science, Tokai University School of Medicine, Kanagawa, Japan. hosaka@is.icc.u-tokai.ac.jp
Nagano
H
H
Inomata
C
C
Kobayashi
I
I
Miyamoto
T
T
Tamai
Y
Y
Tamura
Y
Y
Tokuda
Y
Y
Yonekura
S
S
Saito
H
H
Mori
T
T
D000328:Adult; D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses / Q000523:psychology*; D010344:Patient Advocacy; D016414:Resuscitation Orders; D011795:Surveys and Questionnaires