"Do-Not-Attempt-Resuscitation"-orders in ICCUs: a survey of attitudes and experiences of nurses in Norway.
OBJECTIVE
A "Do-Not-Attempt-Resuscitation" (DNAR)-order can be ordered for a critically ill coronary patient. One question that arises is whether the patient should be informed about the DNAR-decision? The purpose of the present study was to investigate attitudes and experiences towards DNAR-orders of nurses working in Intensive Coronary Care Units (ICCUs) in Norway.


METHODS
A web-based questionnaire.


RESULTS
The response rate was 60% (176/295). A total of 74% of the respondents thought the patient should be informed about a DNAR-order. Given a mentally competent and conscious patient, 50% answered that they "to a relatively high" or "a very high degree" had experienced non-informed patients with a DNAR-order.


CONCLUSIONS
The study revealed a positive attitude among respondents to inform patients about a DNAR-order. However, one half of the respondents had experienced that this information was not given. There may be several explanations for this discrepancy. Patients are treated individually and the right to know does not mean that every patient would want to know or needs to know. The timing of the information and the opportunity to provide it can also be a problem for such critically ill patients in the ICCU.
Naess
Mikael
M
Intensive Coronary Care Unit, Department of Cardiology, Ullevål University Hospital, Oslo N-0407, Norway. mins@uus.no
D032722:Advance Care Planning / Q000941:ethics / Q000458:organization & administration; D024362:Advance Directive Adherence / Q000941:ethics / Q000458:organization & administration / Q000523:psychology; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003422:Critical Care / Q000941:ethics / Q000458:organization & administration* / Q000523:psychology; D003657:Decision Making / Q000941:ethics; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence / Q000523:psychology; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence / Q000523:psychology; D009664:Norway; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D009740:Nursing Staff / Q000193:education / Q000941:ethics / Q000458:organization & administration / Q000523:psychology*; D010353:Patient Education as Topic / Q000941:ethics / Q000458:organization & administration; D028701:Patient Rights / Q000941:ethics / Q000331:legislation & jurisprudence; D017410:Practice Guidelines as Topic; D016414:Resuscitation Orders / Q000941:ethics / Q000331:legislation & jurisprudence / Q000523:psychology; D011795:Surveys and Questionnaires