Printable Do Not Resuscitate Order Form for North Carolina

What is a Do Not Resuscitate Order in North Carolina?

A Do Not Resuscitate (DNR) Order in North Carolina is a medical order written by a doctor. It instructs health care providers not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating.

Who can request a DNR Order in North Carolina?

Any adult patient with the capacity to make their own health care decisions can request a DNR Order. For patients who are minors or adults unable to make their own decisions, a legal guardian or a health care agent under a valid healthcare power of attorney may request one on their behalf.

How can one obtain a DNR Order in North Carolina?

To obtain a DNR Order in North Carolina, the following steps should be taken:

1. The patient or their authorized representative must discuss the wish not to have CPR with the patient's doctor.
2. The doctor, if they agree that a DNR Order is appropriate, will write the order and include it in the patient's medical records.
3. It is recommended to also have a portable DNR form, which should be filled out and signed by both the doctor and the patient or their representative.

Is the North Carolina DNR Order valid in other states?

While some states may honor a North Carolina DNR Order, it is not guaranteed since laws and regulations about DNR orders vary from state to state. If a patient plans to travel or move, it is advisable to check the DNR requirements and obtain a new order if necessary in the new state.

Can a DNR Order be revoked?

Yes, a DNR Order can be revoked at any time by the patient or their authorized representative. Revocation can be done in several ways, including:

• Verbally informing the healthcare providers or emergency responders.
• Destroying the DNR Order form.
• Writing a revocation statement.

What happens if there is no DNR Order?

If a patient does not have a DNR Order and experiences cardiac or respiratory arrest, medical personnel are generally required to perform CPR and take other life-saving measures unless instructed otherwise by a valid medical order.

Are there any special considerations for patients living in nursing homes or other long-term care facilities regarding DNR Orders?

Yes, patients in nursing homes or other long-term care facilities should ensure that their DNR Order is clearly communicated and documented in their personal medical records at the facility. Facilities have policies in place regarding DNR Orders to ensure that the wishes of residents are respected and followed.

Does having a DNR Order affect the quality of care a patient receives?

Having a DNR Order does not affect the quality of care provided to a patient. It specifically instruct healthcare providers not to perform CPR or advanced cardiac life support. However, patients with a DNR Order still receive comprehensive care aimed at maintaining comfort and addressing other health needs and conditions.

Who should be informed about a patient's DNR Order?

It's crucial to inform the following parties about a patient's DNR Order:

• The patient's healthcare providers and the institution where the patient receives care.
• Family members and others who are likely to be involved in decision making.
• Any healthcare agents or legal representatives designated by the patient.

When it comes to filling out the North Carolina Do Not Resuscitate (DNR) Order form, accuracy and completeness are vital to ensure the patient's wishes are legally recognized and respected. Unfortunately, several common mistakes can complicate or invalidate the process. Understanding these pitfalls can help individuals and their families better navigate this sensitive area.

1. Not consulting with a healthcare provider: The DNR order needs a physician's or authorized provider's assessment and signature to be valid. Some individuals mistakenly complete the form without this crucial step, thinking it's purely a personal or family decision.

2. Incorrect patient information: Providing inaccurate patient details such as name, date of birth, or medical record number can lead to significant confusion. This error might result in the DNR order being applied to the wrong patient or not being honored in a critical moment.

3. Failing to update the form: Medical decisions and preferences can change, but sometimes people forget to update their DNR order to reflect these changes. An outdated form may no longer represent the patient's current wishes.

4. Not notifying family members or healthcare proxies: For a DNR order to be effective, it is crucial that family members or designated healthcare proxies are aware of the order and understand the patient’s wishes. Overlooking this step can lead to unwanted interventions or disputes.

5. Lack of signatures: Beyond the healthcare provider's signature, the patient (or their legal representative if the patient is unable) must also sign and date the form. Missing signatures can make the document invalid.

6. Improper storage or accessibility: After the DNR order is correctly filled out and signed, it should be stored in a location where it can be easily found by family members or emergency personnel. When it is not readily accessible, its directives might not be followed in an emergency situation.

While navigating the process, there's a delicate balance between legal formalities and personal wishes. It is highly recommended to seek guidance from healthcare providers or legal professionals to ensure that a DNR order is accurately completed and maintained, thus safeguarding the individual's health care choices.

In North Carolina, when individuals are making decisions about their end-of-life care, the "Do Not Resuscitate" (DNR) Order form is just one of several important legal documents they might consider. A DNR order tells healthcare professionals not to perform CPR if a person's breathing stops or if their heart stops beating. However, to ensure a comprehensive approach to one’s healthcare and personal wishes, other forms and documents are commonly used together with a DNR. Below is an overview of these documents, each playing a crucial role in managing different aspects of one's healthcare and personal decisions.

• Advance Directive/Living Will: This document allows individuals to state their wishes about medical treatment in scenarios where they are unable to communicate or make decisions. It can cover a wide range of treatments, not just the refusal of resuscitation.
• Healthcare Power of Attorney: This form designates another person (an agent) to make healthcare decisions on behalf of the individual, should they be incapacitated or unable to make such decisions themselves.
• Medical Orders for Scope of Treatment (MOST): Similar to a DNR, a MOST form can include instructions about CPR, but it also addresses other treatments that the individual does or does not want, like tube feeding or antibiotics.
• Physician Orders for Life-Sustaining Treatment (POLST): For those with serious illnesses or frailty, a POLST form provides specific instructions for healthcare providers regarding treatments that align with the patient's goals for care, including resuscitation.
• HIPAA Authorization: This document gives healthcare providers permission to discuss or release an individual's healthcare information to designated persons. It's crucial for family members or representatives to stay informed.
• Durable Power of Attorney: This legal document allows an individual to appoint someone to manage their financial affairs either immediately or in the event they become incapacitated.
• Will: A will directs the distribution of an individual's property after their death and can appoint guardians for any minor children.
• Living Trust: Similar to a will, a living trust allows individuals to manage their assets during their lifetime and specifies how those assets should be distributed after death.
• Portable Medical Order: This term sometimes refers to documents like POLST, which are designed to accompany the patient and provide immediate guidance to healthcare providers across various settings.

Considering and preparing these documents in advance can provide peace of mind to individuals and their families, ensuring that healthcare decisions reflect the individual's wishes and that their affairs are in order. Healthcare professionals and legal advisors often recommend discussing these documents with loved ones and legal counsel to make sure all aspects of a person’s care and legacy are covered comprehensively and according to their wishes.

A North Carolina Do Not Resuscitate (DNR) Order Form shares similarities with an Advance Directive. Both documents serve as critical tools for planning medical care, especially in situations where individuals cannot make decisions for themselves. An Advance Directive is broader, encompassing living wills and healthcare power of attorney, allowing individuals to specify their healthcare preferences and designate someone to make healthcare decisions on their behalf. However, a DNR specifically instructs healthcare providers not to perform CPR if a patient's breathing stops or if their heart stops beating, focusing solely on those life-saving measures.

Similar to the DNR, a Medical Order for Scope of Treatment (MOST) form also provides specific instructions regarding a patient's preferences for end-of-life care. However, the MOST form is more comprehensive, covering a wider range of medical interventions beyond resuscitation, such as preferences for intubation, antibiotics, and feeding tubes. While the DNR strictly advises on CPR, the MOST form entails a broader spectrum of life-sustaining treatments and is often used for patients with serious illnesses, outlining a detailed plan for multiple medical scenarios.

The Health Care Power of Attorney (HCPOA) form, akin to the DNR, is a legal document used to indicate a person’s healthcare preferences through an appointed decision-maker. While a DNR directly addresses the issue of resuscitation, a HCPOA designates a trusted individual, known as a healthcare agent, to make a wide range of healthcare decisions on behalf of the person, which might include decisions about resuscitation. This designation ensures that the patient’s medical care preferences are honored, even when they cannot express them personally.

A POLST (Physician Orders for Life-Sustaining Treatment) form also parallels the DNR in its purpose and scope. It is designed for seriously ill or frail patients in outlining their preferences for end-of-life care, including their desires regarding CPR. Unlike the narrower focus of a DNR, a POLST form covers extensive ground, guiding emergency medical personnel and healthcare providers through a patient's wishes about various treatments, not just CPR. It translates these wishes into actionable medical orders, ensuring they are respected across healthcare settings.

Lastly, a Living Will resembles the DNR in that it communicates a person's wishes concerning life-sustaining treatments should they become unable to make decisions for themselves. However, while the DNR is a clear directive against the use of CPR, a Living Will provides broader instructions about a range of life-prolonging procedures one might want or not want, such as mechanical ventilation, artificial nutrition and hydration, and other forms of medical intervention. It serves as a guide for healthcare providers and loved ones in making healthcare decisions that align with the patient’s values and preferences.

Completing the North Carolina Do Not Resuscitate (DNR) Order form requires careful attention to detail and a clear understanding of the document's implications. Here are several dos and don'ts to keep in mind:

• Consult with a healthcare provider before deciding to fill out the form, ensuring it aligns with the individual's health care wishes and medical condition.
• Use clear, legible handwriting or type the information to prevent any misunderstandings or misinterpretations of the order.
• Review the form for completeness, making sure that all required fields are filled out accurately.
• Include the patient’s full legal name and date of birth to ensure clear identification and avoid confusion with other patients.
• Ensure that the form is signed and dated by the authorized individuals as specified by state guidelines, including the patient (or their legal representative) and the physician.
• Make multiple copies of the completed form. Keep the original in a location that is easily accessible to emergency personnel.
• Inform family members and any caregivers about the existence of the DNR order and its location to ensure it is respected and implemented as intended.

• Rush through the process without fully understanding the implications of a DNR order and considering all relevant medical and ethical aspects.
• Leave sections incomplete or make assumptions about what is required. If there is uncertainty, seek clarification from a medical professional or legal advisor.
• Use correction fluid or tape on the form. Mistakes should be clearly crossed out, and the correction should be initialed by the signer.
• Forget to update the form if the individual’s health status or wishes change. A new form should be completed and signed as needed.
• Store the form in a place where it cannot be found quickly in an emergency. Its effectiveness is in its ability to be presented upon request.
• Assume all family members are automatically in agreement with the DNR order without having a discussion. It is vital to communicate the individual’s wishes to avoid future conflicts.
• Sign the form on behalf of the patient without having the legal authority to do so. Proper legal documentation must be in place for a representative to make such decisions.

Many people have misconceptions about the Do Not Resuscitate (DNR) Order in North Carolina. Let's clear up some of the most common misunderstandings:

• All healthcare facilities automatically recognize DNR orders. It's a common belief, but not accurate. Each healthcare facility has its own policy for recognizing and implementing DNR orders. It's crucial for individuals and families to confirm these policies with the facility to ensure their wishes are honored.

• A verbal declaration is sufficient for a DNR order. Actually, North Carolina law requires a written order, signed by a physician, to make a DNR order valid. Verbal wishes by themselves do not carry the legal weight to stop resuscitation efforts.

• DNR orders are permanent and cannot be changed. In reality, a DNR order can be revoked or modified at any time by the patient or their legal surrogate. It's essential to communicate any changes in wishes or health status to healthcare providers promptly.

• Only elderly people need a DNR order. This is a misconception. A DNR order may be appropriate for people of all ages who wish to avoid resuscitation under certain medical conditions, based on their values, wishes, and medical advice.

• DNR orders mean that no treatment will be provided. This misunderstanding could not be further from the truth. DNR orders specifically address the use of CPR (cardiopulmonary resuscitation) in the event of a cardiac or respiratory arrest. They do not negate other forms of medical treatment and care.

• A DNR order must be filed with the state or a legal entity. North Carolina does not require filing DNR orders with a state agency or any legal entity. It should, however, be included in the patient's medical record and made accessible to healthcare providers.

• DNR orders are only valid in the hospital. Another myth. DNR orders can be valid in any setting, including the patient's home, as long as they are properly documented and communicated to all healthcare providers involved in the patient's care.

• Family members can override a DNR order. In North Carolina, if a DNR order is properly in place, family members cannot override it unless they are the legally authorized representative and can provide evidence that the patient's wishes have changed. It's crucial for patients and families to have discussions about DNR orders and other advance directives to ensure everyone understands the patient's wishes.

Understanding these aspects of DNR orders in North Carolina helps ensure that individuals' health care wishes are respected and followed. It's always a good idea to discuss these topics with healthcare providers and legal advisors to make informed decisions.

In North Carolina, the Do Not Resuscitate (DNR) Order form is a critical document for those who wish to make their end-of-life care wishes known, especially the desire not to receive cardiopulmonary resuscitation (CPR) in case of a respiratory or cardiac arrest. Here are ten key takeaways about filling out and using this important form:

• Before making a decision, it's important to discuss your wishes with your family, close friends, and healthcare providers to ensure they understand your preferences regarding end-of-life care.
• The form must be filled out and signed by a licensed healthcare provider. This signifies that your healthcare provider supports your decision and acknowledges your wishes.
• You must clearly express your desire not to be resuscitated. This includes not receiving CPR— which consists of chest compressions, artificial ventilation, or any advanced cardiac life support measures in the event your breathing or heartbeat stops.
• Keep the DNR order in a place where it can be easily found by family or emergency personnel. Some people choose to keep it on their refrigerator or somewhere visible in their living room.
• Informing close family members, caregivers, and potentially even your legal representative about the existence and location of your DNR order ensures that in an emergency, they can inform healthcare professionals about your wishes.
• It is also advisable to carry a wallet card indicating that you have a DNR order. This can be crucial if an emergency occurs when you are not at home.
• If you change your mind, you can always revoke the DNR order. To do so, it's essential to inform your healthcare provider immediately and make sure all copies of the old DNR order are destroyed.
• The DNR order should be reviewed periodically, especially if your health status changes. This is crucial because your medical condition or your preferences about end-of-life care might change over time.
• Understand that the DNR order only applies to CPR. It does not affect other treatments, such as pain medication, nutrition, hydration, or other forms of care you might wish to receive.
• Finally, it's beneficial to consult with legal or medical professionals to fully understand the implications of a DNR order and how it fits within your overall healthcare and legal planning strategy.

Filling out the North Carolina DNR Order is a significant step in healthcare planning. It gives you control over the decisions regarding your health and ensures your wishes are followed in critical moments. Be sure to take the necessary steps to communicate and record these decisions correctly.