NEW ORLEANS, LA – Members of a multidisciplinary inpatient team at Tulane University left a family meeting this morning scratching their heads, as they honored their patient and family’s unusual wish to make the patient DNR (Do Not Resuscitate) on Tuesdays, Thursdays, and Saturdays (TTS).
“I don’t… What the…” started a stymied palliative care nurse practitioner Amy Martin. “I have no idea… I mean, really?”
The patient, who asked for privacy and asked that her case not be discussed further during rounds, is Mary Anderson in room 2122 at Tulane University, a 78-year-old female battling end stage heart failure. She has failed medical management and despite home milrinone remains heavily symptomatic.
And perhaps confused.
The meeting involved Ms. Martin, hospitalist David James, cardiologist Laura Matthews, nursing staff, the patient, her husband and children. The meeting ran for two hours this morning, ending at approximately 11:15 AM before the really odd decision was made.
“They were completely befuddled,” observed charge nurse Elaine Richards. “They just slowly exited the room. They looked at each other, shook their heads, hands on their hips. They were speechless. When I heard the outcome… Let’s just say, now I’ve seen it all.”
“What can you do?” said Dr. Matthews, shrugging her shoulders. “We discussed and she made an informed decision. Apparently. Unfortunately, she does have decision-making capacity. So there you go.” Shortly after the comment, Dr. Matthews sighed and entered the order: DNR TTS.
The code status doesn’t end there.
“It’s not that she’s just Full Code on the other days either,” added Dr. James, staring blankly at the wall. “Her CPR instructions reads like a grocery list. A really strange grocery list.”
Though the details of Anderson’s code status is private and protected by HIPAA, highlights of Anderson’s highly-specific code status include:
– DNR TTS
– Full Code MWF
– No CPR on Sundays
– Chest compressions to be performed only from right side of bed
– Code Team “should be multiethnic”
– Okay with epinephrine but not vasopressin
– Okay with left-sided central venous access, but not the right
– Ventilation to be done by a right-handed respiratory therapist
– Wishes to be shocked exactly 4 times, irrespective of cardiac rhythm
The paperwork was signed and computer orders were entered at 11:35 AM, reflecting the patient’s new historically awkward code status. By 12 PM, Anderson’s defeated inpatient medical team called it a day and went out for Happy Hour to figure out what exactly just happened.
In a last ditch effort, a psychiatry consult placed at 12:01 PM is still pending. GomerBlog will continue to follow this story.
UPDATE 11:00 AM ET:
The hospital menu of ham sandwiches looks delicious tomorrow. Mrs. Anderson has canceled her DNR orders until 1 hour after the ham sandwich has entered her stomach.
UPDATE 07:50 AM ET (03/08/16):
Mrs. Anderson has changed her code status and is now DNR Mondays, Wednesdays, Fridays.
I’ve personally seen “…must be hung like a horse before placing defib pads..” …no word of a lie.
My favorite DNR order I used to see all the time was “Med Code Only.” We could push the drugs but couldn’t do compressions to circulate the blood. So in essence, we were resuscitating the patient’s antecubital… LOL
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A Light Spin on the Issue of DNR. After all it is supposed to be a life changing decision we have here, so its always good to not emphasize how serious it is.
I love reading the comments. No matter how many times you express that it is a satire there are people who are clueless. It is very entertaining.
dude – you realize this is satire right?
Hahahahahaha Yes, they are. LOL
You’re hilarious!
I like those replies from people getting all upset about making fun of patient. They’re as hilarious as the articles themselfs. All Gomers and Gomerfamillies.
This is a satirical website. There is not need to say all what you said. People these days don’t have sense of humor.
Why the fuck do you think it’s appropriate to list the name, age, exact location, medical condition, and details of her medical plan, especially when you lead with “the patient asks for privacy”. Seriously, I would punch the shot out of the person who released this information, the person who typed up this information, and all the peoe involved in approving the publishing of this information.
I hope you die, slow horrible deaths. Preferably embarrassing deaths like dying while enjoying self-erotic asphyxiation and that every detail of your life and death are made public information and your family has to deal with the embarrassment, eternal lung damning you for ruining their lives.
In case you still don’t get it. You’re a piece of shit.
Lolzies Abby Vera
Sadly, this is pretty accurate as to how it really is.
Lol! Craig Sheley
Lol!
Hahaha. Like the “asked for privacy” followed by her name and room number :-) Bet the docs got improved HCAPs for honoring this pt’s autonomy however senseless.
Somebody wanted some control…..lol
get ready for new board question lol
I want chest compression but no life support. God knows after you regain a pulse just bag me for the next 2 days during hypothermia protocol.
Lol, a psych consult is still pending.
your intelligence continues to shine through Fiona Worboys!!
Superb Sue Clarebrough And Maree Nankervis I plan to have the same orders when I am older. But I will request left handed clinicians
Lmfao!!!!!!
Bahaahaa Raechal Stoops
hilarious
Limited NFR taken to new levels Fiona Worboys Maree Nankervis!!
Wait til this goes mainstream as standard of care!!!