Before implementing a DNR or AND, whom should the provider consult?

Before implementing a DNR or AND, whom should the provider consult?

• A. The Client and Family
• B. The Nurse
• C. The Social Worker
• D. The Pharmacist

Answer: (A)

Respecting patient autonomy and obtaining informed consent are essential when decisions about resuscitation are on the table. Before implementing a DNR or AND, the provider should have an open, compassionate discussion with the patient about goals of care, prognosis, and what these orders mean, and include the family to support the patient and represent their values if needed. This ensures the orders truly reflect the patient’s wishes and that everyone involved understands and agrees with the plan. Other professionals like the nurse, social worker, or pharmacist can provide information and support, but the initiation and validation of the decision with the patient and family is the appropriate responsibility of the clinician in dialogue with them. If the patient cannot speak for themselves, a legally authorized surrogate or advance directive guides the discussion, but the starting point remains consultation with the patient and family.

Respecting patient autonomy and obtaining informed consent are essential when decisions about resuscitation are on the table. Before implementing a DNR or AND, the provider should have an open, compassionate discussion with the patient about goals of care, prognosis, and what these orders mean, and include the family to support the patient and represent their values if needed. This ensures the orders truly reflect the patient’s wishes and that everyone involved understands and agrees with the plan. Other professionals like the nurse, social worker, or pharmacist can provide information and support, but the initiation and validation of the decision with the patient and family is the appropriate responsibility of the clinician in dialogue with them. If the patient cannot speak for themselves, a legally authorized surrogate or advance directive guides the discussion, but the starting point remains consultation with the patient and family.