Fillable Do Not Resuscitate Order Form for Washington State

Steps to Using Washington Do Not Resuscitate Order

When considering a Do Not Resuscitate Order, or DNR, individuals in Washington are taking a vital step towards asserting their medical preferences in circumstances where they may not be able to communicate their wishes directly. This form signifies that in the event of cardiac or respiratory arrest, the person does not want resuscitation efforts to be made. Completing this form is a sensitive decision that requires clear understanding and compliance with specific procedural steps to ensure its legal validity and adherence to personal wishes.

1. Begin by acquiring the official Do Not Resuscitate Order form, which can be obtained from a healthcare provider's office or downloaded from relevant Washington state health department or medical association websites.
2. Read the form thoroughly to ensure understanding of what the document entails and the implications of signing it. If there are any uncertainties, consider discussing them with a healthcare provider or legal advisor.
3. Enter the patient's full name, date of birth, and address in the designated areas to clearly identify the individual to whom the DNR order applies.
4. If the patient is able to personally fill out the form, they should then sign and date it in the presence of a witness. The witness, who must be an adult understanding the purpose of the document, must also sign and date the form, confirming the patient's decision.
5. In situations where the patient is unable to sign the form due to physical or cognitive reasons, a legal representative, such as a designated healthcare power of attorney, may sign on behalf of the patient. The same process of witness validation applies.
6. Once completed and signed, submit the DNR order form to the patient's primary healthcare provider. It is vital that the form be easily accessible in the patient's medical records. Moreover, it's advisable for the patient or their representative to keep a copy in a location that is both safe and accessible to family members or caregivers.
7. Discuss with close family members, caregivers, or anyone likely to be present during a medical emergency about the existence of the DNR order and where the document is stored. This step is crucial to ensure that in the event of an emergency, there is no delay in communicating the patient's wishes to healthcare professionals.

Following these steps ensures that the Do Not Resuscitate Order accurately reflects the individual's wishes and is properly integrated into their personal and medical records. It's also a reminder of the importance of periodically reviewing and, if necessary, updating the DNR order to align with any changes in health status or personal preferences regarding end-of-life care.

1. What is a Do Not Resuscitate (DNR) Order in Washington?

   A Do Not Resuscitate Order, or DNR, is a medical order written by a doctor. It instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient’s heart stops beating. In Washington State, a DNR is part of a larger approach to end-of-life planning and is used to respect the patient's wishes.

2. Who can request a DNR Order in Washington?

   Any competent adult can request a DNR order. This can also be requested by a patient's healthcare proxy or legal guardian if the patient is unable to make their own medical decisions.

3. How can someone obtain a DNR Order in Washington?

   To obtain a DNR order, a discussion with a healthcare provider is necessary. The healthcare provider must then agree that a DNR is appropriate for the patient's health status and end-of-life wishes. After this discussion, the healthcare provider can write and sign the DNR order.

4. Where should a DNR Order be kept?

   A DNR Order should be kept in a place where it can be easily found by emergency personnel. Many people choose to keep it on their refrigerator, near their bed, or with other important medical documents. Some also opt to wear a DNR bracelet or necklace.

5. Is a DNR Order permanent?

   No, a DNR Order is not permanent. A DNR can be revoked or cancelled at any time by the patient or their healthcare proxy, if applicable. This is done by informing the healthcare provider who can then document the revocation of the order.

6. Does a DNR Order affect other types of medical treatments?

   No, a DNR Order specifically refers to CPR and does not impact other treatments or interventions that a patient may want. Patients can still receive medication, nutrition, hydration, and other forms of care to keep them comfortable.

7. How is a DNR Order different from a living will?

   A DNR Order focuses specifically on CPR and does not go into broader details about a patient's preferences for other types of medical care. A living will, on the other hand, is a legal document that outlines a wider range of healthcare decisions, including life-sustaining treatments. While a DNR is medically focused, a living will is considered a legal document that provides more comprehensive end-of-life care instructions.

8. Can a DNR Order from another state be honored in Washington?

   Generally, Washington State will honor a valid DNR Order from another state. However, it’s a good idea to consult with a Washington healthcare provider to ensure that the order meets all necessary criteria and is clearly understood by local medical teams.

9. What if emergency medical services (EMS) are not aware of a patient's DNR Order?

   If EMS is called to assist and is not aware of a DNR Order, they are required to begin resuscitation efforts. To prevent this, it is essential to make the DNR Order easily accessible or wear a DNR bracelet or necklace that alerts medical personnel to the order.

When completing the Washington Do Not Resuscitate (DNR) Order form, people often aim to ensure their health care wishes are respected. Unfortunately, mistakes can happen during this process, leading to potential misunderstandings or the document not being honored. Here are five common errors to be mindful of:

1. Not discussing the decision with a healthcare provider first. It's crucial to understand the implications of a DNR order and to ensure it aligns with your overall health care plans.

2. Failing to include all necessary information. Every section of the form is important to accurately convey your wishes. Omitting details can lead to confusion or delay when the order is needed.

3. Incorrectly assuming the form will be recognized in all settings. While a DNR order is generally respected across various healthcare settings, it’s important to verify that your form complies with state laws and regulations.

4. Forgetting to share the completed form with relevant parties. For a DNR order to be effective, family members, healthcare providers, and anyone else involved in your care should be aware of it and know where the document is kept.

5. Not keeping the document accessible. In an emergency, time is of the essence. If your DNR order is not easily accessible, it might not be found in time to be followed.

Being mindful of these mistakes and taking steps to avoid them can help ensure that your wishes are respected and that your medical care aligns with your preferences.

When preparing for medical situations where individuals might not be able to make decisions for themselves, a Washington Do Not Resuscitate Order form is often just one piece of the puzzle. This form is crucial for those who wish not to receive CPR in the event of a cardiac or respiratory arrest. Alongside it, there are several other forms and documents that play vital roles in ensuring a person's health care wishes are respected and clearly communicated to healthcare providers, family members, and legal representatives. These documents serve various purposes, from specifying medical treatments one wishes to avoid to designating who should make decisions on their behalf.

• Advance Directive: This is a document that allows individuals to specify their wishes regarding end-of-life care ahead of time. It's a way to communicate what types of lifesaving measures, if any, they want to receive if they're unable to make decisions for themselves.
• Health Care Power of Attorney (HCPOA): This designates another person (usually a family member or close friend) as the decision-maker for an individual’s healthcare should they become unable to make these decisions on their own. This person works closely with healthcare providers to ensure the patient's wishes, as outlined in their advance directives, are fulfilled.
• Physician Orders for Life-Sustaining Treatment (POLST): Similar to the DNR order but more comprehensive, the POLST form details other types of medical interventions an individual does or does not want beyond CPR. This can include preferences for intubation, antibiotics, and nutrition assistance.
• Living Will: This document complements an advance directive by detailing in writing the individual’s wishes regarding prolonging life through medical interventions. It becomes effective when the person is terminally ill and unable to communicate their decisions about treatment.
• Do Not Intubate (DNI) Order: This form explicitly states that the individual does not wish to be placed on a mechanical ventilator to assist with breathing if they are unable to do so on their own. It's often used alongside a DNR order.
• Emergency Medical Services (EMS) Card: Often carried in a wallet, this card alerts first responders to the presence of a DNR order, POLST form, or any other medical directives that may impact emergency care. It provides quick access to critical information in an emergency situation.

It's important for individuals and their loved ones to discuss and prepare these documents well in advance of any medical crisis. Each plays a specific role in guiding healthcare providers to respect the individual's healthcare wishes. Consulting with healthcare professionals and legal experts can ensure these documents are filled out accurately and according to current state laws. Together, they work hand in hand to ensure a person's medical and personal wishes are upheld during critical moments.

The Washington Do Not Resuscitate (DNR) Order form shares similarities with the Advance Health Care Directive (AHCD). Both documents are vital for medical planning, explicitly expressing a patient's preferences regarding medical treatment at the end of life or if they're unable to communicate their wishes. While the DNR focuses specifically on the refusal of cardiopulmonary resuscitation (CPR) under certain circumstances, the AHCD covers a broader range of medical interventions. AHCD can specify preferences for treatments such as ventilator use, feeding tubes, and other life-sustaining measures, in addition to appointing a health care agent.

Similar to the DNR Order, a Medical Power of Attorney (MPOA) is a legal instrument that allows an individual to designate another person to make health care decisions on their behalf should they become incapacitated. This powerful document complements the DNR by providing a comprehensive approach to decision-making in situations beyond CPR refusal, encompassing a wide array of medical decisions. The key distinction lies in the MPOA's broader scope, enabling the appointed agent to make decisions that reflect the principal's values and preferences across various medical scenarios, not just resuscitation.

The POLST (Physician Orders for Life-Sustaining Treatment) form is another document that parallels the DNR Order in its purpose and application. Designed for seriously ill or frail patients, the POLST outlines specific medical treatments a patient wants towards the end of life, including life-sustaining treatments. Similar to a DNR, it is a doctor's order and effectively communicates a patient's wishes to health care providers. However, the POLST goes further, detailing choices about intubation, mechanical ventilation, and other interventions, thereby offering a more comprehensive guide than the DNR's sole focus on CPR.

The Living Will, like the DNR Order, serves as a directive for end-of-life care, but it addresses a broader range of conditions and treatments. It allows individuals to record their preferences for accepting or refusing medical treatment if they are terminally ill or permanently unconscious, with specific stipulations about life-sustaining measures. While the DNR expressly denies CPR, the Living Will can encompass directives on artificial hydration and nutrition, ventilation, and other interventions, thus providing a wider framework for making one's medical wishes known.

When it comes to completing the Washington Do Not Resuscitate (DNR) Order form, careful attention is required. It's a document that has significant implications for medical care, and ensuring it's filled out correctly is crucial for honoring the wishes of the individual it concerns. Below you will find essential dos and don'ts to guide you through the process.

Do:

1. Ensure that the patient, or their legal healthcare decision-maker if the patient is unable, reviews and understands the form before it’s signed. The clarity of the patient's wishes is paramount.
2. Have the form signed by a healthcare provider, as it's necessary for it to be valid. A doctor’s signature confirms that they have discussed the DNR order with the patient or their representative.
3. Keep the form in an easily accessible location. In case of an emergency, healthcare providers should be able to locate and refer to it quickly.
4. Share copies of the signed form with relevant parties, including immediate family members and caregivers, ensuring that everyone involved in the patient’s care is aware of the patient’s wishes.

Don't:

1. Fill out the form without the direct input of the patient or their authorized healthcare decision-maker. Consent is key to this critical document.
2. Forget to review and renew the document periodically. The patient’s wishes may change, and it’s important the DNR reflects their current preferences.
3. Assume all healthcare providers have immediate access to the form. Proactively sharing the document with relevant medical staff is crucial.
4. Overlook state-specific requirements or updates to the form. Laws and regulations can change, so ensure the information is up to date and follows Washington state guidelines.

The Washington Do Not Resuscitate (DNR) Order form is a vital document guiding healthcare professionals on the wishes of individuals regarding resuscitation. Despite its importance, there are many misconceptions about its use and implications. It is crucial to dispel these myths to ensure individuals make informed decisions about their health and end-of-life care.

• Misconception 1: A DNR order is only for the elderly. The truth is a DNR order can apply to anyone regardless of age if they have a serious health condition and wish to avoid aggressive life-saving interventions in the event their heart stops or they cannot breathe.
• Misconception 2: Having a DNR means you will receive no treatment for any conditions. This is inaccurate; a DNR specifically relates to CPR (cardiopulmonary resuscitation) not being performed. Patients with a DNR order still receive comprehensive medical care aimed at comfort and treating existing conditions.
• Misconception 3: A verbal agreement with a doctor is sufficient to enforce a DNR. In reality, verbal agreements are not enough. The DNR order must be documented formally on the state-approved form and signed by both the healthcare provider and the patient or their legally appointed decision-maker.
• Misconception 4: DNR orders are permanent and cannot be changed. Conversely, a DNR order can be revoked or altered at any time by the patient or their legal representative, ensuring that the patient’s current wishes are always honored.
• Misconception 5: If you are healthy, there's no need to consider a DNR order. Planning for unexpected situations is wise for everyone. Discussing preferences, including the potential for a DNR order, can be an important part of advance care planning, regardless of current health status.
• Misconception 6: DNR orders mean that medical staff won't work hard to save your life. This is not true; a DNR order specifically refers to the administration of CPR. Healthcare professionals are committed to preserving life and will provide all other appropriate treatments and interventions.
• Misconception 7: A DNR order can be applied by family members without the patient’s consent if they believe it’s in the patient’s best interest. In fact, DNR orders require the consent of the patient or their legally authorized representative. It’s a decision that must align with the patient’s wishes.
• Misconception 8: Only those with terminal illnesses should have a DNR. While individuals with terminal conditions often consider a DNR, it's not limited to them. People with chronic conditions or severe illnesses might also choose a DNR to avoid aggressive interventions that do not align with their quality of life goals.
• Misconception 9: DNR orders are only for hospital use. A DNR order can be effective in any setting, including at home, in hospices, and in long-term care facilities. It lets healthcare providers know the patient's wishes, regardless of where they are being treated.
• Misconception 10: Doctors automatically know if someone has a DNR order. It is essential for individuals or their family members to communicate clearly and provide documentation of the DNR order to healthcare professionals in every new medical encounter. Do not assume the order is known or will be transferred between care settings.

Understanding the facts about DNR orders can alleviate fears and ensure that individuals’ healthcare preferences are respected and adhered to. It encourages proactive discussions between patients, family members, and healthcare providers about end-of-life care options and decisions.

Understanding how to properly fill out and use the Washington Do Not Resuscitate (DNR) Order form is a critical process for individuals who are making significant healthcare decisions for themselves or for someone they are legally responsible for. A DNR order, while a sensitive and personal decision, is an important document that medical professionals must respect during emergencies. Here are six key takeaways regarding the filling out and utilization of the Washington DNR Order form:

• Work with a healthcare professional: It is important that the DNR form be filled out in collaboration with a certified healthcare provider. This ensures the document complies with legal requirements and is medically accurate.
• Ensure the form is properly signed: The form requires the signature of the individual (or their legal healthcare decision-maker) and the attending physician, nurse practitioner, or physician's assistant. Without these signatures, the form may not be valid.
• Understand what a DNR order does: A DNR order instructs medical personnel not to perform CPR (cardiopulmonary resuscitation) in the event the person’s heart stops or they stop breathing. It is essential to understand that this does not impact other forms of medical intervention.
• Keep the DNR order accessible: In an emergency, healthcare providers need immediate access to the DNR order for it to be followed. Ideally, it should be kept in a prominent location and family members or caregivers should know where it is.
• Inform loved ones and caregivers: Communication with family members, caregivers, and possibly close friends about the decision and the existence of a DNR order is crucial. This ensures that in an emergency, those present can advocate for the patient’s wishes to be respected.
• Review and update as necessary: Circumstances and decisions about end-of-life care can change. Therefore, it’s important to review the DNR order periodically and make updates if the individual’s health condition or wishes change. Any changes require a new form to be completed, signed, and properly distributed.