The company also monitored nursing homes that had smaller numbers of patients with “do not resuscitate” – or DNR – and “do not intubate” orders in their files. Without such orders, patients are in line for certain life-saving treatments that might lead to costly hospital stays.
Two current and three former UnitedHealth nurse practitioners told the Guardian that UnitedHealth managers pressed nurse practitioners to persuade Medicare Advantage members to change their “code status” to DNR even when patients had clearly expressed a desire that all available treatments be used to keep them alive.
DNR is do everything right up until people reach the Miracle Max “mostly dead” state where staff has 10min to start bringing them back to life without brain damage. Brain damage may still occur. What DNR translates into is you let people stay dead once they’re dead, but you keep doing everything up until the point of dead.
Hospice is the state in which people are allowed to die. Often with drugs to make that death less painful due to the underlying pain of medical issues. Relaxation drugs like Ativan are also available so the patient isn’t in a state of panic as their lungs fail, or because they know they’re terminal and on the brink.
DNI is do everything up until it is ventilator time. CPR and drugs like epinephrine happen. The drugs like epinephrine, by the way, do little when your heart, or CPR, isn’t pumping blood through your body. There are still individuals who choose drugs only, no CPR, but that may be more a medical education deficit. Many a code ends in intubation after CPR, or the patient may continue to die and be brought back over and over until they simply die from bodily stress.
I’m not by any means arguing there isn’t seriously shady action happening in the corporate for profit management of medicine, and I’m certainly not defending United. I do think it’s important to understand how code status works though.
I don’t really see an issue with anyone elderly, of sound mind, choosing DNR. My own parents have DNR as their code statuses and they live independently outside any institutionalized care dwelling. Not wanting CPR or a ventilator is a valid life choice.
Know your code statuses. It is relevant to your own life.
Of course I do. No one should be pressured by anyone in regard to their code status, it’s a deeply personal choice, choice being the operative word.
You made an incorrect statement.
The company also monitored nursing homes that had smaller numbers of patients with “do not resuscitate” – or DNR – and “do not intubate” orders in their files. Without such orders, patients are in line for certain life-saving treatments that might lead to costly hospital stays.
DNR patients do, in fact, have hospital stays, sometimes extended. They get surgery. DNR is do everything up until I’m dead, then stop.
You’re talking about palliative care and hospice. Those types of care remove various life saving cares.
All hospice and palliative have a DNR code status.
Not all DNR code status patients are palliative or hospice.
The company also monitored nursing homes that had smaller numbers of patients with “do not resuscitate” – or DNR – and “do not intubate” orders in their files. Without such orders, patients are in line for certain life-saving treatments that might lead to costly hospital stays.
Two current and three former UnitedHealth nurse practitioners told the Guardian that UnitedHealth managers pressed nurse practitioners to persuade Medicare Advantage members to change their “code status” to DNR even when patients had clearly expressed a desire that all available treatments be used to keep them alive.
They made nurses kill people!
There’s a key difference between DNR and hospice.
Hospice is do nothing life saving.
DNR is do everything right up until people reach the Miracle Max “mostly dead” state where staff has 10min to start bringing them back to life without brain damage. Brain damage may still occur. What DNR translates into is you let people stay dead once they’re dead, but you keep doing everything up until the point of dead.
Hospice is the state in which people are allowed to die. Often with drugs to make that death less painful due to the underlying pain of medical issues. Relaxation drugs like Ativan are also available so the patient isn’t in a state of panic as their lungs fail, or because they know they’re terminal and on the brink.
DNI is do everything up until it is ventilator time. CPR and drugs like epinephrine happen. The drugs like epinephrine, by the way, do little when your heart, or CPR, isn’t pumping blood through your body. There are still individuals who choose drugs only, no CPR, but that may be more a medical education deficit. Many a code ends in intubation after CPR, or the patient may continue to die and be brought back over and over until they simply die from bodily stress.
I’m not by any means arguing there isn’t seriously shady action happening in the corporate for profit management of medicine, and I’m certainly not defending United. I do think it’s important to understand how code status works though.
I don’t really see an issue with anyone elderly, of sound mind, choosing DNR. My own parents have DNR as their code statuses and they live independently outside any institutionalized care dwelling. Not wanting CPR or a ventilator is a valid life choice.
Know your code statuses. It is relevant to your own life.
You don’t see the issue of your medical practitioner trying to convince you to choose cost cutting death over the chance at living?
Of course I do. No one should be pressured by anyone in regard to their code status, it’s a deeply personal choice, choice being the operative word.
You made an incorrect statement.
DNR patients do, in fact, have hospital stays, sometimes extended. They get surgery. DNR is do everything up until I’m dead, then stop.
You’re talking about palliative care and hospice. Those types of care remove various life saving cares.
All hospice and palliative have a DNR code status.
Not all DNR code status patients are palliative or hospice.
It’s an important distinction.