I got this story from Denise, our awesome NP treating patients in Rural Ohio. It is so maddening to see
how the healthcare system writes of patients with DNRs and doesn't treat simple issues as seriously because someone is not "full code"
I was called to see an older male that had been to the ER that night before for hypoglycemia but was returned to the facility with no treatment.
His glucose was in the low 40’s, I ordered d5.9% IV and we still could not get his glucose above 60. I sent him back to the ER and again they did not treat, they sent a note back that he was a DNRCCA (and this was confirmed twice).
I spoke with the family, Had a very long discussion with his daughter regarding Advance Directives and what each level means. We continued to treat the hypoglycemia and within 6 hours his glucose was running in the 200’s. In the meantime, I spoke with the daughter again and we decided to get some testing outpatient for another issue he was having.
Today when I visited with him, he was awake, alert, up in a wheelchair talking to me. To me a DNRCCA does not mean ignore what is going on with the patient. I will do whatever I can, with consent of family, to treat the patient and make them comfortable while discovering what is causing the problem.
Great job Denise! So glad you care and can take the time to treat these patients the way you would treat family.