J Korean Acad Nurs.  2008 Apr;38(2):298-309. 10.4040/jkan.2008.38.2.298.

Hospital Nurses' Experience of Do-Not-Resuscitate in Korea

• Yi M
• Oh SE
• Choi EO
• Kwon IG
• Kwon S
• Cho KM
• Kang Y
• Ok J

• KMID: 820083
• DOI: http://doi.org/10.4040/jkan.2008.38.2.298

Abstract

PURPOSE: The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses. METHODS: Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data. RESULTS: Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR. CONCLUSION: Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

Keyword

Bioethics; Resuscitation Orders; Qualitative Research; Nurses

MeSH Terms

Adult
Attitude to Death
Critical Care
Decision Making
Family/psychology
Humans
Interviews as Topic
Korea
Nursing Staff, Hospital/*psychology
Professional-Family Relations
*Resuscitation Orders/psychology
Social Support
Tape Recording

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