The nurse is caring for a 42-year-old client who has a do not resuscitate (DNR) order on the chart. The client tells the nurse, “I’ve changed my mind about the DNR. I would like to cancel that and be given whatever care is needed to keep me alive.” Which response by the nurse is correct?

  1. “I will notify your health care provider right away.”
  2. “I’m glad to hear this. You shouldn’t be a DNR at your age.”
  3. “Let me call your family and tell them you have changed your mind.”
  4. “You cannot change a DNR once it’s on your chart. It is a legal document.”
Number 1 is correct.
Rationale: Clients have the right to change DNR orders or advance directives whenever they choose. It is important to notify the health care provider immediately so that the DNR order may be rescinded. Response 2 is inappropriate because the nurse is expressing her opinion about what the client should do. Response 3 is inappropriate because the client is of legal age and has rights protected under HIPAA to make her own decisions regarding care. Response 4 is incorrect because although a DNR is a legal document, the client retains the right at any time to change her mind regarding treatment.