Printable Do Not Resuscitate Order Template for Washington

Guidelines on Utilizing Washington Do Not Resuscitate Order

When it comes time to think about end-of-life care, many people choose to have a say in the treatments they receive or decide to forgo. A Do Not Resuscitate (DNR) order is a critical document in this process, instructing medical professionals not to perform CPR if your heart stops or if you stop breathing. For those residing in Washington State, filling out a DNR order requires careful attention to detail to ensure that your wishes are clearly documented and legally recognized. Below, find a step-by-step guide on how to fill out the Washington Do Not Resuscitate Order form correctly, helping you maintain control over your health care decisions.

1. Start by obtaining the correct form from your healthcare provider or the Department of Health website for Washington State. Make sure it's the most current version.
2. Read through the entire form before you begin to fill it out to familiarize yourself with its sections and the type of information needed.
3. In the section designated for patient information, fill in your full legal name, date of birth, and address. Ensure that the information matches other legal identification documents.
4. Discuss your wishes with your physician. Their input is crucial as they need to understand and agree with your decision not to be resuscitated in case of cardiac or respiratory arrest.
5. Have your physician fill out their section of the form. This usually includes their name, contact information, and signature, confirming they have discussed the DNR order with you and agree it reflects your wishes.
6. If applicable, your health care agent or legal representative should also fill in their section. This step is necessary if you are unable to sign the form yourself. They will need to provide their name, relationship to you, and signature.
7. Review the form to ensure all information is correct and all necessary sections have been filled out. Mistakes or omissions could delay or invalidate your DNR order.
8. Sign and date the form. Your signature is required to make the DNR order valid. If you are physically unable to sign, your legal representative or health care agent can sign on your behalf.
9. Keep the original DNR order in a location where it can be easily found by family members or caregivers. Consider also having copies readily accessible in case of an emergency.
10. Inform your family, close friends, and caregivers of your DNR order to ensure your wishes are respected. Provide them with copies or inform them where they can find the original document.

Completing a Do Not Resuscitate Order form is a significant step in planning for your healthcare needs. It communicates your wishes clearly to family, caregivers, and healthcare professionals, ensuring they are respected. Regularly review and update your DNR order as needed to reflect any changes in your health condition or wishes.

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

A Do Not Resuscitate (DNR) Order in Washington state is a medical order written by a doctor. It tells health care providers not to perform cardiopulmonary resuscitation (CPR) if a patient's breathing stops or if the patient's heart stops beating. It is an important document for those who want to refuse life-prolonging measures.

Who can request a DNR Order in Washington?

Any competent adult can request a DNR Order for themselves. For minors or adults unable to make their own medical decisions, a legal guardian, healthcare agent, or a person with durable power of attorney for healthcare may request it on their behalf.

How do I get a DNR Order in Washington?

To get a DNR Order in Washington, you must:

1. Discuss your wishes with your doctor.
2. Your doctor must agree that a DNR is medically appropriate for you.
3. Your doctor will then write the order.

It is also recommended to discuss your wishes with your family or other close contacts to ensure they are aware of your decision.

Where should I keep my DNR Order?

Your DNR Order should be kept in a place where it can be easily found in an emergency. Consider keeping it:

• With you, such as in a wallet or purse.
• In an obvious location in your home, like on the refrigerator or near your bed.
• With your personal medical records.
• At your doctor's office.

Does a DNR Order expire in Washington?

No, a DNR Order in Washington does not automatically expire. It remains in effect until it is revoked. If you change your mind, it is important to inform your doctor immediately to have the DNR Order canceled or modified.

What is the difference between a DNR and a living will?

A DNR Order specifically addresses the use of CPR in emergency situations, indicating that you do not want resuscitative measures. A living will, on the other hand, provides broader instructions about your preferences for end-of-life care and medical treatment. It is important to have both documents as they serve different purposes.

Can a DNR Order be revoked or changed?

Yes. You can revoke or change your DNR Order at any time. To do so, you should:

1. Inform your doctor of your decision to revoke or change the order.
2. Make sure your healthcare representatives, family, and others who are aware of the original DNR Order are informed of the change.
3. Destroy any physical copies of the previous DNR Order to avoid confusion.

Is a DNR Order legally binding across state lines?

While DNR Orders are recognized in most states, the specifics can vary from state to state. If you travel or move, it's important to verify whether your Washington DNR Order will be honored in the new location and what steps you may need to take to ensure your wishes are respected.

1. Not consulting with a healthcare provider: Many individuals fill out the Washington Do Not Resuscitate (DNR) Order without seeking advice from a healthcare professional. DNR orders are significant medical decisions and should be made after discussing the implications with a healthcare provider.

2. Incorrect personal information: A common mistake is entering incorrect personal information. Details such as full legal name, date of birth, and address must be accurately provided to ensure the DNR is valid and enforceable.

3. Omitting necessary signatures: The Washington DNR Order requires signatures from the patient or their legal representative, as well as from a physician. The omission of any required signature invalidates the form.

4. Using an outdated form: Regulations and forms may change. Using an outdated version of the DNR Order can lead to the document not being recognized by medical providers.

5. Failing to specify preferences clearly: The form allows individuals to specify their preferences regarding resuscitation. Failing to clearly outline these wishes can result in confusion or unwanted medical interventions.

6. Not distributing copies appropriately: It is essential to distribute copies of the completed DNR Order to relevant parties. This includes family members, healthcare providers, and hospitals. Not doing so may result in the order not being followed.

7. Lack of witness or notary, when required: Depending on the situation or updates to the law, a witnessed or notarized DNR Order may be required. Not adhering to these requirements can affect the document’s legal standing.

8. Ignoring state-specific steps: Each state has its own procedures and requirements for DNR orders. Failing to follow Washington state-specific steps can lead to the document being unrecognized.

9. Not discussing with family: Avoiding discussions with family members about the decision to have a DNR Order can lead to conflicts and distress during medical emergencies.

10. Mistaking it for a living will: Some people confuse DNR Orders with living wills. While both pertain to end-of-life decisions, a living will is broader, covering more than the specific instruction not to perform CPR.

When navigating the healthcare landscape in Washington, particularly around end-of-life decisions, the Do Not Resuscitate (DNR) Order form is a critical document. However, it is often one part of a more extensive set of forms and documents that individuals and families might consider. Understanding these accompanying documents can ensure that all health care wishes are clearly articulated and can be legally upheld.

• Advance Directive (Living Will): This legal document allows individuals to outline their preferences for medical treatment if they become unable to make decisions for themselves due to incapacity.
• Durable Power of Attorney for Health Care: This designates a specific person, known as a health care agent, to make medical decisions on behalf of the individual if they are unable to do so.
• POLST (Physician Orders for Life-Sustaining Treatment): Similar to a DNR, this medical order indicates what types of life-sustaining treatment a seriously ill or frail patient prefers or declines.
• Will: While not a healthcare document, a will is crucial for outlining how an individual’s assets and affairs should be handled after their death.
• HIPAA Release Form: This form allows healthcare providers to share an individual's health information with designated persons or entities.
• Organ and Tissue Donation Registration Form: This form allows individuals to register their consent for organ and tissue donation upon death, which is separate from the decisions made in a DNR.
• Emergency Contact Form: Although not a legal document, having an emergency contact form filled out ensures that family members or designated contacts are promptly informed in an emergency situation.

These documents complement the Washington Do Not Resuscitate Order form, each serving a unique role in the broader context of healthcare planning. Whether prioritizing end-of-life care preferences or ensuring that assets are distributed as wished after passing, these forms together create a comprehensive plan that respects the individual's wishes and provides clear directions to healthcare providers and loved ones.

The Washington Do Not Resuscitate Order form is similar to several other important documents used within the healthcare and estate planning fields. These documents each serve unique purposes but share the common goal of honoring an individual's wishes regarding medical treatment and end-of-life care. Understanding the similarities and differences can empower individuals and families to make informed decisions about their healthcare planning.

Advance Directive: An advance directive, also known as a living will, is a document that provides instructions for medical treatment in the event an individual becomes unable to make their own healthcare decisions. Like the Do Not Resuscitate (DNR) Order, it often includes wishes regarding life-sustaining treatments. However, while a DNR specifically addresses the non-use of CPR (Cardiopulmonary Resuscitation) in the event of cardiac arrest, an advance directive can encompass a wider range of medical interventions and preferences beyond the scope of CPR.

Healthcare Power of Attorney (HCPOA): This document appoints a person, known as a healthcare proxy or agent, to make medical decisions on behalf of the individual if they are unable. Similar to a DNR, it activates under specific medical conditions, usually when the individual is incapacitated or otherwise unable to communicate their healthcare wishes. While a DNR order directs medical personnel regarding CPR, a healthcare power of attorney allows the proxy to make broader healthcare decisions, which can include the enforcement or non-enforcement of a DNR order based on the individual’s known wishes.

POLST (Physician Orders for Life-Sustaining Treatment): A POLST form complements a DNR order by providing detailed instructions for a range of life-sustaining treatments in addition to CPR, such as mechanical ventilation, artificial nutrition, and hydration. Similar to a DNR, a POLST is designed for those at an advanced stage of illness or frailty. Both documents are medical orders that healthcare professionals must follow, but the POLS T is broader and includes more specific treatment instructions than a DNR.

Each of these documents plays a vital role in healthcare planning, ensuring that individuals' preferences for medical treatment and end-of-life care are known and respected. By understanding the specific purpose and scope of a DNR and how it relates to other healthcare directives, individuals can better prepare for the conversations and decisions that lie ahead.

Filling out a Do Not Resuscitate (DNR) order in Washington is a significant decision. This document instructs medical personnel not to perform CPR if your heart stops or if you stop breathing. To ensure your wishes are clearly communicated and respected, here are some important dos and don'ts:

Do:

1. Discuss your decision with your healthcare provider. They can help you understand the implications of a DNR order and ensure it reflects your wishes accurately.
2. Ensure that all information on the form is accurate and legible. Mistakes or unclear handwriting can lead to confusion in critical situations.
3. Sign and date the form according to state requirements. In Washington, this often requires a witness or notarization, depending on the specific form used.
4. Inform family members or close friends of your decision. This can help prevent confusion or conflict in emergency situations.
5. Keep the DNR order in an easily accessible location. First responders need to see the document quickly to follow your wishes.

Don't:

• Fill out the form without fully understanding its implications. Take the time to discuss your options with a healthcare professional.
• Forget to review and update your DNR order periodically. Your wishes may change over time, and it’s crucial to ensure the document reflects your current preferences.
• Assume talking about your wishes is enough. Verbal instructions are not legally binding in an emergency; a signed and completed DNR form is necessary.
• Fail to inform your primary care physician and any specialists about your DNR order. They should have a copy on file and be aware of your wishes.
• Leave the form in a place where no one can find it. A DNR order is only useful if it can be found and presented to medical personnel when needed.

When it comes to the Washington Do Not Resuscitate (DNR) Order form, there are several misconceptions that can muddy the waters for individuals trying to make informed decisions about their healthcare. It's crucial to dispel these myths to ensure everyone understands what a DNR order entails and how it operates within the state of Washington.

• Only the elderly and terminally ill can have a DNR order. DNR orders are available to any individual, regardless of age or the immediate state of health, who wishes to refuse resuscitation in the event their heart stops or they stop breathing. The decision is personal and can be based on a variety of health concerns or personal beliefs.

• DNR orders mean no medical treatment will be provided. This is a common misconception. A DNR order specifically refuses CPR (cardiopulmonary resuscitation) in the event of cardiac or respiratory arrest. It does not mean that other treatments, like pain management, antibiotics, or nutrition, will be withheld.

• DNR orders are only for use in hospitals. While it's true that DNR orders are often implemented in hospitals, they are also applicable in other settings, such as at home or in hospice care. The key is ensuring that the DNR order is readily accessible and that healthcare professionals are aware of it.

• You need a lawyer to complete a DNR order. While legal advice can be helpful in many situations, you do not need a lawyer to fill out a DNR order in Washington. It is a medical form that requires completion by the individual and their healthcare provider.

• DNR orders cannot be revoked. A DNR order is not permanent and can be revoked at any time by the individual as long as they are capable of making their own medical decisions. This can be done by physically destroying the DNR order, expressing a wish to revoke it to the healthcare provider, or by any other clear indication of the desire to nullify the order.

• Emergency Medical Technicians (EMTs) will not respond if you have a DNR order. EMTs will still respond to emergencies and provide care that does not involve resuscitation efforts. They are trained to offer comfort and support and to manage symptoms effectively within the boundaries set by the DNR order.

• A DNR order is the same as a “Do Not Intubate” (DNI) order. While both orders pertain to end-of-life care preferences, they serve different purposes. A DNI specifically refuses intubation and mechanical ventilation, while a DNR refers specifically to CPR. Some individuals might have both orders, depending on their healthcare wishes.

• DNR orders automatically extend to other states. DNR orders, including those issued in Washington, are not automatically valid in other states due to varying laws and regulations. If traveling or relocating, it's important to look into the requirements of the new state and potentially complete new paperwork.

• Having a DNR means you cannot be admitted to the hospital. This is not true. A DNR order does not affect the ability to be admitted to the hospital for treatment. It only guides healthcare providers on how to proceed in the event of cardiac or respiratory arrest. Other medical treatments and interventions can still be pursued according to the patient's needs and wishes.

Understanding the truth behind these misconceptions is vital for anyone considering a DNR order. It empowers individuals to make informed decisions about their own healthcare and ensures their wishes will be respected.

Filling out the Washington Do Not Resuscitate (DNR) Order form is a significant step for individuals making important decisions about their end-of-life care. Here are key takeaways to guide you through the process and ensure your preferences are clearly understood and respected.

• Understanding the Purpose: The DNR form is designed to communicate an individual's wish not to have cardiopulmonary resuscitation (CPR) in the event their heart stops or they stop breathing. This is a critical choice for those with serious illnesses or at the end of life.
• Consultation: Before filling out the form, it's essential to discuss your health condition and wishes with a healthcare provider. A physician, nurse practitioner, or physician assistant can provide guidance tailored to your healthcare needs.
• Completing the Form: The DNR form must be filled out accurately and signed by both the individual and their healthcare provider to be valid. The provider's signature confirms that they have discussed the DNR order with you and agree with your decision.
• Legibility is Critical: Ensure that all information on the form is clearly written to prevent any confusion during a medical emergency. If information is not legible, it could delay decision-making in critical moments.
• Accessibility: Once the form is completed, it should be kept in a place where it can be easily accessed by family members, caregivers, and emergency medical personnel. Some people choose to have a DNR order as part of their medical alert system.
• Informing Others: It's important to inform close family members, caregivers, and your healthcare proxy (if you have one) about your decision and the existence of the DNR order. Clear communication can help ensure your wishes are followed.
• Legal Status: In Washington, a DNR order is a legally binding document. Healthcare providers and emergency personnel must follow the instructions provided in the order once they are made aware of its existence.
• Review and Updates: Your healthcare wishes may change over time. As such, reviewing and updating your DNR order regularly, or after any significant change in your health status, is advisable to ensure it still reflects your current wishes.
• Revocation: You have the right to revoke your DNR order at any time. This can be done by informing your healthcare provider verbally or in writing. After revoking the order, a new form should be completed if you decide to reinstate a DNR request in the future.

Making decisions about end-of-life care is deeply personal. Understanding how to properly complete and use the Washington Do Not Resuscitate Order form is a crucial step in ensuring your healthcare wishes are known and respected. Always consult with a healthcare provider to make informed decisions based on your individual health needs.