Do Not Resuscitate Order in Florida DNRO

[Babber]

We just had a sad incident, in our neighborhood, where the wife tried to activate the DNR order in their final papers on her husband. It was a sad situation, that the husband that has been very ill, was discovered not breathing.

The paramedics were called and responded promptly. There was no pulse and apparently not breathing for awhile. The wife presented paperwork of her husbands intention to not resuscitate.

They did not honor the request and did preform CPR and revived temporarily, He later passed in the hospital. The questioned arise of why the DNR order was not honored. The reason was, in Florida, the DNRO must be on yellow paper.

The rule is:
"In Florida, the Do Not Resuscitate Order (DNRO) is a specific form, known as DH Form 1896, that must be on yellow paper to be valid. This form is approved by the Florida Department of Health. It instructs medical providers not to perform cardiopulmonary resuscitation (CPR) on the patient in the event of a cardiac or respiratory arrest. The form needs to be signed by both the patient (or their authorized representative) and the patient's physician. "

Form:
The official Florida DNRO is DH Form 1896, which is printed on yellow legal-size paper (8 ½ x 14 inches).

Availability:
You can obtain the form by downloading it from the Florida Department of Health website. Your attorney, healthcare provider, or an ambulance service may also have copies available.

Requirements:
The form must be signed by both the patient (or their authorized representative) and their physician. It should also be on yellow paper.


This was news to me and I am going through the process of updating my final wish.

[HappyTraveler]

This is really important info and thanks for taking the time to write it.

The situations where Living Wills and DNRs come into play can be much trickier than people realize. Now, add this "yellow paper" aspect -- yikes.

It should also be shared that one of the most important aspects, I have learned, is making sure the person who has Healthcare POA understands the wishes stated on the form plus understands and recognizes when they are in a health situation where it can come into play.

It's also worth mentioning that states sometimes revise or add to these forms. So, if someone filled one out in 1995 I imagine it would still be valid but, is likely to be quite vague and not as useful compared to what current forms describe.

[Taltarzac725]

It should be posted on the refrigerator. I have had to call 911 quite a number of times for my late father. They would often check there.


It also needs to be signed by your current physician. We had to get a new one when a family member switched doctors.

This is for Florida.

[OrangeBlossomBaby]

It should be posted on the refrigerator. I have had to 911 quite a number of times for my late father. They would often check there.


It also needs to be signed by your current physician. We had to get a new one when a family member switched doctors.

This is for Florida.

Posting on the refrigerator does no one any favors, if the person has a heart attack on the golf course, or gets into a lethal car accident on the road (for example).

I would suggest that anyone who has a DNR carry it on their person at all times.

You can have a copy - on yellow paper - on the refrigerator door. Or get a life capsule to put IN the fridge, on a shelf of the door inside. That would have the DNR, living will, list of medications and allergies, current physician's name, emergency contacts.

You can ALSO have a magnet on the fridge door informing EMTs that the patient is carrying their DNR on their person.

[Bill14564]

Posting on the refrigerator does no one any favors, if the person has a heart attack on the golf course, or gets into a lethal car accident on the road (for example).

I would suggest that anyone who has a DNR carry it on their person at all times.

You can have a copy - on yellow paper - on the refrigerator door. Or get a life capsule to put IN the fridge, on a shelf of the door inside. That would have the DNR, living will, list of medications and allergies, current physician's name, emergency contacts.

You can ALSO have a magnet on the fridge door informing EMTs that the patient is carrying their DNR on their person.

I understand the idea here but for me, this misses a point ... if I can golf or drive a car then I wouldn't have a DNR in the first place.

A DNR will not come into play for me until I am so ill and physically incapacitated that I am done. I would be at the point where I felt that resuscitation would not be extending my life but only delaying a desired passing. If I am able to play a round of golf or drive a car then I am not close to being ready for things to come to an end.

My father needed to be resuscitated twice (that I know of) until the doctors were able to adjust his medications and pacemaker correctly. He lives a happy and relatively active life today which would not be the case if he carried that yellow paper.

This doesn't mean I haven't shared my wishes about extraordinary measures with my spouse, there might come a time when a difficult decision has to be made. But I'm not willing to have that decision be made automatically after a lightning strike, an accident in a pool, or a "basic" heart attack.

[scubawva]

“ The wife presented paperwork of her husbands intention to not resuscitate.”

What paperwork? All Dr offices know the proper form, it must be signed by the px physician. Did a physician actually sign this paperwork?


Whatever paperwork they had they now know wasn’t acceptable, unfortunately a hard way to learn the requirement.

Anyone with a DNR should have it on them at all times. You never know where one will be when it’s needed. Many times the ill person isn’t at home and the DNR is, the EMS crew must work the px.

Prayers

[asianthree]

I understand the idea here but for me, this misses a point ... if I can golf or drive a car then I wouldn't have a DNR in the first place.

A DNR will not come into play for me until I am so ill and physically incapacitated that I am done. I would be at the point where I felt that resuscitation would not be extending my life but only delaying a desired passing. If I am able to play a round of golf or drive a car then I am not close to being ready for things to come to an end.

My father needed to be resuscitated twice (that I know of) until the doctors were able to adjust his medications and pacemaker correctly. He lives a happy and relatively active life today which would not be the case if he carried that yellow paper.

This doesn't mean I haven't shared my wishes about extraordinary measures with my spouse, there might come a time when a difficult decision has to be made. But I'm not willing to have that decision be made automatically after a lightning strike, an accident in a pool, or a "basic" heart attack.

One can still have a life and be stage 4 Mets to every organ. Have witnessed this scenario more times than you can count.

Sorry you won’t be the one making that decision, in any of your scenarios. One can be walking to the bathroom with zero issues and drop dead, of MI, dissecting AAA, or number of issues you or your doctor hasn’t figured it out yet. Unless your spouse has medical background, to know when to CPR, or sit and wait for 30-45 minutes. It’s a lot to dump on them. Then again more times than anyone can count that Valid DNR, is being hidden by a family member, because they can’t Let Them Go.

A good example my brother-in-law stage four esophageal Mets to liver kidney and lungs, fought for 2.5 years. DNR from day one of diagnosis.
He was 54, and a musician. Drove to his studio to record with his band. 7 hours played, recorded, tweaked, added mix.

Sitting at the mixer board took a drink of water told the guys that 15 minutes, they could all go get some dinner, and listen to the recording. 5 minutes later slumped face first into the mixer board. So just because you know you are going to die doesn’t mean you stop living.

[blueash]

The DNR has both a large page form and a wallet size form. The wallet size is actually a bit large for a wallet... but EMTs are not allowed to go into your wallet to look for it. So... make sure that those you are with know about your wallet DNR so they can get it for EMT

Many have a DNR who are not at all ill. The data on successful outcome meaning survival without major brain damage of out of hospital CPR is grim, It is not unreasonable to elect to let nature take its course in the event of a full cardiac arrest rather than chance being "saved" then dealing with brain damage.

Overall survival and brain death frequency following out-of-hospital cardiac arrest - PMC (https://pmc.ncbi.nlm.nih.gov/articles/PMC5903540/)
Of 130 arrests only 6 did not die or have significant damage.

[asianthree]

The DNR has both a large page form and a wallet size form. The wallet size is actually a bit large for a wallet... but EMTs are not allowed to go into your wallet to look for it. So... make sure that those you are with know about your wallet DNR so they can get it for EMT

Many have a DNR who are not at all ill. The data on successful outcome meaning survival without major brain damage of out of hospital CPR is grim, It is not unreasonable to elect to let nature take its course in the event of a full cardiac arrest rather than chance being "saved" then dealing with brain damage.

Overall survival and brain death frequency following out-of-hospital cardiac arrest - PMC (https://pmc.ncbi.nlm.nih.gov/articles/PMC5903540/)
Of 130 arrests only 6 did not die or have significant damage.

FYI a Tattoo on chest on two people of their “wallet size card” it isn’t legal. Have witnessed at least 10 “DNR” bold letter tatts on chests.

One person with overlapping hands exactly when one should CPR.

Our repeat sweet 95yo, former, Ziegfield follies girl had a CPR circle to make sure someone got it right.

They say medical staff have a warped sense of humor

[Bill14564]

One can still have a life and be stage 4 Mets to every organ. Have witnessed this scenario more times than you can count.

Sorry you won’t be the one making that decision, in any of your scenarios. One can be walking to the bathroom with zero issues and drop dead, of MI, dissecting AAA, or number of issues you or your doctor hasn’t figured it out yet. Unless your spouse has medical background, to know when to CPR, or sit and wait for 30-45 minutes. It’s a lot to dump on them. Then again more times than anyone can count that Valid DNR, is being hidden by a family member, because they can’t Let Them Go.

A good example my brother-in-law stage four esophageal Mets to liver kidney and lungs, fought for 2.5 years. DNR from day one of diagnosis.
He was 54, and a musician. Drove to his studio to record with his band. 7 hours played, recorded, tweaked, added mix.

Sitting at the mixer board took a drink of water told the guys that 15 minutes, they could all go get some dinner, and listen to the recording. 5 minutes later slumped face first into the mixer board. So just because you know you are going to die doesn’t mean you stop living.

Easy for me to take a position now - might have a different opinion if I’m ever in the situation.

At this point , feel like if I can live my life today I can live it tomorrow. If I’m ready to not live it tomorrow it’s because I’m not getting any value from it today. But again, my opinion certainly might be different if I’m actually in the situation.

[Babber]

Thanks to a neighbor that was an EMT, I received the following about DNRO orders:


Frequently Asked Questions About Do Not Resuscitate Orders

The latest version of the Do Not Resuscitate Order (DNRO) (form DH 1896) developed by the Florida Department of Health is available at System Message - Florida Administrative Rules, Law, Code, Register - FAC, FAR, eRulemaking (http://www.flrules.org/gateway/reference.asp?No=Ref17066), where you will click a link that looks like this: You will need the free Adobe Acrobat Reader or similar software to download and print the form. To be valid, the DNRO and any copies must be printed with a full-page yellow background or be printed on yellow paper. Any shade of yellow is acceptable. Forms are also available by writing to: Florida Department of Health, Trauma Office, 4052 Bald Cypress Way, Bin A-22, Tallahassee, Florida 32399 or
by calling 800-226-1911, extension 2795, or local number 850-558-9514.
1. What is a DNRO? How is it different from a DNR, advance directive, or POLST?
2. Who should have a DNRO?
3. Why should an individual complete a DNRO if he or she already has a living will?
4. When and how is the DNRO used?
5. How will the properly completed DNRO look?
6. Does the DNRO have to be notarized or witnessed?
7. Where should I keep my DNRO?
8. Is the DNRO valid outside of Florida? Can I use a DNR, advance directive, or POLST from another state?
9. Can the DNRO be revoked?
10. Is there a portable version of the DNRO?
11. Should 9-1-1 still be called if the patient has a DNRO?
12. Is it permissible to copy the DNRO form?
13. Does the DNRO ever expire?
14. Where can a DNRO form be obtained?

1. What is a DNRO? How is it different from a DNR, advance directive, or POLST? A Do Not Resuscitate Order (DNRO) (form DH 1896) is a one-page, easily-identifiable form developed by the Florida Department of Health pursuant to section 401.45, Florida Statutes, and adopted by rule. The DNRO is only intended to identify a patient whose health care provider has directed paramedics and emergency medical technicians (EMTs) not to resuscitate the patient in the event of respiratory or cardiac arrest. The DNRO is different from Do Not Resuscitate (DNR) directions, advance directives, and Physician Orders for Life Sustaining Treatment (POLST). A DNR, advance directive, or POLST is any written direction from a health care provider to all other providers who treat the patient. A DNR, advance directive, or POLST often includes a combination of directions for when to administer or withhold treatments and procedures for end-of-life, chronic, and Page 1 of 4 terminal illness care. Hospital, facility, and hospice personnel may review the DNR, advance directive, or POLST together with the patient’s other medical records to provide appropriate care. The DNRO is a specific, limited direction to paramedics and EMTs only. Paramedics and EMTs are not required to review and interpret any other type of DNR, advance directive, or POLST document. A DNRO and any copies of the DNRO must be printed with a full-page yellow background or be printed on yellow paper, or they will not be valid. Any shade of yellow is acceptable.

2. Who should have a DNRO? A DNRO is used by someone who does not wish to have respiratory or cardiac resuscitation, like CPR, in the event of cardiopulmonary failure. If you are not sure if a DNRO would be appropriate for you, or you would like additional information, consult your health care provider and your attorney.

3. Why should an individual consider completing a DNRO? An individual who has decided to forego resuscitative treatments and procedures in the event of the individual’s respiratory or cardiac arrest should consider completing a DNRO. The completed DNRO will be part of the patient’s prescribed medical treatment plan and must be signed by the patient’s physician, osteopathic physician, advanced practice registered nurse who is registered for autonomous practice, or physician assistant. Copies that are reproduced with the full-page yellow background or printed on any shade of yellow paper are also valid.

4. When and how is the DNRO used? The DNRO developed by the Department of Health, identified on the bottom left corner of the document as “Form DH 1896, Revised 02/2024, Incorporated by Rule 64J-2.018, F.A.C.,” is intended to be used by presenting it to an EMT or paramedic upon their arrival to treat the patient in a setting other than a hospital, health care facility, or hospice. The EMT or paramedic must keep the DNRO with the patient during transport. Hospitals, facilities, and hospice may honor the DNRO, but the Department of Health does not regulate these facilities and the forms they use. Many types of DNR direction documents, advance directives, and POLST forms are available. When entering a hospital, health care facility, or hospice, consult your health care provider and the facility’s risk management and legal offices concerning the use of a DNRO and other health care directions.

5. How will the properly completed DNRO form look? A properly completed DNRO form will be signed by the competent patient or the patient’s representative, and by a Florida licensed physician, osteopathic physician, advanced practice registered nurse who is registered for autonomous practice, or a physician assistant, and will have a full-page yellow background or be printed on any shade of yellow paper. Copies that are reproduced with the full-page yellow background or printed on any shade of yellow paper are also valid. Page 2 of 4

6. Does the DNRO have to be notarized or witnessed? No. The DNRO should simply be signed by the competent patient or the patient’s representative at the same time that it is signed by the patient’s health care provider. This is usually done in the presence of the patient’s health care provider.

7. Where should I keep my DNRO? Keep your DNRO in a noticeable, easily accessible place. It should be readily available in the event of an emergency to ensure that your wishes will be honored. A copy of the DNRO or the reduced-size DNRO (see the bottom of the DNRO form) may be completed and removed, and carried by the patient with their photographic identification, such as in a wallet. Copies that are reproduced with the full-page yellow background or printed on any shade of yellow paper may be carried by a family member or friend, provided to the patient’s health care provider or local hospital, and secured to the patient’s refrigerator where the DNRO will be readily visible to emergency responders.

8. Is the DNRO valid outside of Florida? Can I use a DNR, advance directive, or POLST from another state? The DNRO is only directed to paramedics and EMTs who are certified in Florida. The Department of Health does not regulate EMTs and paramedics in other locations and so cannot direct them to honor a DNRO. Check the law in the area where you will be to determine if a particular form of DNR, advance directive, or POLST is honored in that area. Florida does not prohibit patients from having both the DNRO and other forms of medical directions addressing resuscitative care.

9. Can the DNRO be revoked? If the patient who created the DNRO is competent, the patient can revoke the DNRO by expressing a contrary intent either orally or in writing, such as saying or writing: “I revoke my DNRO and desire resuscitation or CPR.” A competent patient can also revoke the DNRO by physically destroying it, by failing to present it to paramedics or EMTs, or by signing an order from a physician, autonomous advanced practice registered nurse, or physician assistant that directs paramedics and EMTs to resuscitate the patient. If you intend to revoke your DNRO, be sure to notify any health care provider, hospital, facility, hospice, and person to whom you provided a copy.

10. Is there a portable version of the DNRO? Yes. Attached to the bottom of the DNRO is a reduced-size duplicate of the larger DNRO, described as a “DNRO device.” You may remove this DNRO device from the form, laminate it, and carry it in your wallet next to your identification, or wear it on a necklace, clipped to a key chain, or pinned to your clothing or bedding so it will be with you. The full-size DNRO is still valid if the reduced-size DNRO device is not completed or if it is removed. As long as the reduced-size DNRO is properly completed and signed, any printed wording on the DNRO device and any copies is legible, and the DNRO device and any copies are reproduced on yellow paper, they are all valid.

11. Should 911 still be called if the patient has a DNRO? Do not hesitate to call 911 even if the patient has a DNRO. Paramedics and EMTs will provide support and assistance to family and caregivers and work to keep the patient comfortable. Emergency medical services are also available to transport the patient to the Page 3 of 4 hospital even if resuscitation will not be initiated. Emergency medical services, paramedics, and EMTs are members of the community who provide appropriate care and support in many capacities, including comfort care measures such as oxygen administration, hemorrhage control, and pain management.

12. Is it permissible to copy the DNRO form? Yes. Copies are as valid as the original if they accurately reproduce the signatures, the printed wording is legible, and the copies are printed with a full-page yellow background or are reproduced on any shade of yellow paper.

13. Does the DNRO ever expire? No. A properly completed DNRO does not expire.

14. Where can a DNRO form be obtained? The latest version of the Do Not Resuscitate Order (DNRO) (form DH 1896) developed by the Florida Department of Health is available at Reference Material Home - Florida Administrative Rules, Law, Code, Register - FAC, FAR, eRulemaking (http://www.flrules.org/gateway/reference.asp?No=Ref-17066), where you will click a link that looks like this: You will need the free Adobe Acrobat Reader or similar software to download and print the form. To be valid, the DNRO and any copies must be printed with a full-page yellow background or be printed on yellow paper. Any shade of yellow is acceptable. Forms are also available by writing to: Florida Department of Health, Trauma Office, 4052 Bald Cypress Way, Bin A-22, Tallahassee, Florida 32399 or by calling 800-226-1911, extension 2795, or local number 850-558-9514.

I hope this helps

[RICH1]

the girlfriend/wife was 26 and the DNRO was just printed..
I am shocked how many people that live in the Villages, are not prepared for the next Level.. Is it Ignorance or stupidity ?

[jojoturf]

Just experienced this in NY State. DNR has to be on bright pink paper signed by palliative care or other authority. EMT checked that document immediately upon entering the house. The DNR paragraph in his Living Will meant nothing. Sorry for this persons loss.

[MandoMan]

We just had a sad incident, in our neighborhood, where the wife tried to activate the DNR order in their final papers on her husband. It was a sad situation, that the husband that has been very ill, was discovered not breathing.

The paramedics were called and responded promptly. There was no pulse and apparently not breathing for awhile. The wife presented paperwork of her husbands intention to not resuscitate.

They did not honor the request and did preform CPR and revived temporarily, He later passed in the hospital. The questioned arise of why the DNR order was not honored. The reason was, in Florida, the DNRO must be on yellow paper.

The rule is:
"In Florida, the Do Not Resuscitate Order (DNRO) is a specific form, known as DH Form 1896, that must be on yellow paper to be valid. This form is approved by the Florida Department of Health. It instructs medical providers not to perform cardiopulmonary resuscitation (CPR) on the patient in the event of a cardiac or respiratory arrest. The form needs to be signed by both the patient (or their authorized representative) and the patient's physician. "

Form:
The official Florida DNRO is DH Form 1896, which is printed on yellow legal-size paper (8 ½ x 14 inches).

Availability:
You can obtain the form by downloading it from the Florida Department of Health website. Your attorney, healthcare provider, or an ambulance service may also have copies available.

Requirements:
The form must be signed by both the patient (or their authorized representative) and their physician. It should also be on yellow paper.


This was news to me and I am going through the process of updating my final wish.

Not questioning your facts, but I had my will drawn up by a local lawyer, including a paper saying I didn’t want to be resuscitated. It wasn’t yellow. I gave a copy to my doctor, who didn’t give me a yellow one. So perhaps I need to get that.

If the intention was that the person not be resuscitated, it’s a shame that the spouse called 911 (I assume) and that paramedics were sent. They are trained to do everything possible to save life, not to stop to discuss DNRs. If the spouse had perhaps maintained a quiet vigil for an hour or two until the person was dead, then made a non-911 call, this could have been avoided.

I myself have a DNR because if my heart stops and I receive defibrillation at home (unlikely as I live at home alone and don’t know who to call in the neighborhood, and the door is locked anyway), my chance of living UNTIL RELEASE FROM THE HOSPITAL is only 10%, and then I’d probably be sent to a rehab hospital, possibly with brain damage, and if I got home there’s a high chance that I’d die within a few months. And I might have very painful broken ribs, too. I don’t like those odds. I’ve had a great life. Just let me go.

“The survival rate after a heart restart varies depending on whether the event occurs inside or outside a hospital. Generally, survival to hospital discharge is around 10% for out-of-hospital cardiac arrests and 21% for in-hospital arrests.”

[asianthree]

the girlfriend/wife was 26 and the DNRO was just printed..
I am shocked how many people that live in the Villages, are not prepared for the next Level.. Is it Ignorance or stupidity ?

Neither is called Denial.

[Remembergoldenrule]

Also register it with all the hospitals in the area along with urgent cares and emergency rooms so on file.

[elevatorman]

Every state has a different form.

[maggie1]

Just experienced this in NY State. DNR has to be on bright pink paper signed by palliative care or other authority. EMT checked that document immediately upon entering the house. The DNR paragraph in his Living Will meant nothing. Sorry for this persons loss.


This is crazy! Pink paper, yellow paper, white paper, and I imagine other states have a different color paper they would accept. If a person goes toes up in a state requiring a certain color of paper for a DNRO to be honored, and the party has a DNRO, but not in the correct color, the person could linger in the hospital for days before the end. Why in the world would there not be a standard form that would be honored by all states? This isn't a difficult problem to solve if only the states would use common sense, but I know common sense is not a strong point in government.

[Indydealmaker]

We just had a sad incident, in our neighborhood, where the wife tried to activate the DNR order in their final papers on her husband. It was a sad situation, that the husband that has been very ill, was discovered not breathing.

The paramedics were called and responded promptly. There was no pulse and apparently not breathing for awhile. The wife presented paperwork of her husbands intention to not resuscitate.

They did not honor the request and did preform CPR and revived temporarily, He later passed in the hospital. The questioned arise of why the DNR order was not honored. The reason was, in Florida, the DNRO must be on yellow paper.

The rule is:
"In Florida, the Do Not Resuscitate Order (DNRO) is a specific form, known as DH Form 1896, that must be on yellow paper to be valid. This form is approved by the Florida Department of Health. It instructs medical providers not to perform cardiopulmonary resuscitation (CPR) on the patient in the event of a cardiac or respiratory arrest. The form needs to be signed by both the patient (or their authorized representative) and the patient's physician. "

Form:
The official Florida DNRO is DH Form 1896, which is printed on yellow legal-size paper (8 ½ x 14 inches).

Availability:
You can obtain the form by downloading it from the Florida Department of Health website. Your attorney, healthcare provider, or an ambulance service may also have copies available.

Requirements:
The form must be signed by both the patient (or their authorized representative) and their physician. It should also be on yellow paper.


This was news to me and I am going through the process of updating my final wish.

Thanks for this info. Also begs the question as to why there was a useless copy in the first place.

[Bill14564]

Thanks for this info. Also begs the question as to why there was a useless copy in the first place.

As far as I can tell, in MD there is a form that can be filled out online and used. I believe it must be signed by a physician but I haven't looked into it that closely. However, if I had filled out that form in MD I would have moved it with me down here to Florida expecting it would be honored. Only when it mattered would I have discovered it was a useless copy.

[FredJacobs]

There is a difference between a DNRO and a DNR -

What is a DNRO? How is it different from a DNR, advance directive, or POLST?

A Do Not Resuscitate Order (DNRO) (form DH 1896) is a one-page, easily-identifiable form
developed by the Florida Department of Health pursuant to section 401.45, Florida Statutes,
and adopted by rule. The DNRO is only intended to identify a patient whose health care
provider has directed paramedics and emergency medical technicians (EMTs) not to
resuscitate the patient in the event of respiratory or cardiac arrest.

The DNRO is different from Do Not Resuscitate (DNR) directions, advance directives, and
Physician Orders for Life Sustaining Treatment (POLST). A DNR, advance directive, or
POLST is any written direction from a health care provider to all other providers who treat
the patient. A DNR, advance directive, or POLST often includes a combination of directions
for when to administer or withhold treatments and procedures for end-of-life, chronic, and
terminal illness care. Hospital, facility, and hospice personnel may review the DNR, advance
directive, or POLST together with the patient’s other medical records to provide appropriate
care.

The DNRO is a specific, limited direction to paramedics and EMTs only. Paramedics and
EMTs are not required to review and interpret any other type of DNR, advance directive, or
POLST document. A DNRO and any copies of the DNRO must be printed with a full-page
yellow background or be printed on yellow paper, or they will not be valid. Any shade of
yellow is acceptable.

[scubawva]

“Also register it with all the hospitals in the area along with urgent cares and emergency rooms so on file.”

Must be with the patient. Original.

[HappyTraveler]

This is crazy! Pink paper, yellow paper, white paper, and I imagine other states have a different color paper they would accept. If a person goes toes up in a state requiring a certain color of paper for a DNRO to be honored, and the party has a DNRO, but not in the correct color, the person could linger in the hospital for days before the end. Why in the world would there not be a standard form that would be honored by all states? This isn't a difficult problem to solve if only the states would use common sense, but I know common sense is not a strong point in government.

I don't specifically know what the point of the colored paper is. Obviously, there have been issues (forgeries?) that they are attempting to mitigate using colored paper.

This isn't a difficult problem to solve if only the states would use common sense, It inherently IS a difficult issue but, it's not the states that are lacking, it's THE FAMILIES. Often times, relationships are not good or communication is poor, some members don't understand the issues, some don't want to understand them, some have particular motivations, etc. The families are where the difficulty is.

Frankly, people being so ultra-focused on the DNR and DRNO are missing the larger and more important instructions. Let me use the state of NC as an example....they call it: an Advanced Directive or Living Will (because it covers several health situations, not just DNR).That is where my mother lived for decades. She filled out a Living Will in 1994. Unfortunately, neither she nor my brother, who was her POA, sought to update it all those decades since. Hers was one page, but when she got very sick in 2021 and we scrambled to do an update, it had become four pages and rightfully so. The state of NC realized that there is much more nuance to these situations so, greater specificity was needed.

Here is the link to the most current (I think) version of it and it's well worth your time to scan it, then you'll understand the breadth of it beyond just DNR. Also, I direct you to the text on bottom of page 3/top of page 4. Notice how they want the witness to be someone in no way related to, medically-treating or a beneficiary of the estate. So, in NC, they don't want your Doctor, any employee of theirs or of a facility where you might be living to be signing it. Obviously, all of that is there because there have been problems in the past. https://www.sosnc.gov/webfiles/documents/forms/advance_healthcare_directives/advance_directive_for_a_natural_death.pdf

The reasons it's important to update these Directives/Living Wills every ten years or so, is:
a) I imagine you might answer the questions differently when you're 65 and in good health versus when you're 85 or 90 and maybe not in great health. I know I would. Sure, save me when I'm still fairly young and can recover from whatever health issue and go on to live a nice life. No, I don't want to be saved when I'm very aged, in declining health and especially if I would become wheelchair-bound upon recovery when elderly (life becomes prison-like).
b) The forms change....as I described with my mothers situation in NC. Older ones might still be honored but, it's better to be fairly up-to-date to avoid any problems.

[LarryL]

We just had a sad incident, in our neighborhood, where the wife tried to activate the DNR order in their final papers on her husband. It was a sad situation, that the husband that has been very ill, was discovered not breathing.

The paramedics were called and responded promptly. There was no pulse and apparently not breathing for awhile. The wife presented paperwork of her husbands intention to not resuscitate.

They did not honor the request and did preform CPR and revived temporarily, He later passed in the hospital. The questioned arise of why the DNR order was not honored. The reason was, in Florida, the DNRO must be on yellow paper.

The rule is:
"In Florida, the Do Not Resuscitate Order (DNRO) is a specific form, known as DH Form 1896, that must be on yellow paper to be valid. This form is approved by the Florida Department of Health. It instructs medical providers not to perform cardiopulmonary resuscitation (CPR) on the patient in the event of a cardiac or respiratory arrest. The form needs to be signed by both the patient (or their authorized representative) and the patient's physician. "

Form:
The official Florida DNRO is DH Form 1896, which is printed on yellow legal-size paper (8 ½ x 14 inches).

Availability:
You can obtain the form by downloading it from the Florida Department of Health website. Your attorney, healthcare provider, or an ambulance service may also have copies available.

Requirements:
The form must be signed by both the patient (or their authorized representative) and their physician. It should also be on yellow paper.


This was news to me and I am going through the process of updating my final wish.

Why would the Florida make such an assinine rule? Who benefits from it? That said - Thanks for the heads up.

[thelegges]

There is a simple solution. Your spouse doesn’t want to be resuscitated. Once no pulse is detected, sit with your loved one, honor their wishes. Retrieving any paperwork, no matter the state.

Then call 911, it can be hard to not honor wishes but it’s still the choice of the person still breathing, not the one who can no longer respond.

[HappyTraveler]

There is a simple solution. Your spouse doesn’t want to be resuscitated. Once no pulse is detected, sit with your loved one, honor their wishes. Retrieving any paperwork, no matter the state.

Then call 911, it can be hard to not honor wishes but it’s still the choice of the person still breathing, not the one who can no longer respond.

Almost never are these situations simple. That's one of the primary problems -- people think they are! They seem to be expecting a situation of absoluteness to be before them and that everyone in the family is clear about it. Most of the time, it is NO and NO.

I offer more detail in Post #23. I have more to share but, haven't decided if it's worth the time to write it because I'm not sure whether readers actually value it.

[thelegges]

Almost never are these situations simple. That's one of the primary problems -- people think they are! They seem to be expecting a situation of absoluteness to be before them and that everyone in the family is clear about it. Most of the time, it is NO and NO.

I offer more detail in Post #23. I have more to share but, haven't decided if it's worth the time to write it because I'm not sure whether readers actually value it.

Both my spouse and I 45 years in the OR, plus working COVID, which brought more death count in a week, than most families see in their entire lifetime. For Both my parents we waited 30 minutes before making the call. Father in law about 40 minutes.

Best friend, started CPR immediately, continuing for 21 minutes, until rescue arrived. Conversion was never going to happen but continued anyway.

It may be hard to understand, but emotions don’t come into play when it’s your medical profession. Not for strangers or family. We also know when to sit and wait, or start counting.

Doesn’t mean hours or days later emotions doesn’t surface, but loosing it in front of colleagues or family when their is a job to do can never comes into play.

While hard to make plans for your child’s death, there is a game plan and will never deviate.

[blueash]

If the intention was that the person not be resuscitated, it’s a shame that the spouse called 911 (I assume) and that paramedics were sent. They are trained to do everything possible to save life, not to stop to discuss DNRs. If the spouse had perhaps maintained a quiet vigil for an hour or two until the person was dead, then made a non-911 call, this could have been avoided.


There clearly are situations where the person has not suffered an arrest but perhaps is having difficulty breathing or chest pain. It is perfectly correct to call 911 in this situation as intervention before arrest is warranted even if there is a DNR.
So EMT's get called and before or shortly after their arrival, the person arrests. The immediate call for help as right, and the request to not resuscitate once absence of a heartbeat is established is also right.

[RoseyRed]

Totally agree! it is different for everyone due to individual situations.

[RoseyRed]

:bigbow::bigbow::bigbow:This is crazy! Pink paper, yellow paper, white paper, and I imagine other states have a different color paper they would accept. If a person goes toes up in a state requiring a certain color of paper for a DNRO to be honored, and the party has a DNRO, but not in the correct color, the person could linger in the hospital for days before the end. Why in the world would there not be a standard form that would be honored by all states? This isn't a difficult problem to solve if only the states would use common sense, but I know common sense is not a strong point in government.

[RoseyRed]

Very good point of view! I did not consider the complex family issues so many of us have these days!

[Dlpdo]

I understand the idea here but for me, this misses a point ... if I can golf or drive a car then I wouldn't have a DNR in the first place.

A DNR will not come into play for me until I am so ill and physically incapacitated that I am done. I would be at the point where I felt that resuscitation would not be extending my life but only delaying a desired passing. If I am able to play a round of golf or drive a car then I am not close to being ready for things to come to an end.

My father needed to be resuscitated twice (that I know of) until the doctors were able to adjust his medications and pacemaker correctly. He lives a happy and relatively active life today which would not be the case if he carried that yellow paper.

This doesn't mean I haven't shared my wishes about extraordinary measures with my spouse, there might come a time when a difficult decision has to be made. But I'm not willing to have that decision be made automatically after a lightning strike, an accident in a pool, or a "basic" heart attack.

Not true Bill. You could have terminal cancer and still be driving or possibly playing golf but not want extraordinary measures taken in a medical emergency.

[Bill14564]

Not true Bill. You could have terminal cancer and still be driving or possibly playing golf but not want extraordinary measures taken in a medical emergency.

Please see post #10