Getting a Do Not Resuscitate (DNR) form in Wisconsin involves understanding state-specific orders, knowing where to obtain the proper paperwork, and ensuring the document is properly signed and filed. This guide outlines the types of DNR forms, how to obtain them, how to complete them correctly, and how to manage out-of-hospital and in-hospital scenarios. It also covers revocation and how DNR decisions interact with broader advance directives.
What A Do Not Resuscitate Order Means In Wisconsin
A DNR order indicates that medical teams should not perform cardiopulmonary resuscitation (CPR) if the person’s heart or breathing stops. In Wisconsin, DNR orders can apply in hospital settings or be carried as an out-of-hospital directive to guide EMS responders. These orders are medical decisions, typically made with a physician’s guidance, and are documented to optimize the patient’s care aligned with their wishes and medical prognosis.
Types Of DNR Documents Available In Wisconsin
Wisconsin recognizes both hospital-based DNR orders and out-of-hospital DNR documents. Hospital DNR orders are placed in the patient’s medical record by a licensed clinician and are intended to guide care within the facility. Out-of-hospital DNR forms are designed for use when the patient is outside a hospital, such as at home, and are intended to be recognized by emergency responders across the state. In both cases, the forms require a physician’s signature and, in many cases, a witness or notary depending on the form used.
How To Obtain A DNR Form In A Hospital Or Clinic
Obtain a DNR form by discussing goals of care with a physician, advanced practice clinician, or palliative care team. In a hospital or clinic, request the hospital DNR order or the appropriate Wisconsin out-of-hospital form if planning for movement between settings. Some facilities provide standardized DNR packets that include instructions for completing the order, ensuring the patient’s or surrogate’s consent is clearly documented, and signing requirements are met.
Steps To Complete A Wisconsin DNR Order
Follow these steps to properly complete a Wisconsin DNR order:
- Discuss goals of care with the treating clinician, including prognosis, benefits, and risks of CPR.
- Decide whether to proceed with a DNR order based on medical guidance and patient/family preferences.
- Obtain the physician’s signature on the DNR form, or place the DNR order in the hospital’s electronic medical record as required.
- Ensure the form clearly states the scope (in-hospital DNR vs. out-of-hospital DNR) and includes patient name, date of birth, and validity period if applicable.
- Store and share copies with all relevant parties, including family members and the patient’s medical team. For out-of-hospital forms, provide a portable copy to the patient or designated agent and ensure EMS has access to the form.
- Confirm that the form is properly recognized by EMS and hospital staff, reducing delays in an emergency.
Using An Out-Of-Hospital DNR Form In Wisconsin
The Wisconsin Out-of-Hospital Do Not Resuscitate (OOH-DNR) process is designed for use when a patient is not in a hospital setting. Steps typically include physician approval, patient or surrogate consent, and the distribution of a portable DNR form to the patient or caregiver. Ensure the form is easily accessible at home, in a wallet card, or on a mobile health record. Informing family, caregivers, and primary care providers about the DNR status helps prevent confusion during emergencies. EMS providers are trained to honor a valid OOH-DNR when presented with the form during a medical crisis.
Revoking Or Updating A Wisconsin DNR Order
A DNR order can be revoked or changed at any time by the patient, if competent, or by a legally authorized surrogate with appropriate medical guidance. To revoke, communicate the change clearly to healthcare providers and update the DNR documentation in the medical record or remove/void the out-of-hospital form as applicable. Follow up with the physician to ensure all copies and records reflect the updated decision. Regular review is advised, especially after significant changes in health status or care preferences.
Additional Considerations: Living Wills And Health Care Power Of Attorney
While a DNR focuses on CPR and resuscitation, broader advance directives clarify preferences for overall medical care. A Wisconsin living will outlines treatment preferences if a person becomes unable to communicate, while a health care power of attorney designates a trusted individual to make medical decisions on the patient’s behalf. It is prudent to align the DNR order with these documents to ensure consistency across care settings. Consider consulting an attorney or a patient advocate to ensure documents are valid, properly witnessed, and compatible with state law.
Key Takeaways For Wisconsin Residents
- A DNR in Wisconsin can be hospital-based or an out-of-hospital form recognized by EMS.
- Proper completion requires physician involvement, clear patient or surrogate consent, and appropriate storage and accessibility.
- Out-of-hospital forms should be portable and accessible to emergency responders at any location.
- Revocation or updates should be communicated promptly to all involved providers and properly documented.
- Align DNR decisions with broader advance directives to ensure consistency in care preferences.