Attorney-Approved North Carolina Do Not Resuscitate Order Template

Attorney-Approved North Carolina Do Not Resuscitate Order Template

A North Carolina Do Not Resuscitate Order (DNR) form is a legal document that allows individuals to refuse resuscitation efforts in the event of a medical emergency. This form provides clarity to healthcare providers and family members regarding a patient's wishes concerning life-sustaining treatment. Understanding this document is essential for ensuring that personal healthcare preferences are respected during critical situations.

Fill Out Do Not Resuscitate Order Here

The North Carolina Do Not Resuscitate (DNR) Order form is a critical document that allows individuals to express their wishes regarding medical treatment in emergency situations. This form is particularly significant for those who have serious health conditions or are nearing the end of life. By completing a DNR Order, a person can indicate that they do not wish to receive cardiopulmonary resuscitation (CPR) or other life-saving measures in the event of cardiac or respiratory arrest. The form must be signed by a qualified healthcare provider, ensuring that it meets the necessary legal requirements and reflects the individual's medical circumstances. Additionally, it is important to note that the DNR Order is designed to be easily accessible and recognizable by emergency medical personnel, thus ensuring that a person's wishes are respected during critical moments. Understanding the implications of this form is essential for anyone considering it, as it involves both personal values and medical ethics. Furthermore, family members and caregivers should be informed about the existence of a DNR Order, as it can significantly impact decision-making in urgent situations.

Outline

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⇓ Do Not Resuscitate Order

North Carolina Do Not Resuscitate Order Sample

North Carolina Do Not Resuscitate Order (DNR)

This Do Not Resuscitate Order is created in accordance with the North Carolina General Statutes, specifically G.S. 90-21.17A.

Patient Information:

  • Patient Name: _____________________________
  • Date of Birth: _____________________________
  • Address: _________________________________
  • Medical Record Number: __________________

Healthcare Provider Information:

  • Provider Name: __________________________
  • Provider License Number: ________________
  • Contact Information: ______________________

Please confirm the following:

  1. The patient has been informed of the implications of this order.
  2. The patient’s wishes regarding resuscitation are clearly stated.
  3. All parties involved understand this DNR order is effective immediately upon signing.

Patient Signature: ___________________________

Date: _____________________________________

Witness Signature: _________________________

Date: _____________________________________

This document should be kept in a prominent location accessible to emergency medical personnel and healthcare providers. It is essential for ensuring that the patient's wishes regarding resuscitation are respected and followed.

Key takeaways

Understanding the North Carolina Do Not Resuscitate (DNR) Order form is essential for patients and healthcare providers. Here are nine key takeaways to keep in mind:

  1. The DNR Order is a legal document that indicates a person's wishes regarding resuscitation efforts in the event of cardiac or respiratory arrest.
  2. Patients must be competent to make this decision. If a patient is unable to communicate their wishes, a legally authorized representative may complete the form on their behalf.
  3. The form must be signed by the patient or their representative and a physician. Without these signatures, the order is not valid.
  4. It is crucial to discuss the DNR Order with healthcare providers to ensure that all parties understand the implications and the patient's wishes.
  5. The DNR Order should be easily accessible. Keep a copy in the patient's medical records and provide copies to family members and caregivers.
  6. In North Carolina, the DNR Order is recognized across all healthcare settings, including hospitals, nursing homes, and home care.
  7. Patients can revoke the DNR Order at any time. This can be done verbally or by destroying the document.
  8. Healthcare providers are required to honor the DNR Order unless they believe it was not completed in accordance with the law.
  9. Regularly reviewing and updating the DNR Order is advisable, especially if the patient's health status changes or if they have new preferences.