Homepage >> Fillable Do Not Resuscitate Order Template >> Free Do Not Resuscitate Order Form for the State of Washington

Common mistakes

  1. Not understanding the purpose: Many individuals fill out the form without fully grasping what a Do Not Resuscitate (DNR) order entails. It's crucial to know that this document indicates a person's wish to forgo resuscitation efforts in the event of cardiac or respiratory arrest.

  2. Incomplete information: Failing to provide all required personal details can lead to confusion. Ensure that your name, date of birth, and other identifying information are accurately filled out.

  3. Not signing the form: A common oversight is neglecting to sign the DNR order. Without a signature, the document is not legally binding.

  4. Missing witness signatures: In Washington, the DNR form requires the signatures of two witnesses. Skipping this step can invalidate the order.

  5. Using outdated forms: Some people mistakenly use older versions of the DNR form. Always ensure you have the most current version to avoid legal issues.

  6. Not discussing with healthcare providers: A DNR order should be discussed with your doctor. Failing to do so may result in misunderstandings about your wishes.

  7. Forgetting to inform family members: It's essential to communicate your DNR decision with family. They should be aware of your wishes to avoid conflict during emergencies.

  8. Not keeping copies: After filling out the form, individuals often forget to keep copies for themselves and their healthcare providers. Always have multiple copies accessible.

  9. Neglecting to review regularly: Life circumstances can change. Failing to review and update your DNR order can lead to outdated wishes being followed.

  10. Assuming verbal instructions are enough: Some individuals believe that verbally communicating their wishes is sufficient. However, a written DNR order is necessary for it to be honored legally.

Similar forms

  • Advance Directive: This document outlines an individual's preferences for medical treatment in situations where they cannot communicate their wishes. Like a Do Not Resuscitate Order, it ensures that healthcare providers respect the patient's choices regarding life-sustaining measures.

  • Living Will: A living will specifically addresses the types of medical treatment a person does or does not want at the end of life. It serves a similar purpose to a DNR by guiding healthcare providers in accordance with the patient's desires.

  • Healthcare Power of Attorney: This legal document designates a person to make healthcare decisions on someone’s behalf if they are unable to do so. While a DNR focuses on resuscitation preferences, the healthcare power of attorney encompasses a broader range of medical decisions.

  • Durable Power of Attorney: The https://azformsonline.com/durable-power-of-attorney/ form is a vital legal document that allows an individual to appoint someone else to handle financial and legal matters on their behalf, remaining effective even if the individual becomes incapacitated.
  • Physician Orders for Life-Sustaining Treatment (POLST): POLST is a medical order that outlines a patient's preferences for life-sustaining treatments. Similar to a DNR, it is intended for patients with serious health conditions and is recognized by healthcare providers as a binding directive.

  • Do Not Intubate (DNI) Order: This order specifically instructs healthcare providers not to place a patient on a ventilator. It is closely related to a DNR, as both documents address the limits of medical intervention in critical situations.

  • Comfort Care Order: This document emphasizes the provision of comfort and pain relief rather than aggressive treatments. Like a DNR, it prioritizes the patient's comfort and quality of life over invasive medical procedures.

Dos and Don'ts

When filling out the Washington Do Not Resuscitate Order form, it’s important to approach the task with care and clarity. Here are six essential tips to keep in mind:

  • Do ensure that you fully understand the implications of a Do Not Resuscitate (DNR) order.
  • Do discuss your wishes with your healthcare provider and family members.
  • Do fill out the form completely and accurately to avoid any confusion.
  • Do keep a copy of the completed form in an accessible location.
  • Don't use vague language that could lead to misinterpretation of your wishes.
  • Don't forget to update the form if your health status or preferences change.

Taking these steps will help ensure that your wishes are respected in a critical situation.

Preview - Washington Do Not Resuscitate Order Form

Washington Do Not Resuscitate (DNR) Order

This document serves as a Do Not Resuscitate (DNR) order in accordance with Washington state law, specifically RCW 70.122. The purpose of this order is to express the wishes of the individual named below regarding resuscitation efforts in case of cardiac or respiratory arrest.

Patient Information:

  • Full Name: _______________________________________
  • Date of Birth: ____________________________________
  • Address: _______________________________________
  • City, State, Zip Code: __________________________

Physician Information:

  • Physician’s Name: ___________________________________
  • Phone Number: ____________________________________
  • Medical Facility: __________________________________

This DNR order will be valid until revoked or modified. The patient understands that this order will prevent medical personnel from performing cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest.

Signature: __________________________________________

Date: ____________________________________________

Witness Information:

  • Name of Witness: _________________________________
  • Signature of Witness: __________________________
  • Date: __________________________________________

This document should be placed in a location where it can easily be found by medical personnel in case of an emergency.

Misconceptions

Understanding the Washington Do Not Resuscitate (DNR) Order form is crucial for making informed medical decisions. Here are ten common misconceptions about this important document:

  1. A DNR means no medical care will be provided. This is false. A DNR specifically addresses resuscitation efforts but does not prevent other medical treatments.
  2. Only terminally ill patients need a DNR. This is not true. Anyone can choose a DNR, regardless of their health status, if they wish to avoid resuscitation.
  3. A DNR is the same as a living will. This is a misconception. A living will outlines broader healthcare wishes, while a DNR specifically focuses on resuscitation.
  4. You cannot change your mind once a DNR is signed. This is incorrect. Individuals can revoke or modify their DNR at any time as long as they are competent to do so.
  5. A DNR is only valid in hospitals. This is misleading. A DNR can be honored in various settings, including at home or in long-term care facilities.
  6. All healthcare providers are required to follow a DNR order. This is not entirely accurate. While most providers will honor a DNR, it is essential to communicate your wishes clearly to all involved in your care.
  7. A DNR can be verbal. This is a misconception. In Washington, a DNR must be documented in writing and signed by the patient or their authorized representative.
  8. Having a DNR means giving up on life. This is a misunderstanding. A DNR reflects a personal choice about the type of medical interventions one wants in specific situations.
  9. DNR orders are only for older adults. This is incorrect. People of any age can have a DNR if they choose to forgo resuscitation.
  10. Once a DNR is signed, it is permanent. This is false. DNR orders can be updated or revoked as circumstances and preferences change.

Being aware of these misconceptions can help individuals make better decisions regarding their healthcare preferences.

How to Use Washington Do Not Resuscitate Order

Filling out the Washington Do Not Resuscitate Order form is an important step in expressing your healthcare wishes. Once completed, this form will guide medical personnel in understanding your preferences regarding resuscitation efforts in emergency situations. Here’s how to fill it out correctly.

  1. Obtain the Washington Do Not Resuscitate Order form. You can find it online or request a physical copy from your healthcare provider.
  2. Start by filling in your full name. This should be your legal name as it appears on your identification.
  3. Next, provide your date of birth. This helps to confirm your identity.
  4. Indicate your address. This information is necessary for record-keeping purposes.
  5. Check the appropriate box to indicate whether you are a patient or a representative filling out the form on behalf of someone else.
  6. If you are a representative, include your name and relationship to the patient.
  7. Sign and date the form at the bottom. Your signature is crucial as it validates your wishes.
  8. Make copies of the completed form. Keep one for your records and provide copies to your healthcare provider and any family members involved in your care.

Once you have completed these steps, ensure that everyone involved in your healthcare is aware of your wishes. It’s a good idea to discuss your decision with family and healthcare providers to ensure clarity and understanding.