end of life communication

Today we did something a little different for MR and discussed some challenges of determining code status.

Some key tips from todays talk:
-Try to get an idea of goals of care at admission
-Determine if the patient is capable of making own decisions and guide family discussions towards what the patient would like (possible what this patient at their time of health would feel about their current status)
-Be clear that DNR does NOT equal do not treat, but instead means will not try aggressive means of resuscitation when the patients medical state is so far gone that there is little chance of returning to baseline

This is always a tricky conversation and requires practice and honesty.

Here is a A nice NEJM article to read.