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In New Jersey, the Do Not Resuscitate (DNR) Order form plays a crucial role in ensuring that individuals can express their wishes regarding medical treatment in critical situations. This form is designed for patients who wish to forgo cardiopulmonary resuscitation (CPR) in the event of a cardiac arrest or respiratory failure. It is important to understand that a DNR order is not a decision to stop all medical treatment; rather, it specifically addresses the use of CPR. The form must be completed and signed by a physician, and it requires the patient’s consent or the consent of a legally authorized representative. Once executed, the DNR order should be prominently displayed, often on the patient’s medical chart or at their residence, to ensure that emergency responders and healthcare providers are aware of the patient’s preferences. This document empowers individuals to maintain control over their end-of-life care, providing peace of mind for both patients and their families during difficult times.
Consider More Do Not Resuscitate Order Templates for Different States
What Makes a Dnr Valid - The existence of a DNR should be communicated promptly to all caregivers.
Whats Dnr Mean - This form reflects a compassionate approach to end-of-life care that honors the patient’s values and wishes.
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Virginia Dnr Form - Filling out a Do Not Resuscitate Order helps prevent unwanted medical interventions.
Dos and Don'ts
When filling out the New Jersey Do Not Resuscitate Order form, it is important to follow specific guidelines to ensure that the form is completed correctly and reflects the individual’s wishes. Below is a list of things to do and not to do during this process.
- Do ensure that the form is signed by the patient or their legal representative.
- Do provide accurate and complete information, including the patient's name and medical details.
- Do discuss the decision with healthcare providers to understand the implications of the order.
- Do keep a copy of the completed form in a safe place and share it with relevant family members and healthcare professionals.
- Don't use the form without having a clear understanding of what a Do Not Resuscitate Order entails.
- Don't forget to update the form if there are changes in the patient’s health status or wishes.
New Jersey Do Not Resuscitate Order Sample
New Jersey Do Not Resuscitate Order
This Do Not Resuscitate (DNR) Order is executed pursuant to New Jersey law, specifically the New Jersey Administrative Code N.J.A.C. 8:36-5.1 et seq. This document is intended for use in medical emergencies when an individual does not wish to receive resuscitative measures.
Patient Information:
- Patient's Name: _______________________________
- Date of Birth: _______________________________
- Address: _______________________________
- Phone Number: _______________________________
Medical Information:
- Attending Physician's Name: _______________________________
- Physician's Phone Number: _______________________________
The patient, named above, wishes to prevent resuscitative measures, including, but not limited to:
- Cardiopulmonary resuscitation (CPR)
- Intubation
- Other advanced cardiac life support (ACLS) measures
By signing below, the patient or their authorized representative acknowledges understanding of this DNR Order and its implications.
Patient or Authorized Representative Signature: _______________________________
Date: _______________________________
Witness Signature: _______________________________
Date: _______________________________
This DNR Order should be presented to all healthcare providers and included in the medical record. It is essential that this document be readily available in case of a medical emergency.
Listed Questions and Answers
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What is a Do Not Resuscitate (DNR) Order in New Jersey?
A Do Not Resuscitate Order is a legal document that allows a person to refuse resuscitation in the event of cardiac or respiratory arrest. In New Jersey, this order is specifically designed for individuals who have a terminal illness or are facing a medical condition where resuscitation would not be beneficial. By having a DNR order in place, patients can ensure that their wishes regarding end-of-life care are respected by medical professionals.
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How do I obtain a DNR Order in New Jersey?
To obtain a DNR order in New Jersey, you must first discuss your wishes with your healthcare provider. If you and your doctor agree that a DNR order is appropriate, your physician will complete the New Jersey DNR Order form. This form must be signed by both the physician and the patient or the patient’s legal representative. Once completed, the DNR order should be kept in a visible location, such as on the refrigerator or with other important medical documents, to ensure that emergency responders can easily access it.
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Can a DNR Order be revoked?
Yes, a DNR order can be revoked at any time. If you decide that you want to cancel your DNR order, you can do so verbally or in writing. It’s important to inform your healthcare provider and any family members or caregivers about your decision. Additionally, if you have a DNR bracelet or card, you should remove it to avoid any confusion during a medical emergency.
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What happens if I do not have a DNR Order?
If you do not have a DNR order in place and experience a cardiac or respiratory arrest, emergency medical personnel are required to perform resuscitation efforts. This can include CPR, intubation, and other life-saving measures. If you have strong feelings about your end-of-life care, it’s crucial to communicate those wishes to your healthcare provider and consider completing a DNR order to ensure your preferences are honored.
PDF Characteristics
| Fact Name | Description |
|---|---|
| Purpose | The New Jersey Do Not Resuscitate Order (DNR) form is designed to communicate a patient's wish not to receive cardiopulmonary resuscitation (CPR) in the event of cardiac or respiratory arrest. |
| Governing Law | This form is governed by New Jersey Statutes Annotated (N.J.S.A.) 26:2H-66 et seq., which outlines the legal framework for advance directives and DNR orders in the state. |
| Eligibility | Any adult, or a parent or guardian of a minor, can complete a DNR order, provided they have the capacity to make informed medical decisions. |
| Signature Requirement | The DNR order must be signed by the patient or their authorized representative, and it requires the signature of a physician to be valid. |