Recently I came across a legal conundrum of an NFR order in my workplace. Patient A has a documented NFR . Patient A has a tracheostomy - it was blocked and needed emergency replacing . Fastest way was to call the code team to reinsert a new tracheostomy instead of waiting for the RMO to come up and letting the patient die while waiting. We did that and patient's family was called in. It is my understanding that an NFR is not for active resuscitation which was made clear when the doctors came up that patient is not for CPR . The thing is the family wasn't too happy about it - said that we needed to let him die 'comfortably ' (i.e. give morphine) even if the tracheostomy was blocked. Now the thing is that this patient was given the option that if he was given morphine- he will be almost sure to die - patient refused the morphine option way out. As far as I know - the relative of this patient who requested that we do not do anything in the situation ,has no power of attorney or guardianship. BUT the registrar wrote down that the patient is no longer for any active management in regards to his tracheostomy even if it is a mechanical obstruction. Ethically I sure as hell don't want to be watching the man dying again from a blocked tracheostomy - it was horrifying - he was really fighting for his life instead of giving it up and he refused morphine when told he will almost be surely to die.
Not for resuscitation orders
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