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Yi, Oh, Choi, Kwon, Kwon, Cho, Kang, and Ok: Hospital Nurses' Experience of Do-Not-Resuscitate in Korea
Original Article
Journal of Korean Academy of Nursing

Journal of Korean Academy of Nursing 2008; 38(2): 298-309.

Published online: 30 April 2008

DOI: https://doi.org/10.4040/jkan.2008.38.2.298

Hospital Nurses' Experience of Do-Not-Resuscitate in Korea

Myungsun Yi1, Sang Eun Oh2, Eun Ok Choi3, In Gak Kwon4, Sungbok Kwon5, Kyung-mi Cho6, Youngah Kang7, Jeonghui Ok8

1Professor, College of Nursing, Seoul National University, Seoul, Korea.

2Professor, College of Nursing, Chonnam National University, Gwangju, Korea.

3Associate Professor, Department of Nursing & Research Institute of Geriatric Health, Inje University, Busan, Korea.

4Professor, Department of Clinical Nursing Science, Samsung Medical Center, Seoul, Korea.

5Assistant Professor, Department of Nursing, Dongshin University, Naju, Korea.

6Associate Professor, Department of Nursing, Kyungin Women's College, Incheon, Korea.

7Nurse Coordinator, Department of Hematology, Asan Medical Center, Seoul, Korea.

8Nurse, Department of Nursing, Asan Medical Center, Seoul, Korea.

Address reprint requests to: Yi, Myungsun. College of Nursing, Seoul National University, 28 Yeongeon-dong, Jongno-gu, Seoul 110-799, Korea. Tel: 82-2-740-8829, Fax: 82-2-6442-8829, donam@snu.ac.kr

Received 22 January 2008       Accepted 31 March 2008

Copyright © 2008 Korean Society of Nursing Science

Abstract

Purpose

The purpose of the study was to describe the experiences of do-not-resuscitate (DNR) among nurses.

Methods

Data were collected by in-depth interviews with 8 nurses in 8 different hospitals. Conventional qualitative content analysis was used to analyze the data.

Results

Eight major themes emerged from the analysis: DNR decision-making bypassing the patient, inefficiency in the decision-making process of DNR, negative connotation of DNR, predominance of verbal DNR over written DNR, doubts and confusion about DNR, least amount of intervention in the decision for DNR change of focus in the care of the patient after a DNR order, and care burden of patients with DNR. Decision-making of DNR occurred between physicians and family members, not the patients themselves. Often high medical expenses were involved in choosing DNR, thus if choosing DNR it was implied the family members and health professionals as well did not try their best to help the patient. Verbal DNR permission was more popular in clinical settings. Most nurses felt guilty and depressed about the dying/death of patients with DNR.

Conclusion

Clearer guidelines on DNR, which reflect a family-oriented culture, need to be established to reduce confusion and to promote involvement in the decision-making process of DNR among nurses.

Keywords: Bioethics, Resuscitation Orders, Qualitative Research, Nurses

Notes

This research was supported by the Korean Association for Qualitative Research in Nursing.

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