Attorney-Approved New Jersey Do Not Resuscitate Order Template

When filling out and using the New Jersey Do Not Resuscitate Order form, keep these key points in mind:

1. Eligibility: The form is intended for individuals with a serious medical condition who wish to refuse resuscitation efforts.
2. Signature Requirement: The form must be signed by the patient or their legal representative to be valid.
3. Medical Provider's Role: A licensed physician must sign the form to confirm the medical necessity and ensure it is properly executed.
4. Distribution: Once completed, provide copies of the form to healthcare providers, family members, and keep one in a visible location at home.
5. Revocation: The patient can revoke the order at any time, and this should be documented appropriately.
6. Understanding Implications: Ensure that all parties involved understand the implications of the order, including what it means for end-of-life care.

When filling out the New Jersey Do Not Resuscitate Order form, it is crucial to approach the process carefully. Here are some important dos and don'ts to keep in mind:

• Do ensure that the form is filled out completely and accurately.
• Do discuss your wishes with your healthcare provider and loved ones.
• Do sign and date the form in the appropriate sections.
• Do keep copies of the completed form for your records.
• Do review the form periodically to ensure it still reflects your wishes.

• Don't leave any sections blank; incomplete forms may not be honored.
• Don't sign the form without understanding its implications.
• Don't forget to inform your family and healthcare providers about your decision.
• Don't assume that verbal instructions are enough; written documentation is necessary.
• Don't ignore state regulations or requirements related to the form.

In New Jersey, the Do Not Resuscitate (DNR) Order form is an important document that allows individuals to express their wishes regarding resuscitation efforts in the event of a medical emergency. However, several other forms and documents often accompany the DNR to ensure that an individual's healthcare preferences are clearly communicated and respected. Below is a list of some key documents that may be used alongside the DNR form.

• Advance Directive: This document allows individuals to outline their healthcare preferences in advance, specifying the types of medical treatment they do or do not want in case they become unable to communicate those wishes.
• Durable Power of Attorney for Healthcare: This form designates a trusted person to make medical decisions on behalf of an individual if they are incapacitated, ensuring that their wishes are honored.
• POLST (Physician Orders for Life-Sustaining Treatment): A POLST form translates a patient’s wishes regarding life-sustaining treatments into medical orders, which healthcare providers must follow.
• Operating Agreement: This essential document, particularly for LLCs, outlines management structure and member roles. For templates, consider visiting Fast PDF Templates to ensure accuracy and completeness in your agreement.
• Living Will: This document outlines an individual’s preferences regarding end-of-life care and can specify their desires concerning life-sustaining treatments, including resuscitation.
• Healthcare Proxy: Similar to a durable power of attorney, a healthcare proxy allows someone to make medical decisions on behalf of the individual, ensuring that their healthcare preferences are upheld.
• Medical History Form: This form provides healthcare providers with critical information about a patient’s medical background, which can inform treatment decisions, especially in emergencies.
• Emergency Medical Services (EMS) Protocol: This protocol outlines the procedures that emergency responders should follow, which may include respecting a DNR order during a medical emergency.
• Patient Identification Bracelet: This bracelet can indicate that a patient has a DNR order in place, alerting healthcare providers to their wishes quickly in an emergency situation.
• Notification of DNR Status: This document serves to inform family members and healthcare providers of an individual’s DNR status, ensuring that everyone involved is aware of the patient’s wishes.
• Healthcare Provider Communication: A form or document that facilitates communication between patients and their healthcare providers regarding treatment preferences, including DNR orders.

Having these documents in place, along with the DNR Order form, can help ensure that an individual’s healthcare preferences are respected and followed. It is vital for individuals to discuss their wishes with family members and healthcare providers to foster understanding and avoid confusion during critical moments.

What is a Do Not Resuscitate (DNR) Order in New Jersey?

A Do Not Resuscitate (DNR) Order is a legal document that instructs medical personnel not to perform cardiopulmonary resuscitation (CPR) if a person's heart stops beating or they stop breathing. In New Jersey, this order is intended for individuals who wish to avoid aggressive resuscitation efforts in the event of a medical emergency.

Who can request a DNR Order?

Typically, a DNR Order can be requested by individuals who are at least 18 years old and are capable of making their own medical decisions. In cases where a person is unable to make decisions, a legally authorized representative, such as a family member or guardian, may request a DNR on their behalf.

How do I obtain a DNR Order in New Jersey?

To obtain a DNR Order, you must complete the New Jersey DNR Order form. This form can be obtained from healthcare providers, hospitals, or online through state health department resources. After filling out the form, it needs to be signed by a physician, as well as the patient or their representative.

What information is required on the DNR Order form?

The DNR Order form requires several key pieces of information, including:

1. The patient’s name and date of birth.
2. The name of the physician who is signing the order.
3. A statement of the patient's wishes regarding resuscitation.
4. Signatures of the patient or their authorized representative and the physician.

Is a DNR Order valid in all healthcare settings?

Yes, a properly completed and signed DNR Order is generally valid in all healthcare settings in New Jersey, including hospitals, nursing homes, and at home. However, it is crucial to ensure that the DNR form is readily accessible to medical personnel when needed.

Can a DNR Order be revoked?

Yes, a DNR Order can be revoked at any time by the patient or their authorized representative. To revoke the order, the individual should inform their healthcare provider and ensure that the DNR form is removed from their medical records. It is also advisable to communicate this change to family members and caregivers.

What happens if a DNR Order is not honored?

If a DNR Order is not honored, it can lead to unwanted resuscitation efforts. In such cases, family members or the patient may have grounds for legal action against the healthcare providers involved. Therefore, it is essential to ensure that the DNR Order is clearly documented and communicated to all relevant parties.

Are there any limitations to a DNR Order?

While a DNR Order specifically addresses resuscitation efforts, it does not limit other medical treatments. Patients can still receive necessary medical care, including pain management and other supportive treatments. It's important to discuss these aspects with healthcare providers to ensure comprehensive care that aligns with the patient's wishes.

Can I create a DNR Order for someone else?

Yes, you can create a DNR Order for someone else if you are their legally authorized representative. This could be a family member or a designated healthcare proxy. It's essential to have open discussions with the individual about their wishes and ensure that the DNR form is filled out and signed correctly.

Where should I keep my DNR Order?

It’s crucial to keep your DNR Order in a place that is easily accessible. Many people choose to keep it in their medical records, with their healthcare provider, or at home where family members can find it quickly. Some individuals also carry a copy in their wallet or purse for emergency situations.