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Chemo Consent and Advanced directives

  • 1.  Chemo Consent and Advanced directives

    Posted 08-07-2019 10:43
    ​Hello- We currently do not have a consent for chemotherapy for the patient to sign (the provider includes that they obtained consent in their office note). We worked to develop a consent, but are now told that our language about code status needs to be changed. The consent developed states:


    I understand if I have an acute reaction during treatment, every resuscitative effort will be made to keep me alive. This will occur even if by my Advanced Directive or by a joint decision between myself (or my personal representative) and my physician, a decision has been made that I not be resuscitated.

    We utilized various other facility consents when building. We are being told we need to honor the patient's advanced directives while being treated and cannot word the consent as such.
    What do other Outpatient Cancer Centers have in process?


    Jennifer Coutu, MSN, RN, OCN
    Ellington CT

  • 2.  RE: Chemo Consent and Advanced directives

    Posted 08-08-2019 11:52
    Hello Jennifer,

    In our outpatient clinic this situation is addressed by treating what ever reaction the patient is experiencing. Should the patient be DNR/DNI that must be apparent from the onset, meaning the patient and nurse must confirm on the first infusion. If family is around they must be present ie spouse, adult children to hear both patient and nurse. With that stated there has not been an incident where there was an anaphylatic response to the first chemotherapy infusion where patient had to be resuscitated, they are usually treated immediately and infusion stopped. So gratefully a patient has not gotten to that point. Perhaps the term resuscitated does not need to be a part of your statement, as it is understood that any sign/symptom of reaction will be addressed during infusion in spite of Advance Directives.

    Phyllis Ortiz, RN, BSN, OCN

    Phyllis Ortiz
    Oncology Triage Nurse
    Albuquerque NM