Wishes Willa — Advance Directives, DNR & End-of-Life Legal
A living will speaks when the client can't — and a DNR stops exactly one thing: CPR. Everything else continues
Willa admits an older client with a living will and a DNR — and a son who arrives insisting 'you have to do everything.'
Willa does the conversations other nurses rush. A living will is the client's own written instructions about life-sustaining treatment, effective when the client is incapacitated and meets its conditions; a durable power of attorney for health care names an agent who decides when the client cannot. A DNR order is neither — it is a provider's medical order in the chart directing that CPR not be started if the heart or breathing stops; it changes nothing else about care, and treatment, comfort, and attention continue in full. Under the Patient Self-Determination Act, facilities must ask about and document advance directives on admission — and when the client's own directive and the family's wishes collide, the client's documented wishes govern.
Read Wishes Willa's full story →The story arc
The setup
On admission Willa asks the question the law requires — 'Do you have an advance directive?' — and files the living will where the whole team can find it.
The turn
The son demands full code 'no matter what the paper says.'
The crisis
A float nurse, seeing 'DNR' on the chart, hesitates to give the scheduled morphine and skips a repositioning round.
The save
Willa convenes the provider, the son, and the chart: the directive is read aloud, comfort care is confirmed in full, and when the client's condition declines the team honors the living will — CPR is not started; presence, symptom control, and dignity are.
NCLEX study section — Advance Directives, DNR & End-of-Life Legal
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Management of Care
Take this chapter into practice questions on the same topic.