Invited Commentary

Commentary on “Impact of Do-Not-Resuscitate Orders on Nursing Clinical Decision Making”

Authors: G. Richard Holt, MD, MSE, MPH, MABE, DBioethics


I appreciated the authors of the article “Impact of Do-Not-Resuscitate Orders on Nursing Clinical Decision Making” bringing forth this study for our consideration.1 The topic has important implications for patient care in the hospital setting, as well as in nursing facilities and other clinical settings. The study, which I presume was intended as a quality improvement study, directs our attention toward the issue of potential unconscious bias and experience in nurses in decision making for elevating concerns regarding changes in patient status and vital signs. The questions and concerns addressed by the study for nurses are reflective of, but differ a bit from, those involved with physician clinical decision making.

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1. Engels R, Graziani C, Higgins I, et al. Impact of do-not-resuscitate order on nursing clinical decision making. South Med J 2020;113:326-332.