June 26, 2025 • 14 mins
You’ve probably seen it in movies... someone collapses, a family member screams “They have a DNR!” and suddenly everyone freezes. But what actually happens in real life when a do-not-resuscitate order enters the scene?
In this episode, Jimmy and Megan dig into what a DNR really means, how it's used in emergency situations, and what makes it legally valid (hint: it’s not a tattoo). Jimmy shares a jaw-dropping story about teaching CPR at a ranch where not one, not two, but three generations of workers had DNRs... and were so serious about it, they even removed the battery from their AED.
From red folders taped to the fridge to expired forms stuffed in safes, they break down the biggest misunderstandings around DNRs and medical directives. You’ll learn why having the paperwork on you is crucial, what responders are legally allowed to do, and why even seasoned EMTs have performed 40 minutes of CPR while someone frantically searched for the right document.
It’s a conversation about planning, choice, and what it really means to respect someone’s wishes during a crisis. Whether you’re a responder, a family member, or just someone who wants to understand this stuff better, this episode clears up a lot of confusion, and may just inspire you to have a hard conversation or two.
Life Safety Associates specializes in emergency response training for corporate ERT Teams. We help businesses create competent and confident first responders who are ready to handle unexpected emergencies. For more information you find us @lifesafetyassoc or email@lifesafety.com.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Jimmy (00:00):
What's happening to their life and safety podcast with
your girl, megs, and Jimmy.
Today we're gonna be talkingabout medical directives,
specifically do not resuscitateorders or DNR orders.
So there's lots of layers tothat do not resuscitate or
(00:24):
medical directives.
We're gonna only really hit onhigh level of this.
Lots of layers to that do notresuscitate or medical
directives.
We're going to only really hiton high level of this.
We're not lawyers obviously.
Obviously, we don't even playone on TV, right?
So we're going to be prettygeneric about this, and so the
(00:48):
question we get a lot in classLiz, I can speak to this and
Megan you can speak to this toois we get people asking us what
happens if we show up and thepatient has a DNR, right?
So before we get into thatprocedure and what we do with
that, let's talk about a do notresuscitate order, what it is
and kind of what a medicaldirective is.
(01:08):
So a medical directive is apiece of paper, basically, that
has the patient's wishes on itand how much and what they want
done with them.
As far as medical care does,For whatever reason, sometimes
people don't want to beintubated or they don't want to
be kept alive by a machine, soto speak, and maybe they want to
(01:37):
not be a donor for tissues andthings like that, or maybe they
only want to donate certainorgans or tissues or something
like that.
So that's all in their medicaldirectives.
Megan (01:53):
My understanding is, a lot of the times, people who
have medical director directiveswe words are typically like
either terminal patients or theyhave some sort of chronic
illness sort of thing.
That like has them thinkingabout those, which is not to say
that those are the only peopledo, but more often my experience
(02:16):
with it is more often than notpeople who have chronic things
or fatal things will typicallyhave some sort of medical
directive or will know vaguelywhat they want yeah, and, and
mine is more well a lot of thatobviously, uh, being the
response role.
Jimmy (02:36):
But my other side of that is also what, um, you know,
people's kind of forwardthinking you know, some planners
, things like that.
We used to go to a ranch farmand this place was owned by a
(02:58):
pharmaceutical company whoraised sheeps and rabbits.
Oh, they were not injured.
They were not injured.
They were not injured.
They were actually raised veryhumanely and had just really an
amazing facilities for where theanimals lived.
Megan (03:20):
It was really kind of cool, um well, they want to give
their drugs the best chance ofsurvival right.
Jimmy (03:27):
Well, what they used, though, was actually an agent
from their blood for testing, solike if you were testing
somebody for drugs and theyurinated in the cup, the ages,
the reagents in those testingstrips came from the blood of
these animals.
So, once a week maybe a littlebit more than like, less than
(03:49):
that, like maybe like once amonth these animals donated
blood, and they lived in thisrad ranch farm situation
fascinating and the people thatworked there took care of them
and then, like once, wheneverthey, whatever that was they
(04:10):
would herd them into these roomsthat were pretty clinical,
pretty scary looking, to behonest with you, and they would
um draw blood from them.
But there was three generationsout there.
There was a grandfather, theand the son all lived or worked
on this ranch and they livedclose by and all three of them
(04:32):
had do not resuscitate orders onthem and they were so adamant
about it they actually took outthe battery of their AED that
the company put into the companybreak room area for the people
that worked in this facility.
So it was pretty wild, Prettywild.
(04:53):
So I'm out there teaching themCPR and they were like we're
never going to do it and I waslike, yikes, okay, you have to
write that down.
Megan (05:04):
I mean good for them, I guess.
Jimmy (05:05):
Yeah.
Megan (05:06):
If that's what they want and they're confident in it, yay
for choice.
Jimmy (05:11):
Yeah, exactly Exactly.
And, um, the grandfatheractually had it tattooed on his
chest.
You know, people always kind ofjoke about that and that was
like, oh, I'm going to tattoo iton my chest, or something like
that.
There's a statement.
He actually did it and showedit to me.
Megan (05:30):
Oh, I want to talk about that.
That was one of the things Iwant to talk about.
Is that a legally bindingrequest?
Jimmy (05:37):
So you have to, and this is what I told him.
I said you have to have it onyou.
You actually have to have thepaper on you.
What I understand, you have tohave paper on you and it has to
be within date.
So the DNRs do expire.
Um, I don't remember exactlyhow long they are for, so I
(05:58):
don't know.
Maybe you can Google that realquick, but you have to have it
on you and it has to be withindate.
Like I said, they do expire andthat's what I told the
gentleman.
And he's like oh okay, I'm likeso where is your DNR at?
Megan (06:17):
The period can range from one to five years, depending on
the state there you go.
So one to five years dependingon the state.
Jimmy (06:20):
There you go.
So one to five years, dependingon the state.
So I was like, so where's it at?
You'd have to prove it to me.
And he was like, well, it's athome in my safe.
And I said that doesn't do meany good.
How do I know that somebodydidn't you know.
Lie yeah, poison you and justwrite that on your chest and
(06:45):
he's like, uh, I don't knowright, and I don't know if it's
expired or not.
Maybe you changed your mind andmaybe you're, you know, scorned
a lover or scorned a partner,decided to write that on you
after they poisoned you.
I don't know, you know, andhe's like, oh good point.
So he and their family, becausethey're so adamant about not
(07:09):
having CPR done on them,actually took them and they
stuck them in a folder and theyput it on the refrigerator of
the break room of the place theyworked.
Megan (07:20):
That's what I've heard is a good place for.
When I was in EMT school theysaid hey, if somebody says that
they have any DNR, check thefridge, because a lot of times
they'll magnet it to the fridgeso it's easy to find in an
emergency.
Jimmy (07:31):
Yes, yeah, and you were kind of talking about terminally
ill patients and things likethat.
They usually have like a redfolder or envelope or something
like that next to their bed withusually something like DNR or
medical directive or somethinglike that on their next to their
bed, yeah.
You know.
So that's on there a lot.
(07:52):
So what happens on the street?
So we show up, we're at themall or wherever, and we want to
be a good Samaritan andsomebody starts yelling at you
don't touch that person, Justhave a DNR.
That's my insert family member,right?
(08:12):
What do we do?
That's the question I alwaysget.
What do we do?
So how do you answer that inyour class, and then I'll give
you my answer.
Megan (08:24):
I answered that, legally speaking, you're not required to
provide care to anybody.
If you're feeling unsafe, likeif you feel that you're going to
be threatened by this personwho's telling you not to provide
care for their family memberand you think your safety is in
(08:47):
danger by providing care, thenabsolutely step back and don't
provide care.
That being said, if your safetyis in danger, you have no way
of knowing if this person islying to you or not.
Jimmy (09:07):
So if you feel comfortable providing care, I
would provide care personally,but that's a personal choice.
Yeah, no, that's what I usuallytell people.
Also, if it, you know, if youdecide to help and you're
helping the person and maybe theperson feels is maybe
threatening or something likethat and it's not safe or you
don't feel safe anymore, thenmaybe you should back away, you
know, and again, they have toprove it.
You can't just walk up and saythat you know.
(09:28):
It's like me saying I don'tknow, maybe my wife has a really
good life insurance and I'mlike no, don't save her, you
know, something like that.
That's messed up but that's youknow, unfortunately there are
people who think like that.
So If you don't feelcomfortable or it's unsafe for
you to be there because of thefamily, then definitely back
(09:50):
away.
But if you feel you want tocontinue to help, it's your help
, and to piggyback on what yousaid, it's your choice, right?
It depends on you know, seeingsafety.
Take care of yourself first andread the room.
Yeah, read the room.
Yeah, yeah.
Megan (10:07):
Read the room.
Yeah, but I guess overarchingis unless they provide you the
paperwork, then still providecare unless you feel unsafe.
Jimmy (10:16):
Yes, absolutely, absolutely.
Megan (10:27):
And that's the same for EMTs and paramedics is we're
trained to provide care until wehave the paperwork in hand,
with the doctor and the lawyerand the patient's signature.
Jimmy (10:33):
Yeah, or it has to be notarized or something like that
.
I don't remember exactly how itwas, but yeah, yeah, we
actually performed CPR on a lady.
My engine crew and an ambulancecrew and some volunteer
firefighters we all took turnsdoing CPR on a lady while her
son ran around the house lookingfor the mom's DNR.
(10:58):
It was rough, it was rough.
And I think the third one hefound was the one that wasn't
expired and I think we did CPR,did CPR no less than 40 minutes.
Oh God, yeah, it was rough.
It was rough Like theparamedics were like we're not
going to push any meds while youlook for this, but we're going
(11:20):
to continue compressions.
So I think about five of us orsix of us like switched doing
compressions.
It was rough, it was rough.
And then, you know, when thesun Gave us the do not resist
state order and we stopped andthen we had to, you know, help
him process what just happened.
(11:41):
Yeah, which was super gnarly, Ibet, and crunchy, yeah, yeah,
and this was something I didn'tknow about that.
You know, we had to call thecounty, we had to call the
coroner to come pick up thispoor lady.
Yeah, because we didn't take tocall the county, we had to call
the coroner to come pick upthis poor lady yeah.
Because we didn't take her inthe ambulance.
(12:02):
So you know, she had to bepicked up and that was just kind
of a very surreal incident, youknow.
And the question I get a lotafter this kind of comes up in
our class is why do people haveDNRs and you kind of mentioned
the terminally ill, you knowsomething like that People with
medical issues.
(12:22):
You know that's definitely abig deal of it, but at the end
of the day it's that person'schoice.
What do they want done?
You know, how do they want tolive their life?
How do they want to be treated?
You know, and there's religiousissues there, um, personal
(12:43):
issues, there's all kinds ofthings not for us to judge why
or how come.
It's for us to either help themor not help them, based on
their wishes right at the end ofthe day.
um so hopefully that helped youand just kind of shine some
light on some do not resuscitateorder stuff, what if let's say
that you know there is a patientwho is in need of help.
Megan (13:06):
They have a family member shouting saying, hey, they have
a DNR.
You know, don't provide careand you feel unsafe.
But you still want to help butyou physically don't feel safe
providing care.
What's the best thing to do inthat scenario?
Jimmy (13:18):
Well, I still think you call 911.
Megan (13:20):
Exactly, and you providing care.
Jimmy (13:21):
What's the best thing to do in that scenario?
Well, I still think you call9-1-1, exactly and, um, you know
, get professionals out there,you know, and help the best you
can, and that's realisticallythe only thing we can do.
Do the best you can andremember, calling 9-1-1 is
helping yeah you know, and don'tever be afraid to call 911.
(13:45):
Even if you don't think it's abig deal, it might be a big deal
or it might grow into a bigdeal.
Trust your instincts.
Yeah, trust your instincts.
All right, team, thanks forvisiting us and hanging out with
us on our Life and Safetypodcast, peace.
What's happening to their life and safety podcast with
your girl, megs, and Jimmy.
Today we're gonna be talkingabout medical directives,
specifically do not resuscitateorders or DNR orders.
So there's lots of layers tothat do not resuscitate or
(00:24):
medical directives.
We're gonna only really hit onhigh level of this.
Lots of layers to that do notresuscitate or medical
directives.
We're going to only really hiton high level of this.
We're not lawyers obviously.
Obviously, we don't even playone on TV, right?
So we're going to be prettygeneric about this, and so the
(00:48):
question we get a lot in classLiz, I can speak to this and
Megan you can speak to this toois we get people asking us what
happens if we show up and thepatient has a DNR, right?
So before we get into thatprocedure and what we do with
that, let's talk about a do notresuscitate order, what it is
and kind of what a medicaldirective is.
(01:08):
So a medical directive is apiece of paper, basically, that
has the patient's wishes on itand how much and what they want
done with them.
As far as medical care does,For whatever reason, sometimes
people don't want to beintubated or they don't want to
be kept alive by a machine, soto speak, and maybe they want to
(01:37):
not be a donor for tissues andthings like that, or maybe they
only want to donate certainorgans or tissues or something
like that.
So that's all in their medicaldirectives.
Megan (01:53):
My understanding is, a lot of the times, people who
have medical director directiveswe words are typically like
either terminal patients or theyhave some sort of chronic
illness sort of thing.
That like has them thinkingabout those, which is not to say
that those are the only peopledo, but more often my experience
(02:16):
with it is more often than notpeople who have chronic things
or fatal things will typicallyhave some sort of medical
directive or will know vaguelywhat they want yeah, and, and
mine is more well a lot of thatobviously, uh, being the
response role.
Jimmy (02:36):
But my other side of that is also what, um, you know,
people's kind of forwardthinking you know, some planners
, things like that.
We used to go to a ranch farmand this place was owned by a
(02:58):
pharmaceutical company whoraised sheeps and rabbits.
Oh, they were not injured.
They were not injured.
They were not injured.
They were actually raised veryhumanely and had just really an
amazing facilities for where theanimals lived.
Megan (03:20):
It was really kind of cool, um well, they want to give
their drugs the best chance ofsurvival right.
Jimmy (03:27):
Well, what they used, though, was actually an agent
from their blood for testing, solike if you were testing
somebody for drugs and theyurinated in the cup, the ages,
the reagents in those testingstrips came from the blood of
these animals.
So, once a week maybe a littlebit more than like, less than
(03:49):
that, like maybe like once amonth these animals donated
blood, and they lived in thisrad ranch farm situation
fascinating and the people thatworked there took care of them
and then, like once, wheneverthey, whatever that was they
(04:10):
would herd them into these roomsthat were pretty clinical,
pretty scary looking, to behonest with you, and they would
um draw blood from them.
But there was three generationsout there.
There was a grandfather, theand the son all lived or worked
on this ranch and they livedclose by and all three of them
(04:32):
had do not resuscitate orders onthem and they were so adamant
about it they actually took outthe battery of their AED that
the company put into the companybreak room area for the people
that worked in this facility.
So it was pretty wild, Prettywild.
(04:53):
So I'm out there teaching themCPR and they were like we're
never going to do it and I waslike, yikes, okay, you have to
write that down.
Megan (05:04):
I mean good for them, I guess.
Jimmy (05:05):
Yeah.
Megan (05:06):
If that's what they want and they're confident in it, yay
for choice.
Jimmy (05:11):
Yeah, exactly Exactly.
And, um, the grandfatheractually had it tattooed on his
chest.
You know, people always kind ofjoke about that and that was
like, oh, I'm going to tattoo iton my chest, or something like
that.
There's a statement.
He actually did it and showedit to me.
Megan (05:30):
Oh, I want to talk about that.
That was one of the things Iwant to talk about.
Is that a legally bindingrequest?
Jimmy (05:37):
So you have to, and this is what I told him.
I said you have to have it onyou.
You actually have to have thepaper on you.
What I understand, you have tohave paper on you and it has to
be within date.
So the DNRs do expire.
Um, I don't remember exactlyhow long they are for, so I
(05:58):
don't know.
Maybe you can Google that realquick, but you have to have it
on you and it has to be withindate.
Like I said, they do expire andthat's what I told the
gentleman.
And he's like oh okay, I'm likeso where is your DNR at?
Megan (06:17):
The period can range from one to five years, depending on
the state there you go.
So one to five years dependingon the state.
Jimmy (06:20):
There you go.
So one to five years, dependingon the state.
So I was like, so where's it at?
You'd have to prove it to me.
And he was like, well, it's athome in my safe.
And I said that doesn't do meany good.
How do I know that somebodydidn't you know.
Lie yeah, poison you and justwrite that on your chest and
(06:45):
he's like, uh, I don't knowright, and I don't know if it's
expired or not.
Maybe you changed your mind andmaybe you're, you know, scorned
a lover or scorned a partner,decided to write that on you
after they poisoned you.
I don't know, you know, andhe's like, oh good point.
So he and their family, becausethey're so adamant about not
(07:09):
having CPR done on them,actually took them and they
stuck them in a folder and theyput it on the refrigerator of
the break room of the place theyworked.
Megan (07:20):
That's what I've heard is a good place for.
When I was in EMT school theysaid hey, if somebody says that
they have any DNR, check thefridge, because a lot of times
they'll magnet it to the fridgeso it's easy to find in an
emergency.
Jimmy (07:31):
Yes, yeah, and you were kind of talking about terminally
ill patients and things likethat.
They usually have like a redfolder or envelope or something
like that next to their bed withusually something like DNR or
medical directive or somethinglike that on their next to their
bed, yeah.
You know.
So that's on there a lot.
(07:52):
So what happens on the street?
So we show up, we're at themall or wherever, and we want to
be a good Samaritan andsomebody starts yelling at you
don't touch that person, Justhave a DNR.
That's my insert family member,right?
(08:12):
What do we do?
That's the question I alwaysget.
What do we do?
So how do you answer that inyour class, and then I'll give
you my answer.
Megan (08:24):
I answered that, legally speaking, you're not required to
provide care to anybody.
If you're feeling unsafe, likeif you feel that you're going to
be threatened by this personwho's telling you not to provide
care for their family memberand you think your safety is in
(08:47):
danger by providing care, thenabsolutely step back and don't
provide care.
That being said, if your safetyis in danger, you have no way
of knowing if this person islying to you or not.
Jimmy (09:07):
So if you feel comfortable providing care, I
would provide care personally,but that's a personal choice.
Yeah, no, that's what I usuallytell people.
Also, if it, you know, if youdecide to help and you're
helping the person and maybe theperson feels is maybe
threatening or something likethat and it's not safe or you
don't feel safe anymore, thenmaybe you should back away, you
know, and again, they have toprove it.
You can't just walk up and saythat you know.
(09:28):
It's like me saying I don'tknow, maybe my wife has a really
good life insurance and I'mlike no, don't save her, you
know, something like that.
That's messed up but that's youknow, unfortunately there are
people who think like that.
So If you don't feelcomfortable or it's unsafe for
you to be there because of thefamily, then definitely back
(09:50):
away.
But if you feel you want tocontinue to help, it's your help
, and to piggyback on what yousaid, it's your choice, right?
It depends on you know, seeingsafety.
Take care of yourself first andread the room.
Yeah, read the room.
Yeah, yeah.
Megan (10:07):
Read the room.
Yeah, but I guess overarchingis unless they provide you the
paperwork, then still providecare unless you feel unsafe.
Jimmy (10:16):
Yes, absolutely, absolutely.
Megan (10:27):
And that's the same for EMTs and paramedics is we're
trained to provide care until wehave the paperwork in hand,
with the doctor and the lawyerand the patient's signature.
Jimmy (10:33):
Yeah, or it has to be notarized or something like that
.
I don't remember exactly how itwas, but yeah, yeah, we
actually performed CPR on a lady.
My engine crew and an ambulancecrew and some volunteer
firefighters we all took turnsdoing CPR on a lady while her
son ran around the house lookingfor the mom's DNR.
(10:58):
It was rough, it was rough.
And I think the third one hefound was the one that wasn't
expired and I think we did CPR,did CPR no less than 40 minutes.
Oh God, yeah, it was rough.
It was rough Like theparamedics were like we're not
going to push any meds while youlook for this, but we're going
(11:20):
to continue compressions.
So I think about five of us orsix of us like switched doing
compressions.
It was rough, it was rough.
And then, you know, when thesun Gave us the do not resist
state order and we stopped andthen we had to, you know, help
him process what just happened.
(11:41):
Yeah, which was super gnarly, Ibet, and crunchy, yeah, yeah,
and this was something I didn'tknow about that.
You know, we had to call thecounty, we had to call the
coroner to come pick up thispoor lady.
Yeah, because we didn't take tocall the county, we had to call
the coroner to come pick upthis poor lady yeah.
Because we didn't take her inthe ambulance.
(12:02):
So you know, she had to bepicked up and that was just kind
of a very surreal incident, youknow.
And the question I get a lotafter this kind of comes up in
our class is why do people haveDNRs and you kind of mentioned
the terminally ill, you knowsomething like that People with
medical issues.
(12:22):
You know that's definitely abig deal of it, but at the end
of the day it's that person'schoice.
What do they want done?
You know, how do they want tolive their life?
How do they want to be treated?
You know, and there's religiousissues there, um, personal
(12:43):
issues, there's all kinds ofthings not for us to judge why
or how come.
It's for us to either help themor not help them, based on
their wishes right at the end ofthe day.
um so hopefully that helped youand just kind of shine some
light on some do not resuscitateorder stuff, what if let's say
that you know there is a patientwho is in need of help.
Megan (13:06):
They have a family member shouting saying, hey, they have
a DNR.
You know, don't provide careand you feel unsafe.
But you still want to help butyou physically don't feel safe
providing care.
What's the best thing to do inthat scenario?
Jimmy (13:18):
Well, I still think you call 911.
Megan (13:20):
Exactly, and you providing care.
Jimmy (13:21):
What's the best thing to do in that scenario?
Well, I still think you call9-1-1, exactly and, um, you know
, get professionals out there,you know, and help the best you
can, and that's realisticallythe only thing we can do.
Do the best you can andremember, calling 9-1-1 is
helping yeah you know, and don'tever be afraid to call 911.
(13:45):
Even if you don't think it's abig deal, it might be a big deal
or it might grow into a bigdeal.
Trust your instincts.
Yeah, trust your instincts.
All right, team, thanks forvisiting us and hanging out with
us on our Life and Safetypodcast, peace.
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