ABSTRACT
Patients in the critical care unit [CCU] are, by definition, the sickest patients in acute care hospitals and face higher risk of death than any other hospital population and usually require advanced life support such as mechanical ventilation, inotropes, or dialysis. Since every day critical care nurses encounter death and dying in the critical care units, Nurses are vital to end-of-life care as they are the ones present at the bedside, they have an opportunity to observe behaviours and actions that are barriers to a peaceful and dignified death while they provide end-of-life care. Do-not- resuscitate orders [DNR] are used in many countries to limit the use of cardiopulmonary resuscitation [CPR] in certain situations. There is still a continuing debate about the ethics, legalities and the appropriate medical indications for use of DNR. The status of DNR can raise many issues for nurses, including ethical dilemmas, conflict, and power struggles among members of the health care team. Therefore, this study was carried out to describe critical care nurses' knowledge and attitudes regarding the Do not resuscitate [DNR] status in Critical Care Units. A descriptive design was used and The study was conducted in the critical care units of Alexandria Main University Hospital, namely the: Casualty Care Unit [Unit I], General intensive Care Unit [Unit III], Chest intensive Care Unit, Coronary care unit, Neurosurgery intensive Care Unit, Triage and the Burn intensive care unit. A convenient sample consisting of one hundred and forty [140] critical care nurses working in the previously mentioned intensive care units were included. They were interviewed by using knowledge and attitudes regarding do not resuscitate [DNR] status structured interview schedule. Results showed that: the majority of critical care nurses have knowledge about DNR status regarding the following: the meaning of DNR as withholding CPR, provided care as administering oxygen, the medical management as defibrillation / cardioversion and documentation. Regarding critical care nurses attitudes towards DNR status, most of them were of the opinion of continuing monitoring patients' vital signs, providing care as suctioning artificial airway. Conclusions: Clear policy and documentation for DNR status are suggested to reduce confusion and promoting nurses involvement in decision making process of DNR and improving nursing practice