An audit of nurses' views on DNR decisions in 1989 and 2003.

Guidelines on making do not resuscitate (DNR) decisions have changed in recent years in keeping with changing attitudes and legislation. Decisions should now be discussed with all competent patients, and nursing staff should be involved in the process. The views of nursing staff in 1989 and 2003 were compared, focusing on what factors they thought were important in coming to a DNR decision and any implications it had for other treatment. A patient's wishes, their previous quality of life and the chances of successful resuscitation were rated highly in both studies. Advanced age was rated as important less often in 2003 but was still thought to be an important factor by 61% respondents. In 2003 nurses were significantly more likely to state that active treatment, such as admission to an intensive care unit or surgical intervention, could be appropriate for patients with DNR orders. However, the number of respondents who considered intravenous fluids (18%) or antibiotics (26%) inappropriate for patients not for resuscitation was concerning.