What are 'code status' and 'advance directives,' and why must PMU staff be aware of them?

• A. They reflect patient preferences regarding resuscitation and treatment; staff must honor directives and document them.
• B. They are administrative forms not essential.
• C. They relate to billing codes.
• D. They describe wait times.

Answer: (A)

Code status and advance directives are about what a patient wants or doesn’t want in terms of life-sustaining care, including decisions about resuscitation. They serve as a patient’s legal and ethical instructions for how treatment should proceed if the patient cannot speak for themselves.

PMU staff must be aware of these directives so care can align with the patient’s wishes at all times. This means recognizing when a patient has a DNR order, a POLST/MOLST form, a living will, or a durable power of attorney for healthcare, and then acting accordingly. The directives guide whether to initiate or withhold resuscitation, intubation, ventilation, hospitalization, and other treatments, and they often specify comfort-focused or limited-care goals.

Practical points to keep in mind: ensure the directive is current, clearly documented in the patient’s chart, and easily accessible to all team members and shifts. If a directive exists, communicate it during handoffs and follow it during patient care. If updates occur, reflect them promptly. Advanced directives also involve appointing a surrogate decision-maker when the patient can’t decide, which helps ensure that the patient’s preferences are respected even in emergencies.

In short, these directives protect patient autonomy, guide appropriate care, and reduce the risk of providing unwanted or non-beneficial treatments.