Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


School of Nursing




It is imperative that Advanced Practice Registered Nurses (APRNs) have the skill set necessary to initiate code status discussions with people. The literature supports that healthcare providers tend to avoid the topic, for reasons that include feeling uncomfortable, not having enough time, and not wanting to take away hope. How do we break down these barriers to ensure that healthcare providers feel comfortable and prepared to have code status discussions? The purpose of this project was to explore perceived barriers encountered by the Advanced Practice Registered Nurse (APRN) student population. A survey was developed that included sections on comfort level with code status discussion, beliefs about DNR, barriers encountered in code status discussions, and two open ended questions. Findings revealed that participants overall were comfortable with having code status discussions, but were unfamiliar with the MOLST tool, a relatively new measure being used to facilitate code status discussions. Most participants believed that patients should always be informed about code status and should be asked if they would like to be a DNR. Numerous barriers were cited, the most common being unrealistic expectations and feeling uncomfortable addressing the issue of code status. More education, time and support, were cited as what would enable participants to have better conversations. Starting these discussions in the primary care office and then ensuring that this information is passed on could potentially improve outcomes. Advocating for policy changes at the institutional, state, and national levels is needed. Quality, patient-centered code status discussions are imperative in ensuring the patients are allowed to have good deaths.

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