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Do Not Resuscitate Order For Dun & Bradstreet Holdings Employees

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Healthcare Provider Update: Provides PPO and CDHP medical plans with HSA options, dental, vision, FSAs, and paid parental leave up to 16 weeks 9. As ACA costs increase, D&Bs employer contributions and flexible spending options help employees maintain affordable and comprehensive coverage. Click here to learn more

What Is It?

As a Dun & Bradstreet Holdings employee, you have the right to decline medical treatment, even if you die as a result of your decision. Depending on your medical condition, your prognosis, and your views on the quality of life, you may wish to refuse lifesaving measures, such as cardiopulmonary resuscitation (CPR). Executing a do not resuscitate (DNR) order is one way of doing this. A DNR is a doctor's order that tells all other medical personnel not to perform CPR if you go into cardiac arrest. Cardiac arrest occurs when your heart stops beating, blood flow to your brain stops, and you stop breathing. If the blood flow is not quickly restored, permanent damage to the brain and other organs can occur. CPR simulates heartbeat and breathing, while attempting to restart these functions.

The term  CPR  actually encompasses a variety of separate procedures, including cardiac compression, endotracheal intubation, assisted ventilation, defibrillation, and cardiac medications. Most states recognize two types of DNRs. One is effective only while you are hospitalized. The other is used by people outside the hospital--for example, nursing home residents, hospice patients, and even those who are not receiving medical treatment.

Typically, terminally ill patients and elderly individuals execute DNRs to avoid prolonging their final illnesses. However, some states allow healthy adults to execute the orders, as well. Depending on the laws of your state, a DNR used outside the hospital may be called a 'pre-hospital DNR,' 'out-of-hospital DNR,' 'outpatient DNR,' 'DNR for EMS,' or 'CPR directive.' As a result of your request, your doctor generally notes an in-hospital DNR order on your chart. Out-of-hospital DNRs take various forms, depending on the laws of your state. ID bracelets, MedicAlert necklaces, and wallet cards are some methods of noting DNR status.

When Can It Be Used?

Availability of DNRs Is Determined By State Law

Not all states have DNR laws. For Dun & Bradstreet Holdings employees, you may want to consider how your state's laws govern whether DNRs are permissible, who can execute a DNR, and what form the order must take. These laws may permit in-hospital DNRs, out-of-hospital DNRs, both of these, or neither of these. Some state laws allow any person of legal age to execute a DNR, while others permit DNRs only for individuals with terminally ill conditions. Some states allow children to participate in decisions regarding DNR in certain cases. Check the laws of your state and any other states where you spend a significant amount of time.

Strengths

Allows You to Exercise Choice In Medical Treatment

Cardiopulmonary resuscitation (CPR) has produced some miraculous results when used on normally healthy individuals in trauma situations. However, it can be a painful and even violent procedure. Its effectiveness is limited when used on terminally ill or hopelessly deteriorated patients. In some cases, CPR only delays the moment of death.

For example, CPR could restore your heartbeat, but if permanent brain or organ damage occurs during cardiac arrest, you may be dependent on life support machines. Executing a do not resuscitate (DNR) order allows you to choose a natural death.

Example(s):  Hal is hospitalized with a terminally ill condition. He is on a respirator and knows he has only a short time to live. Hal consults his doctor and learns that the laws of his state permit in-hospital DNRs. This will allow him to forego CPR if his heart fails. Hal asks his doctor to execute a DNR as soon as possible. The following week, Hal's heart stops. Because of Hal's DNR, hospital personnel do not attempt CPR.

Specifically Intended for an Emergency Situation

If you go into cardiopulmonary arrest, your DNR lets medical personnel know that you don't want CPR. Because of the emergency nature of this situation, other types of advanced directives are usually not timely enough to accomplish this goal.

Tradeoffs

Extremely Limited Usefulness

Although a do not resuscitate (DNR) order is a very powerful instrument, it is only effective under specific conditions. Generally, a DNR comes into play only if you go into cardiac arrest, and it frequently only allows you to refuse cardiopulmonary resuscitation (CPR), although in some states it may allow you to decline other drastic medical treatment as well. A living will or durable power of attorney for health care may be needed to convey other medical treatment instructions, such as your wishes regarding life support and intravenous feeding.

Out-of-Hospital DNR May Not Be Effective In Other States

As a Dun & Bradstreet Holdings employee, it is beneficial to understand how an out-of-hospital DNR that is valid in your state may not be valid in other states. Therefore, if you spend a significant amount of time in another state, you should find out whether that state's laws recognize DNRs, whether you are eligible to have a DNR in that state, and what restrictions are placed on the form of the DNR.

Doctors May Be Hesitant to Broach This Topic or Reluctant to Write a DNR

If you are hospitalized with a serious illness, your doctor may not bring up the option of executing a DNR. If you don't want to be resuscitated, you should initiate this discussion with your doctor. Also, studies indicate that many doctors are slow to write DNRs, even when they are aware of their patients' preferences, although the reasons for this vary. If you are a Dun & Bradstreet Holdings employee and want to ensure your wishes are followed, you should touch base with your doctor to make sure the DNR is placed on your chart.

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How to Do It

Research Your State's Laws Regarding Dnrs

Not all states provide for these orders. Each state has its own eligibility requirements, particularly for out-of-hospital DNRs.

Discuss Your Wishes With Your Doctor

Your doctor should be able to provide information on your prognosis and counsel you on your options. If you are a Dun & Bradstreet Holdings employee, your doctor's signature will most likely be required on any DNR you execute.

Execute Your Out-of-Hospital DNR Properly And Keep It With You

If you are a Dun & Bradstreet Holdings employee interested in DNR, you must consider how if your state allows out-of-hospital DNRs, there is probably a required format for the order. Examples of state-required DNR formats include ID bracelets, necklaces, wallet cards, and letter-size forms. If your DNR is not in the required form, it may not be honored. If medical personnel can't find your DNR order, they are obligated to give full and immediate care. Thus, it is extremely important to execute your DNR order properly and keep it with you (or in an appropriate place) at all times.

Example(s):  Hal is a resident of an assisted-living facility. Hal is 89 years old and feels he has lived a good life. He does not want to die in a hospital or be dependent on machines for his survival. Hal discusses his feelings with his doctor. Hal's doctor suggests executing an out-of-hospital DNR, which will instruct medical personnel not to perform cardiopulmonary resuscitation (CPR) if Hal goes into cardiac or respiratory arrest. Hal agrees and receives an ID bracelet noting his DNR status. Hal wears his bracelet faithfully. Six years later, Hal's heart fails as he jogs in the park. Medical personnel arrive on the scene, but immediately notice  Hal's DNR ID bracelet. CPR is not attempted.

Tell People About Your Decision

In general, other people cannot reverse your decision once you execute a DNR. As a Dun & Bradstreet Holdings employee however, if your DNR is misplaced or for some reason is not followed, it would be important for your family and friends to understand your wishes. Although this topic may be difficult to discuss, those close to you are more likely to support and uphold your decision if they understand how you feel and why you feel that way. If you have appointed a representative in a durable power of attorney for health care (DPAHC) , it is especially important that this person be aware of your decision.

Coordinate All Advanced Directives

Since a DNR is so limited in scope, you may wish to establish a living will and/or DPAHC as well. If you do so, make sure your wishes are stated consistently throughout these documents. In some states, the most recent document will govern if there is a conflict, so you must make sure your wishes are clear.

Tax Considerations for Dun & Bradstreet Holdings Employees

Income Tax

None

Gift And Estate Tax

None

Questions & Answers for Dun & Bradstreet Holdings Employees

What If You Go Into a Coma Before Executing Your DNR, And You Can't Express Your Wishes?

Your healthcare representative, if you have appointed one, may be able to have a DNR executed on your behalf. As a Dun & Bradstreet Holdings employee, there must be evidence that this is what you would want. You might include these instructions in your durable power of attorney for health care , especially if the laws of your state do not allow out-of-hospital DNRs. Be aware, however, that this method of instruction is useless in an emergency if your representative is not present. In some states, with your family's consent, your doctor may be able to execute a DNR on your behalf. Again, it would be unwise to rely on this course of action in an emergency.

Can You Change Your Mind?

Yes, it is possible to revoke a DNR order. If you have an out-of-hospital DNR, you may be able to revoke it by simply removing the bracelet or the wallet card. However, some states also have a database of DNR patients. If this is true in your state, you may need to take additional steps to revoke your DNR. When your doctor writes the DNR, ask what steps are necessary to revoke the order.

Additionally, medical personnel must give emergency care to anyone who requests it. For example, Emergency Medical Service guidelines in Wisconsin instruct personnel to perform cardiopulmonary resuscitation (CPR) if a person rips off his or her DNR bracelet or asks for CPR during cardiac arrest.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Dun & Bradstreet Holdings offers its employees both a pension plan and a 401(k) plan. The pension plan, referred to as the Dun & Bradstreet Retirement Account, is based on credited service and compensation earned prior to the freeze date of July 1, 2007. This plan follows a traditional defined benefit structure, with benefits calculated using years of service and final average pay. The retirement plan's normal retirement age is typically 65, though employees may become eligible for early retirement based on age and years of service. Participants in the pension plan have access to their benefits at age 59½ with applicable reductions. Dun & Bradstreet employees who were part of the pension plan before July 1, 2007, continue to accrue benefits under this plan​ (Aon). The company also provides a 401(k) plan known as the Dun & Bradstreet 401(k) Plan, administered by Fidelity. Employees can contribute between 1% to 75% of their annual compensation as regular or catch-up contributions. The company matches contributions up to 7%, although the match percentage varies by employee and is subject to the IRS contribution limits. Eligibility for participation in the 401(k) plan typically requires employees to be at least 21 years old and to have completed at least 1,000 hours of service within a calendar year. The 401(k) plan is flexible, allowing employees to choose between traditional pre-tax contributions and Roth post-tax contributions​
Restructuring and Layoffs: Dun & Bradstreet Holdings has been undertaking a significant restructuring plan to streamline its operations and enhance efficiency. In late 2023, the company announced a reduction in its workforce as part of this initiative. This move is aimed at consolidating its global operations and focusing on core business areas. Given the current economic and investment environment, including fluctuations in market performance and evolving tax policies, it is crucial for employees and stakeholders to stay informed about such changes. Understanding these developments can help in making informed decisions about career and investments.
Dun & Bradstreet Holdings offers stock options and RSUs as part of its employee compensation package. Stock options typically provide employees the right to purchase shares at a set price, while RSUs are granted as company shares without a purchase requirement. According to the 2022 10-K filing, stock options and RSUs are awarded to key employees, executives, and directors based on performance and tenure
Dun & Bradstreet Holdings offers comprehensive health benefits to its employees, designed to support their well-being and work-life balance. The company's healthcare benefits include a variety of health plans such as PPOs and high-deductible health plans (HDHPs) with Health Savings Accounts (HSAs). They also provide access to dental, vision, and mental health services. Key healthcare-related terms and acronyms used by the company include: HDHP: High-Deductible Health Plan, allowing employees to pay lower premiums with higher out-of-pocket costs. HSA: Health Savings Account, available for employees enrolled in HDHPs, allowing them to save money pre-tax for medical expenses. EAP: Employee Assistance Program, providing confidential support for employees dealing with personal or work-related issues, including mental health resources. Dun & Bradstreet also encourages a holistic approach to wellness through its Wellness Program, offering employees resources and tools to maintain physical and mental health. In recent years, the company has expanded its telehealth options, allowing employees to access healthcare providers virtually, which gained prominence during the COVID-19 pandemic
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For more information you can reach the plan administrator for Dun & Bradstreet Holdings at 103 JFK Pkwy Short Hills, NJ 7078; or by calling them at (800) 526-9018.

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