New Jersey POLST Form: When You Need It and How It Works

An advance directive tells your family what you want. A POLST tells the paramedics what to do. That distinction matters — because when EMS arrives at your home, they follow medical orders, not patient-written documents.

The Practitioner Orders for Life-Sustaining Treatment (POLST) is a physician-signed medical order printed on a distinctive green form. Unlike an advance directive that expresses preferences, a POLST creates immediate, binding clinical orders that emergency responders, hospitals, and nursing homes must follow across all care settings.

Who Qualifies for a POLST

POLST is not for healthy adults doing routine planning. It is specifically designed for patients who meet one or more of these clinical criteria:

• Terminal diagnosis — an incurable condition expected to cause death
• Advanced frailty — significant functional decline making recovery unlikely
• The "surprise question" standard — a clinician would not be surprised if the patient died within the next 12 months

If you are a healthy adult planning ahead, an advance directive is the right document. POLST becomes relevant when your health status changes and you need actionable medical orders, not just documented preferences.

What the POLST Covers

The New Jersey POLST addresses three core medical decisions:

Section A — Cardiopulmonary Resuscitation (CPR): Whether to attempt CPR if your heart stops or you stop breathing. Options are Full CPR (attempt resuscitation) or Do Not Attempt Resuscitation (DNAR).

Section B — Medical Interventions: The level of treatment you want beyond CPR. Three options:

• Full Treatment — ICU admission, intubation, mechanical ventilation, cardioversion
• Limited Treatment — IV fluids, cardiac monitoring, antibiotics, but no intubation or ICU
• Comfort Measures Only — pain management and comfort care; transfer to hospital only for comfort needs

Section C — Artificial Nutrition: Whether you want a feeding tube if you cannot eat. Options range from long-term tube feeding to a trial period to no artificial nutrition.

How POLST Differs from an Advance Directive

A key point: if you have both a POLST and an advance directive, the POLST overrules the advance directive wherever they conflict. The POLST also completely replaces any separate out-of-hospital DNR order.

How to Complete a POLST in New Jersey

You cannot complete a POLST on your own. The form requires:

1. A conversation between the patient (or their surrogate decision-maker) and a physician, Advanced Practice Nurse (APN), or Physician Assistant (PA)
2. The clinician's signature — this is what makes it a medical order
3. The patient's or surrogate's signature confirming the discussion took place

Start by asking your primary care physician or specialist to initiate the POLST conversation. If you are in a nursing home or hospice, the facility's medical director can complete it.

Where to Keep the POLST

The POLST must be physically accessible during a medical emergency. For patients living at home, keep it:

• On the refrigerator door (standard location for first responders)
• On the bedroom door or headboard
• In a visible location that EMS can find within seconds of arriving

Do not store it in a filing cabinet, safe, or with other legal documents. The entire purpose of the POLST is immediate visibility. If the paramedic cannot find it, they default to full resuscitation.

For patients in nursing homes or assisted living, the facility stores the POLST in the medical record and ensures it travels with the patient during transfers.

The New Jersey Advance Directive & Living Will Kit includes a POLST coordination guide that shows how your advance directive, POLST, and DNR interact — and prevents the conflicting-document problem that causes clinical confusion during emergencies.

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