OT: Elderly home nurse refuses to perform CPR, woman dies

[cosmo]

http://www.turnto23.com/news/local-news ... ents-death
http://losangeles.cbslocal.com/2013/03/ ... ing-woman/

(CBSLA.com) — The staff of a Bakersfield senior living facility refused to do CPR on a dying woman. The 911 tapes reveal an operator desperately trying to get the staff to help the 87-year-old woman — but they refused. The incident happened Tuesday at Glenwood Gardens in Bakersfield. The woman died at a hospital. CBS2/KCal9′s Brittney Hopper reports it’s an important story for anyone with a loved one in an independent living facility. A 911 dispatcher says, “Are we just going to wait and let this lady die?” A nurse at the facility replies, “Well, that’s why we’re calling 911.”

The 911 dispatcher said, “We need to get CPR started” to which the nurse said, “They’re refusing CPR. They’re going to let her just die.” The dispatcher implores the nurse to help. And the nurse explains it’s against facility policy for staff to administer CPR.

The 911 dispatcher has trouble believing this. “I understand your boss is telling you you can’t do it but if there’s anybody, a human being, I don’t, is there anybody that’s willing to help this lady and not let her die?”

The nurse said, “Um, not at this time.”

Hopper played the 911 tape for Doctor Thomas Horowitz — a medical ethicist. He says he’s disgusted. “Pathetic. Absolutely pathetic. I’m disappointed in a facility that would dis-empower it’s people to help rather than to help.”

[johnthomasmacdonald]

Reminds me of the video of the hospital waiting room in brooklyn with the women passing out and falling to the floor and no one doing anything while she laid there for about an hour and in fact died there - surrounded by people and staff - not one of whom checked to see how she was doing - we are a sick society - and one in deep denial about how sick we are

https://www.youtube.com/watch?v=FOCpOZ4txvs

[kteague]

I was hoping to hear more details on this. If the company has a blanket policy that their employees don't do CPR, and they are a nursing facility, that is disturbing. Just wondering though how much more there is to this story. Who was refusing CPR - a family member? Was there a living will with expressed directive for such a situation? Did the paramedics do CPR? If she had a pulse or was still breathing, CPR may not have been indicated. Just so much unknown. My poor mother who said very little due to damage from a stroke was in her miserable last days in the hospital. Every time a hospital staff person walked in the room she moaned and said "I wish I was dead." Over and over and over she said it. A nurse was sympathetic to the effect it must be having on me to have heard that so many times. I explained to her it was Mom's way of assuring that everyone knew not to try to save her. Bless her heart. In the situation in the news, if there is a blanket and blatant disregard for life, that's awful. What if someone simply choked and needed the Heimlich Maneuver done for them to return to a normal life? This situation serves as a warning to be very sure to read the fine print when entrusting our loved ones to the care of a facility. Maybe this is commonplace and we just don't know it. Anyone know?

[Goofproof]

This isnt black or white, in many cases cpr without quality of life, isnt a blessing, its just added pain and prolong suffering. A lot of facts are missing here, the odds are that those involved dont even know the full story. Jim

We all need to get our end of life set up before the need arises, but due to out own mortality, dont want to do it. Myself included. ..

[LSAT]

Maybe she had a DNR on file with the facility. (?)

[JeffH]

My Mother is in a nursing home right now. If she has heart failure, I hope they don't do cpr on her. She does have a DNR. Her quality of life is terrible and I wouldn't wish it on anyone.


JeffH

[BlackSpinner]

My Mother is in a nursing home right now. If she has heart failure, I hope they don't do cpr on her. She does have a DNR. Her quality of life is terrible and I wouldn't wish it on anyone.


JeffH

This. My mother is home here with us but no-one will do CPR on her. First of all properly done CPR on her would break all her ribs, second of all she has a DNR and has expressed that to us long ago.

[Guest]

The CPR success rate is only about 10%, and very few survivors actually go on to lead lives without complications. There's socialized ramifications that determine who receives CPR and who doesn't -- in particular, people perceived as young, having many years left to live, or having plenty of social connections and support tend to receive CPR from paramedics more often and with much greater effort. Even people who have flat-lined EKGs with a lot of social clout continue to be administered resuscitation drugs in hospitals. Healthcare workers prioritize their treatment by "who is most important," and resuscitation decisions are mottled by cultural factors. Advanced directives are checked for right away for 80 year-olds but to even think to check for a 20 year old is outlandish. It's a matter of principle, though, that I consider it unethical that the nurse didn't even "try" to save her life. I mean, when should policy overrule the value of a human life?

[chunkyfrog]

I notice a tendency now to post DNR signs at bedside in hospitals.
A bit disturbing to see unless you are close to the situation.
I can easily imagine a reporter getting so captured by a "story" that they neglect to get the whole story.
To think I once considered journalism!
(I decided against it because of rampant nepotism observed before it was too late to back away)

[SisterBenedict]

When I get to a certain age or level of illness, not only will I file a DNR with my doctor and with my Health Care Proxy, I will also get the letters tattooed across my chest.

[ems]

I have a DNR, a P of A and other necessary papers in a draw in my desk. Will my kids remember it's there when the need arises, who knows.

[Guest]

This is what happened to my Mother just this passed November at the Weslayan nursing home in Elyria, Ohio., My Mother did not receive any medical care. A doctor came in once a month. She was taken ill went to the Elyria Hospital was unresponsive for 4 days, and she came out of it, she was improving rapidly, then she started appear like she was drugged with some type of sleep or relax medicine. She was diebetic and high blood pressure and she was never put back on her medicine, you could she her fading and no medical help at all. They bathed her and such, but, If you love your people please take this as a warning if you get to read this, NEVER put your people in nursing homes. It true what they say. They let my Mother die!

[Janknitz]

This story stirs up emotions but too much is unknown.

First, the facts state that it takes place in a "senior living facility", not a hospital or nursing home. California has multiple levels of care, including residential care facilities for the elderly (RCFE's) which are often small private homes with just six residents attended to by non-profressional staff and assisted living facilities which are residences for seniors that may or may not have nursing staff--often they do not.

The policy at this senior living facility--whatever it may be--may be to call 9-1-1 when someone "codes" regardless of whether they are "no code" or not. California has recently adopted POLST forms--Physian's Orders for Life Sustaining Treatment. THose replace the myriad of forms used for DNR's in the past--every place had a different form and policy, and it was confusing for paramedics to know what to do when responding to such calls, so it's been standardized (to a degree) with the POLST form, which is bright pink and posted on your refrigerator at home if you have one, though in most facilities, it's in a file (California law does not permit "no code" or other signs to be posted at a patient's bedside, BTW). It's unclear if this woman may have a POLST which may have stated she doesn't want CPR and other such measures--we just don't know.

And as for this statement "“They’re refusing CPR. They’re going to let her just die.”, we don't know who "they" are. It may possibly be the woman's health care agent acting under a properly executed advance health care directive (combination of durable power of attorney for health care and a living will which is used in California) who is requesting no CPR.

It may even be that the woman calling (who may or may not have been a real "nurse") had a moral dilemma and took it upon herself to call 9-1-1 when she didn't feel comfortable with the woman's own decision (or that of her authorized surrogate decision-maker) not to have CPR and other measures taken.

The 9-1-1 tape sounds very dramatic and makes good news, but we just don't have sufficient facts to draw ANY conclusions or condemn anyone.

[Bons]

I moonlight as a home health aide (housework, hygiene help, etc.). It is against the law for us to do anything that can be considered medical care, even putting a bandaid on a cut. All of our clients are informed of that policy.We could be arrested for performing CPR while on the job.

Perhaps the "nurse" was not really a nurse, since assisted living facilities are not required to have nurses on staff at all hours. In that case, there was no one who could legally perform CPR.

[kteague]

I guess a lot has changed in home health care. Guess I'll ask a friend who is a manager at a home care agency what their policies are these days. When I was still in that field home health aides had to get CPR certified. Guess times are changing.