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

[pikov22]

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.”

Perhaps the woman had an advanced directive that said "Do not resusciate."

[Christine L]

The nurse can have a book full of excuses but at the end of the day, she is still a coward. Her family should be ashamed at her and she never be employed to care for others again.

Would you be considered a self-righteous coward for anonymously accusing a woman you know nothing about in a situation you know very little about?

[BlackSpinner]

Another thing- WTF are they doing publishing 911 calls? What happened to all those vaunted privacy rules?
Since this was a medical emergency don't medical privacy laws apply?

[cosmo]

Would you be considered a self-righteous coward for anonymously accusing a woman you know nothing about in a situation you know very little about?

These are words of a coward.

Dispatcher: Okay, I'll walk you through it all. We, EMS takes the liability for this, Colleen. I'm happy to help you. This is EMS protocol.

At this point, the nurse asks someone else to get a supervisor. She is heard telling someone else at Glenwood Gardens, "Can you get (unintelligible) … right away. I don't know where he is. But she's yelling at me and saying we have to have one of our other residents perform CPR. I'm feeling stressed and I'm not going to do that, make that call."

Dispatcher: Colleen, is there anybody who works there who is willing do to it?

Nurse: We can't do that.

Dispatcher: Are we just going to let this lady die?

On the polar opposite, Charles Albert Poland, the Alabama school bus driver will forever go down as a hero. Saved 21 kids. The last kid was a special needs kid who didn't flee with the rest. The so called nurse was more afraid of losing a paycheck rather than help a dying person.

The school bus driver, 66-year-old Charles Albert Poland, Jr., refused to let him take the children and blocked access to the aisle of the bus, as twenty-one children escaped through the emergency exit at the back of the bus. Dykes fired four shots, killing Poland, and left the bus taking Ethan, a five-year-old student from Midland City Elementary School, with him.

[BlackSpinner]

Except, you know, she still has a job and can look after her family. She did as she was required to do for her job. The family agreed with her decision.

And you are being a judgemental asshole.

[DiverCTHunter]

Looking at their state survey, Medicaid and MediCAL reports, I can tell that they are a combination Assisted Living Facility (ALF) / Skilled Nursing Facility (SNF), and as such the SNF side is required to have CPR certified caregivers on the floor at the time. The facility's most recent survey was deficiency free, and some of the followup stories in the local news sites point out that they have an "excellent" reputation.

Obviously, the transcript is disturbing, which makes for great sensationalistic news coverage. I suspect (as many other posters have pointed out) that there WAS a DNR order in place, but that begs the question of why 911 was contacted in this case.

I'm curious if this was on the ALF side, and whether the "nurse" referred to in the story was an RN, PRN, LPN, CNA, or just a candy striper. Overall, it sounds like there's been a rush to judgement based on a news outlet's poorly researched story.

[cosmo]

"The woman who died in California did not have a Do Not Resuscitate order."

http://www.newson6.com/story/21476283/c ... efused-cpr

[Janknitz]

Here's what California Association for Nursing Home Reform (CANHR.org) has to say:

"Most of you have probably heard about the refusal of a Bakersfield Glenwood Gardens nurse to provide CPR to an 87 year old resident, despite the pleas of the 911 dispatcher. The woman lived in the Glenwood Gardens independent living section. Although Glenwood Gardens has applied for CCRC status, it has not yet been approved, so the unit was not subject to DSS, CCL regulations for assisted living. Not that it mattered, since there are no regulations that require CPR, even in assisted living.

The resident did not have a do-not-resuscitate order - thus, one would assume that she wanted to be resuscitated, but that is a big assumption, since the deceased's own daughter said she was "satisfied with the care provided."

All sorts of ethical and legal issues arise here - including whether CPR should be mandated in all senior living facilities, the efficacy of CPR in the first place, the necessity of preparation of advance directives, etc. Again, it probably wouldn't have made any difference here, since the facility's policy was that employees do not attempt cardiopulmonary resuscitation on residents of Glenwood's independent living facility. And the fact that such a policy is legal in California.

Nevertheless, the 911 tape is very disturbing - it's a first for us in over 30 years of advocacy."

[pikov22]

"The woman who died in California did not have a Do Not Resuscitate order."

http://www.newson6.com/story/21476283/c ... efused-cpr

"It was later revealed that Ms Bayless had signed a Do Not Resuscitate form..."

http://www.dailymail.co.uk/news/article ... z2McfEX0IM

???

[Christine L]

And you (Cosmo) are being a judgemental asshole.

... who is sitting smugly at his computer helping no one.

A brat who doesn't even have his facts straight and gleefully rushes to judge someone else.

[cosmo]

And you (Cosmo) are being a judgemental asshole.

... who is sitting smugly at his computer helping no one.

Myself and the nurse are one the same

[chronic]

A very few people on here deserve praise for not jumping to judgementally condemn the nurse or whatever she was who called 911. The rest of you people should be somewhat ashamed of yourselves, but, I don't think you will be.

[ems]

I don't often agree with Cosmo but I sure do this time! I was taught to help anyone in need if I possibly could...

And all this name calling is plain silly. Say what you think if you want to... but name calling doesn't help.

Now, I just hope I don't have to eat my own words.

[hyperlexis]

I don't often agree with Cosmo but I sure do this time! I was taught to help anyone in need if I possibly could...

And all this name calling is plain silly. Say what you think if you want to... but name calling doesn't help.

Now, I just hope I don't have to eat my own words.

I was taught CPR in grade school gym class in what, like 1984? Again in high school gym class, year after year. Most kids probably from the 1970s onward have been, in fact. (Plus we expertly know how to use condoms. Thanks gym class!)

If I can do CPR or the Heimlich maneuver, or any grade school kid today knows how to do it (and likely would!) then some dumbass masquerading as a disciple of Florence Nightengale had better well know it too - and do it!

No way, no how, I do not believe this woman on the tape was a nurse or even an NA. I bet she was only a staff person. And a very stupid staff person at that. Because no way on Gds earth could an actual nurse, who has taken an oath to protect patients in her care (not her employer), just sit there and not aide a person in distress (who admittedly did not have a DNR and was not in hospice). No way. That woman was not a nurse.

[VikingGnome]

Everyone has a right to self-determination. We cannot force somebody having an obvious heart attack to go to the ER. We can't force people to go through chemotherapy and radiation therapy for cancer. We can't force people with OSA to use their CPAP every night.

My own mother is 88 and has lived a long, very fulfilling life. However, with short term memory problems from ruptured cerebral aneurysm 24 years ago and the judgement of a 5-year-old she cannot live alone. My sister has cared for my mother for 20 years in that condition (since my dad died). Whenever my sister and her husband fly to Florida to visit their only grandchild, 24-hour home care is required for Mom. Mom can no longer dial a telephone, cook anything (stove or microwave), get herself into the shower, remember to take her meds. She remembers all the family and can recognize our voices on the phone but doesn't remember what she has done today or this week. She says, "When I go to sleep, I forget everything." She recovered language skills but her speech is slow and sometimes scrambled (words out of order). She constantly apologizes for her communication deficits and has low self esteem because of it.

If Mom coded at home, would my sister call 911? I honestly do not know. I know that Mom gave my sister Proxy Authority for her healthcare and Power of Attorney just after my Dad died (20 years ago). None of us siblings would question my sister's decision if one had to be made because she has taken care of Mom for 20 years. My sister has been very good at keeping us up to date on Mom's health status and anything going on. Last week she had laser surgery on eye because of scar tissue in front of implanted lens after cataract surgery.

For the naysayers of CPR, that very same sister survived a sudden cardiac arrest two years ago (Valentine's day). Her husband (a dentist) found her blue on the kitchen floor without a heartbeat. He administered cardiac compressions for 20 minutes until EMTs arrived. EMTs took over and shocked my sister's heart twice to get it beating again. ER doctors were unable to intubate her so they did an emergency tracheostomy to establish an airway. They had to shock her heart two more times when she went back into ventricular arrhythmia. Two doctors recommended that my brother-in-law have her removed from the respirator. Lots of fear of brain damage. She was unconscious and unresponsive for 3 days in ICU but gradually she started moving and waking up. On day 5 they transferred to a heart hospital and implanted a defibrillator in her chest. In two years, it has NOT gone off but came close twice while she was asleep at 4 AM. Her doctor sent her for sleep study and her AHI was 69. She's been on CPAP now for 8 months and no more heart arrhythmias.

Did my brother-in-law make the right call by keeping my sister on a respirator. ABSOLUTELY. It's wonderful to have my sister alive and well. She is still employed and can do everything she did before. Was there any way to predict the outcome? NO. Most doctors become deeply concerned about brain damage following 30-minutes of CPR and my sister's doctors were quite skeptical. It just wasn't "her time to go."