T Nation

Attendant at Nursing Home Refuses CPR

http://gma.yahoo.com/video/gma-911-dispatcher-pleads-nurse-080000658.html

I can understand on some level how a technically-non-medical staffed facility might take the position that they’d open themselves up legally to providing medical assistance in emergencies, but this situation that occurred is just insane. How can any human being just stand aside, do nothing, and watch someone die because of company policy?

I’m sure some more legally schooled folks can chime in with their professional and personal thoughts.

S

Its a DNR…

Not sure how legal it is to save someone with a DNR but if its against someones wishes then you cant do much.

I wouldn’t put myself in that attendant’s shoes for any amount of money, but I think the policy exists for good reason. A person that old would never recover from the broken ribs on top of the brain being without oxygen for minutes.

From a different article:
http://www.kget.com/news/local/story/Dramatic-911-tape-reveals-dispatcher-s-fight-to/g2pqsOnJJUGDHFDtxoK04Q.cspx
“Her daughter told 17News she is satisfied with Glenwood’s handling of the situation.”

Related, something I saw recently showed that 90% of physicians surveyed would not want to receive CPR in the case of irreversible brain damage.

First I would like to know if the staff are actually Nurses or its that normal BS they are calling non-nurses (Medical assistants and CNA’s)

A lot of patients in those types of homes have DNR orders. If the facility only had DNR patients such as some hospice facilities, I could see them withholding CPR but even with DNR patients, you can still give them oxygen and make them comfortable. You just dont do all the other stuff that goes along with a medical emergency of this sort such as intubation, IVs, medications, compressions, etc…

Not enough info was given to really get a clear picture.

[quote]harrypotter wrote:
Its a DNR…

Not sure how legal it is to save someone with a DNR but if its against someones wishes then you cant do much.[/quote]

I didn’t see anything about a DNR, did I miss something?

In a similar, but not so dramatic vein, I have a friend who is a physical therapist at an assisted living facility. Their instructions are to not pick up a resident if that resident should fall. They can squat down next to the person and shout out encouragement and instructions, but they’re not allowed to assist in any way. All they are allowed to do is call 911. This happens 3-4 times a day, where an ambulance and fire truck are dispatched to pick up an old person.


I had put together our living trust, filled out a hey-ooge life insurance policy, and had included a signed DNR.

since that time, I have been woken up repeatedly with a pillow over my face, and my wife putting all her weight on it.

she sez it has to do with my snoring.

[quote]Dr. Pangloss wrote:

[quote]harrypotter wrote:
Its a DNR…

Not sure how legal it is to save someone with a DNR but if its against someones wishes then you cant do much.[/quote]

I didn’t see anything about a DNR, did I miss something?

In a similar, but not so dramatic vein, I have a friend who is a physical therapist at an assisted living facility. Their instructions are to not pick up a resident if that resident should fall. They can squat down next to the person and shout out encouragement and instructions, but they’re not allowed to assist in any way. All they are allowed to do is call 911. This happens 3-4 times a day, where an ambulance and fire truck are dispatched to pick up an old person.
[/quote]

I would laugh at this but its so tragic.

“COME ON GURL! YOU CAN DO EEET!”

This is how shit is run in California, a shining example.

Couple things. The woman was not a DNR. She was a full code.

Secondly, the woman who was refusing to do CPR was an RN (that’s what they said on the news last night)

The companies policy is to call 911 and stand by with the patient. Without a doubt this is to avoid a lawsuit. The “good sameritan law” does not apply to people who are medically trained, which all the staff members would be (CPR/AED at a minimum) If the attempt to render aid and fail they would be opening themselves and the company up for a potentially huge law suit.

It’s a crummy situation but that’s how it goes. The patients family also said they didn’t have a problem with how it went down and that they knew the SNF’s policies before sending her there.

So fucked. What’s even worse is the operator told the nurse to get a passerby yet she did nothing.

Reminds me of a couple months ago here in the Bay Area where personnel wouldn’t help a drowning man

[quote]gregron wrote:
Couple things. The woman was not a DNR. She was a full code.

Secondly, the woman who was refusing to do CPR was an RN (that’s what they said on the news last night)

The companies policy is to call 911 and stand by with the patient. Without a doubt this is to avoid a lawsuit. The “good sameritan law” does not apply to people who are medically trained, which all the staff members would be (CPR/AED at a minimum) If the attempt to render aid and fail they would be opening themselves and the company up for a potentially huge law suit.

It’s a crummy situation but that’s how it goes. The patients family also said they didn’t have a problem with how it went down and that they knew the SNF’s policies before sending her there.[/quote]

Even as an EMR with the fire department, we are only ever required to help if we are on duty, for a volunteer that means pretty much only when there is a call.

We also get certain immunities. We can take out doors and windows, and break ribs giving CPR. We can even render treatment to someone who told us no if they loose consciousness or we deem them to be in an altered mental state. I do not know how immunities work for on the job nursing home staff. If they can get sued for breaking ribs, I’d probably have the same no CPR policy.

[quote]Rhino Jockey wrote:
A lot of patients in those types of homes have DNR orders. If the facility only had DNR patients such as some hospice facilities, I could see them withholding CPR but even with DNR patients, you can still give them oxygen and make them comfortable. You just dont do all the other stuff that goes along with a medical emergency of this sort such as intubation, IVs, medications, compressions, etc…

Not enough info was given to really get a clear picture.[/quote]

Oxygen is a considered a drug, at least in Tennessee. I don’t know if you can give it to a DNR patient.

[quote]gregron wrote:
Couple things. The woman was not a DNR. She was a full code.

Secondly, the woman who was refusing to do CPR was an RN (that’s what they said on the news last night)

The companies policy is to call 911 and stand by with the patient. Without a doubt this is to avoid a lawsuit. The “good sameritan law” does not apply to people who are medically trained, which all the staff members would be (CPR/AED at a minimum) If the attempt to render aid and fail they would be opening themselves and the company up for a potentially huge law suit.

It’s a crummy situation but that’s how it goes. The patients family also said they didn’t have a problem with how it went down and that they knew the SNF’s policies before sending her there.[/quote]

Yup, you can thank sue happy America for this. It’s a damn shame too.

[quote]usmccds423 wrote:

[quote]gregron wrote:
Couple things. The woman was not a DNR. She was a full code.

Secondly, the woman who was refusing to do CPR was an RN (that’s what they said on the news last night)

The companies policy is to call 911 and stand by with the patient. Without a doubt this is to avoid a lawsuit. The “good sameritan law” does not apply to people who are medically trained, which all the staff members would be (CPR/AED at a minimum) If the attempt to render aid and fail they would be opening themselves and the company up for a potentially huge law suit.

It’s a crummy situation but that’s how it goes. The patients family also said they didn’t have a problem with how it went down and that they knew the SNF’s policies before sending her there.[/quote]

Yup, you can thank sue happy America for this. It’s a damn shame too. [/quote]

Damned if you do. Damned if you don’t.

The reporter is pretty bad to start with. It totally pointless to make a report over the whole thing if the lady had DNR order. Bad journalists know health and life stuff gets people all emotionnal, and it’s all they can get readers with.

Ya, sure you get a shocking title “911 Dispatcher Pleads With Nurse Who Refuses to Perform CPR”.
-“What a bitch, how could she?!?”

But then the reader finds out that the lady is 87 YO. You know what happens at 87? Natural death.
People at this age should already have their DNR discussed and resuscitation maneuver taken off.
You guys know the odds of a successful CPR at 87?
It’s likely less than 1/1 000 000.
Even even when CPR is initiated right away on inpatient in an hospital, the odds of survival with intact brain function is abysmal.

CPR is not a good choice at that age, you get 99,9% chance of it should being broken ribs/tooth, making a mess of the body and making sure the last feeling the patient has when he/she leaves this world is the pain of a cardiac massage or having a tube shoved down their throat or 0,1% chance of having Gran-ma hooked on a ventilator machine for a few day before passing out or entering a neurovegetative state.

If she was “full code”, herself or her family didn’t understand what they were getting into anyway.

This is just another shining example of how badly needed tort reform is needed.

[quote]JCMPG wrote:
This is just another shining example of how badly needed tort reform is needed. [/quote]

You know the juries could do this themselves. Hand out smaller judgements. No new laws needed.

Until greed is removed from society, you will always get potential lawsuits.

Its sad but when it happens to someone younger and nobody does jack, it makes you think how bad things have really become.