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(Bakersfield Californian)   While internet rages over a "nurse" failing to perform CPR at a "nursing home", family of the 87 year old woman is OK with it   (bakersfieldcalifornian.com) divider line 380
    More: Followup, rage, CPR, home, California Attorney General, Kern County, legal recourse, elder abuse, nurses  
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9260 clicks; posted to Main » on 06 Mar 2013 at 1:46 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-03-06 06:37:09 AM

Securitywyrm: The 4chan Psychiatrist: me texan: This whole furor is stupid to begin with regardless.  Anyone actually trained in CPR knows you do not perform CPR unless the victim is not breathing.  The 911 lady shouldn't be on 911.

Yeah, no; take ACLS and you will see that some people can appear to be "breathing" but the reality is that they are in need of CPR.  The scenario, as it was described, necessitated CPR.

That said, people need to understand that CPR is not some magical bullet.  On an 87 year old woman, it has a very low chance of succeeding, and if it does, you are looking at a completely fractured rib-cage, and a high likelihood of severe brain-damage.  People who say, "Do everything you can to resuscitate me" need to be every bit as cognizant of the potential consequences of their decision, as do those signing DNR/DNIs.

That said, it's rather unconscionable, and frankly disturbing, to picture that nurse just standing there, phone in hand, speaking calmly with that dispatcher while she watches a woman die who has no DNR/DNI on file.

She was not a 'nurse' in the way you're thinking. You're thinking of a 'registered nurse' or 'licensed nurse practitioner.' In an actual hospital her job title would be 'orderly' meaning the person who changes the sheets, helps someone get between rooms, that sort of thing. It's a private institution, and giving someone a nicer job title helps morale.
Think of it this way: In retail, how many people with the word 'manager' in their title are really just supervisors with no actual managerial authority? Why is the civilian pilot of an airplane or the civilian in charge of a boat called the Captain despite having no military rank? Why do some people get addressed as "Sir" despite not being knighted?


The 'nurse' in question was actually a Resident Services coordinator according to other news reports.

This is much adieu about nothing, imo.  The facility wasn't a nursing home by ANY stretch of the imagination; they're not licensed or insured to provide any health-related services; and above all...the family is satisfied with the care that the woman received.  End of story.
 
2013-03-06 06:43:39 AM
We hold low level employees legally responsible for the things they do on the job. Why can't we also hold CEOs responsible when their banks destroy the economy
 
2013-03-06 06:51:20 AM

Quinsisdos: Always love it when there's some sparks flying between various hospital departments/professions. Made the time go by quicker on slow days in x-ray.


The only department that's worse about dropping their phones and pagers into nasty things than trauma is radiology. Why is that?

/telecoms
 
2013-03-06 06:56:55 AM

SarcasticFark: The 'nurse' in question was actually a Resident Services coordinator according to other news reports.

This is much adieu about nothing, imo. The facility wasn't a nursing home by ANY stretch of the imagination; they're not licensed or insured to provide any health-related services; and above all...the family is satisfied with the care that the woman received. End of story.


None of that matters.  The key issue is the call and the fact that they hid behind policy.  Licensing, insurance, etc., none of it was actually in play.  All that was needed was a human who could follow instructions.  This was denied based on policy.  The public doesn't want to hear that policy trumps human life.  It doesn't matter that she may still have died.  There was a case last year where a lifeguard ran out of his "zone" in an attempt to help someone who was drowning.  He was fired because policy.  After which there was a public shiat fit.  This "it's policy" crap, especially when it's made so public, doesn't fly where life in concerned.
 
2013-03-06 06:57:48 AM

bencoon: Quinsisdos: Always love it when there's some sparks flying between various hospital departments/professions. Made the time go by quicker on slow days in x-ray.

The only department that's worse about dropping their phones and pagers into nasty things than trauma is radiology. Why is that?

/telecoms


Because we dont.  We just tell YOU that lol.

texting while taking a whizz and drop phone in toilet?  Take out glove, retrieve phone, call TCS, tell them some made up gory story...new phone. lol
 
2013-03-06 07:04:36 AM

me texan: This whole furor is stupid to begin with regardless.


Hitler might have been an evil bastard but he wasn't stupid.
 
2013-03-06 07:09:23 AM

Bumblefark: So, the family that dumped her there has no problem with the fact that she's dead?

Weird. It's almost as if they didn't actually care all that much.


That's okay too. We can't help the dead; it's the living who feel pain.
 
2013-03-06 07:11:09 AM
Contrary to what you've seen on E.R. CPR only works 8% of the time.
 
2013-03-06 07:11:43 AM
I have to respond.  First off, you do not know all the facts.  Nor do I. Second, a nurse has a duty to respond, at least where I live.  CPR does not mean chest compressions.  It means Cardio Cerebral pulmonary rescussitation.  If there was a pulse then there would be no compressions.  Apparently, she was not breathing.  Nobody ever checked for a pulse.  But even a bartender has to hook up the AED and check.  I would think this was a hospice, but then no 911 call would be made.  The lady who was apparently mentally intact had not prepared a DO Not Rescussitate order, therefore you must assume she wished to receive medical attention.  The nurse who refused to help should lose her license.  She is also professionally liable for this death.  Her employer is also liable, You cannot establish a policy that is contrary to the law to protect you from the law.  Her duties under the law were established when she received a nursing license.  There may be no charges against her, however, the state board would still be correct to terminate her license.  Also the life insurance could decide not to pay.  This is more likely.  It would be very easy to establish liability of the nurse and the facility.  But, I'll bet people are already pulling their relatives out of that facility.
 
2013-03-06 07:38:26 AM
I don't understand how CPR would have helped this woman. It sounds like she was breathing already.

If anything, I think CPR would have caused her to suffer before dying.
 
2013-03-06 07:39:39 AM
It's a crisis. IT'S A CRISIS!!  IT'S A CRIIIISSIIIIIISSS!
 
2013-03-06 07:41:03 AM
The nurse wasn't a nurse, the nursing home wasn't a nursing home, but don't let that stop you from being outraged.
 
2013-03-06 07:41:57 AM

stuhayes2010: Contrary to what you've seen on E.R. CPR only works 8% of the time.


I dunno - It's worked for me about 95% of the time.


991.com
A couple of their tunes are a bit weak, but most of them are solid.
 
2013-03-06 07:50:28 AM

Rising_Zan_Samurai_Gunman: hardinparamedic: Apparently, the woman did NOT have a Do Not Resuscitate order or Advanced Directive stating NO CPR.

It doesn't matter if the family was happy with the care or not. If she was negligent, or violated the rules of her nursing practice, she needs to be held accountable for it.

Except its not a nursing facility and the residents are informed of what care will and will not be given when they choose to live there instead of the assisted living facility or the full nursing facility also run by the same organization.
  While I can understand why some people are seemingly upset over what happened, the family is ok with it, so it should all be good.  Just because it is theoretically possible to extend someones life doesn't mean we have to try and extend their life at any point unless they are in a medical facility that is under standards to take all measures unless otherwise specified.   CPR most likely wouldn't have saved her life, and it could have potentially been worse by instead extending it just long enough to die in a hospital a day or two later disoriented and dealing with pain from a few bruised or broken ribs (very possible for an 87 year old getting CPR).


Making the family happy is not the point. The patient was a full code and the nurse refused to treat the patient as such. All the philosophical objections to CPR in the world mean squat if you don't document a dnr/dni status. Even if the patient was desired to be made dnr/dni by the family what makes you so confident this is what the patient wanted? We deal with issues like this constantly in the ICU.
 
2013-03-06 07:55:31 AM

Doom MD: Rising_Zan_Samurai_Gunman: hardinparamedic: Apparently, the woman did NOT have a Do Not Resuscitate order or Advanced Directive stating NO CPR.

It doesn't matter if the family was happy with the care or not. If she was negligent, or violated the rules of her nursing practice, she needs to be held accountable for it.

Except its not a nursing facility and the residents are informed of what care will and will not be given when they choose to live there instead of the assisted living facility or the full nursing facility also run by the same organization.
  While I can understand why some people are seemingly upset over what happened, the family is ok with it, so it should all be good.  Just because it is theoretically possible to extend someones life doesn't mean we have to try and extend their life at any point unless they are in a medical facility that is under standards to take all measures unless otherwise specified.   CPR most likely wouldn't have saved her life, and it could have potentially been worse by instead extending it just long enough to die in a hospital a day or two later disoriented and dealing with pain from a few bruised or broken ribs (very possible for an 87 year old getting CPR).

Making the family happy is not the point. The patient was a full code and the nurse refused to treat the patient as such. All the philosophical objections to CPR in the world mean squat if you don't document a dnr/dni status. Even if the patient was desired to be made dnr/dni by the family what makes you so confident this is what the patient wanted? We deal with issues like this constantly in the ICU.


Except that she wasnt a nurse at the facility.  The facility was not licensed for it.

she was NOT operating in the capacity of a nurse..she was just an employee who HAPPENED to have a nursing license.

she wasn't obligated to perform CPR, nor compelled by the nursing board because...wait for it...she wasn't a practicing nurse.
 
2013-03-06 08:14:14 AM

cretinbob: hardinparamedic: It doesn't matter if the family was happy with the care or not. If she was negligent, or violated the rules of her nursing practice, she needs to be held accountable for it.

She's not a nurse. She had no duty to act. I still haven't heard the 911 recording where she identifies herself as a nurse either. I've just read it.


She is a HUMAN and had a human moral obligation to help a dying old woman with a very simply procedure that she KNOWS HOW TO DO.

If she was willing to stand by and do nothing (because she feared fear getting fired) and watch an old woman die slowly she is a piece of shiat regardless of what her contract says or what the law says.
 
2013-03-06 08:20:47 AM

The more you eat the more you fart: Doom MD: Rising_Zan_Samurai_Gunman: hardinparamedic: Apparently, the woman did NOT have a Do Not Resuscitate order or Advanced Directive stating NO CPR.

It doesn't matter if the family was happy with the care or not. If she was negligent, or violated the rules of her nursing practice, she needs to be held accountable for it.

Except its not a nursing facility and the residents are informed of what care will and will not be given when they choose to live there instead of the assisted living facility or the full nursing facility also run by the same organization.
  While I can understand why some people are seemingly upset over what happened, the family is ok with it, so it should all be good.  Just because it is theoretically possible to extend someones life doesn't mean we have to try and extend their life at any point unless they are in a medical facility that is under standards to take all measures unless otherwise specified.   CPR most likely wouldn't have saved her life, and it could have potentially been worse by instead extending it just long enough to die in a hospital a day or two later disoriented and dealing with pain from a few bruised or broken ribs (very possible for an 87 year old getting CPR).

Making the family happy is not the point. The patient was a full code and the nurse refused to treat the patient as such. All the philosophical objections to CPR in the world mean squat if you don't document a dnr/dni status. Even if the patient was desired to be made dnr/dni by the family what makes you so confident this is what the patient wanted? We deal with issues like this constantly in the ICU.

Except that she wasnt a nurse at the facility.  The facility was not licensed for it.

she was NOT operating in the capacity of a nurse..she was just an employee who HAPPENED to have a nursing license.

she wasn't obligated to perform CPR, nor compelled by the nursing board because...wait for it...she wasn't a practicing nurse.


She's got a nursing license but she's not a practicing nurse? You don't need the facility to be licensed to perform basic CPR, you can do that on a sidewalk. Obligation? Do you know what an asshat I'd have to be to refuse to perform CPR on someone on a sidewalk because I had no "obligation" to? Wouldn't something like that be worthy of admonishment by society?
 
2013-03-06 08:30:23 AM

hardinparamedic: ThunderPelvis: A fairly recent poll of doctors found that they'd reject most extreme life-saving measures, including CPR.

Why? Because doctors know that these procedures have a terrible record when it comes to saving lives, and, even on the rare occasions when they do save lives for any meaningful length of time, regularly result in permanent disability.

/don't have time for cite. You have teh google.

Except for the fact that some arrests are highly survivable, even at old age, with prompt bystander care and BLS into ACLS care, combined with rapid transport to a cardiac facility. In-hospital Cardiac Arrest survival approaches 75%.

The AHA is very specific on this. You don't get to play god because you think you can decide who can leave the hospital with a CPC score of 1.


Umm... providing cpr is playing god...
 
2013-03-06 08:37:11 AM

hardinparamedic: Rising_Zan_Samurai_Gunman: Except its not a nursing facility and the residents are informed of what care will and will not be given when they choose to live there instead of the assisted living facility or the full nursing facility also run by the same organization.

It does not matter if that woman was a licensed nurse in the employ of that capacity in that "assisted living" facility.


Reading comprehension fail. There were  three facilities: "independent living", "assisted living", and "skilled nursing." This woman specifically chose the independent living facility and did not want medical help. The "licensed nurse in the employ of that capacity in that 'assisted living' facility" would have been in a different building across the campus.
 
2013-03-06 08:38:49 AM
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* Assisting in implementing/revising service plans based on resident needs
* Obtaining and administering medication as prescribed by physician
* Documenting and reviewing medication sheets for accuracy and compliance with physician orders
* Other duties as assigned
We seek the following qualifications:
* Must have current LVN state nursing certification in good standing
* Must have CPR certification <------- WHY??????
* Must have a minimum of 1 year nursing experience, preferrably in a SNF facility
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2013-03-06 08:39:36 AM

Doom MD: Obligation? Do you know what an asshat I'd have to be to refuse to perform CPR on someone on a sidewalk because I had no "obligation" to? Wouldn't something like that be worthy of admonishment by society?


If you're facing admonishment by society for not acting, then you  do have an obligation, by definition. But we as a society have realized that forcing people to do something against their will usually results in a bad outcome. Hence why random passersby do not have an obligation to perform CPR on someone who collapses in front of them.
 
2013-03-06 08:41:42 AM

GardenWeasel: * Must have CPR certification <------- WHY??????


Because:

GardenWeasel: BSL offers its residents access to a full continuum of services - independent living, assisted living, retirement centers/continuing care retirement communities (CCRC) and management services.


This, however, occurred in one of the independent living centers, which have no nursing staff.

The job offer doesn't specify what facility they're looking for people for, but since they're looking for a nurse, it's probably the assisted living or managed care facilities. Not the one with the concierge and housekeeping.
 
2013-03-06 08:47:26 AM
There are nurses at independent living centers too.
 
2013-03-06 08:49:01 AM

Theaetetus: GardenWeasel: * Must have CPR certification <------- WHY??????

Because:
GardenWeasel: BSL offers its residents access to a full continuum of services - independent living, assisted living, retirement centers/continuing care retirement communities (CCRC) and management services.

This, however, occurred in one of the independent living centers, which have no nursing staff.

The job offer doesn't specify what facility they're looking for people for, but since they're looking for a nurse, it's probably the assisted living or managed care facilities. Not the one with the concierge and housekeeping.


I retract the question without more information. I was under the impression that Glenwood was an ILF only. However, according to the website, it also offers AL and skilled nursing services as well. I don't know if that is just the Brookdale boilerplate language, or specific to Glenwood.
 
2013-03-06 08:49:12 AM

log_jammin: evil saltine: The facility's policy takes precedence over what the 911 dispatcher says.

Then why call 911 in the first place?


That's my question in this whole thing. What was the "nurse" doing calling 911 if she wasn't going to do anything?
 
2013-03-06 08:50:06 AM
The more you eat the more you fart:

Now that I'm back, I can type before I leave for bed. I do owe you an apology. I let my personal feelings on the matter, as well as my fatigue and disgust at what was being presented color my words, and I was far more cutting and personal with you than I intended to be. I never intended to question your educational level, or accuse you of being a lax or unskilled nurse by any means. This was not an attempt to challenge you on who's got the bigger dick at the ConEd Urinal.

I would genuinely enjoy a more civil route of discussion from now on with you. I honestly believe that, despite our disagreement on this topic, that you have a wealth of knowledge and experience that you can share.

I do, however, distinctly disagree with several things you've said over the past few days. While you may be right, and California State Law may not be even remotely similar to the law in the State of Tennessee, I feel that ethically what happened can only be described as a nightmare.

That said, I think you have a severe misrepresentation about my profession, and just how we fit into the healthcare continuum in the system I operate in. I am not someone who went to school for two months and got a certificate. I hold an Associates Degree in my profession. While I do not have the prestigious Masters degree you hold, I am currently pursuing my BS in Nursing. I resent the fact you have called me "uneducated", and have inferred that I have no medical training at a collegiate level. I have 16 credit hours devoted to Anatomy and Physiology, Microbiology, and Nursing Pathophysiology. I have another 12 in Psychology, and I have another 8 in Biology and Science. I have over two years of intense, hands-on drilling in pediatric and neonatal critical care transport before I was even allowed to touch a patient on my own. I have to maintain general competencies each year that are above and beyond what most nurses have to demonstrate.

Contrary to what you said, I can pronounce death in the field. I can, under specific criteria like your profession, order CPR not to be performed in the absence of a DNR. Like you, my profession is dictated by the system in which I operate in and the role I operate in, and what my medical director is willing to sign off on. In addition, our skillset incorporates procedures and medications that are typically relegated to advanced practice nurses, such as suturing, chest tube placement, and the use of drugs like Ketamine and Propofol.

I do not believe, in the least, that I have to be a nurse to criticize the actions of another nurse I feel is wrong, ethically or morally. I do not have to be a nurse to look at the nursing law of my state, and point out when a practice that is undertaken is illegal or questionable according to the prescribed acts of that profession. In the past decade of doing what I do, and 12 years if you count the two I spent as a CNA in high school, I have seen countless acts of what can only be described as some of the most malicious malpractice and abuse in the LTC industry in the United States. I have also seen the slimy practices of the LTC industry when you attempt to report abuse in that industry.

If anything, I'm a very by the book person. I do not like taking shortcuts, and I do not like committing unethical acts, or seeing others do the same and attempt to justify them with situational morality. I hold the people I work with, and myself, up to high standards.

Again, I'm sorry for being rude with you. I genuinely believe you're an experienced, caring, and skilled nurse and care provider. However, at the very least - ethically and morally - I do not believe that occurred was defensible. I also understand that, had it happened in my State, the person involved would be in major trouble with both the LTC Facility Licensing Board, and the State Board of Nursing for what happened, and for withholding life support without an adequate POST form in hand.
 
2013-03-06 08:50:19 AM
I think we collectively have developed a delusional unferstanding of what CPR is capable of, its risks and likely outcomes. It is apropriate for otherwise healthy people who have suffered trauma but are otherwise healthy. Even in these cases the risk of brain damage is uncomfortably high. To top it off effective chest compressions WILL result in broken ribs with the healthiest bones. An 87 y o women with likely advanced bone density loss, impaired clotting and weak sympathetic musculature will be a crushed bruised and otherwise traumatized mess after CPR likely fails because she was dying from multiple system collapse and not because heart just needed a lil loving. This whole nonsense illustrates the fact that anyone who knows what the fark they are talking about has better things to do than babble on the internet.
 
2013-03-06 08:52:38 AM
This reminds me of Red vs. Blue where red team gave Sarge CPR for being shot in the head. CPR isn't a magical cure-all, people. You keep the heart and lungs pumping until you can stabilize them- or not. It's not going to reverse a stroke.
 
2013-03-06 08:55:24 AM

log_jammin: There are nurses at independent living centers too.


Not this one: "She was fully aware that Glenwood Gardens did not offer trained medical staff."
 
2013-03-06 08:58:30 AM

Theaetetus: log_jammin: There are nurses at independent living centers too.

Not this one: "She was fully aware that Glenwood Gardens did not offer trained medical staff."


Again, leading to my confusion on why GG has postings for nursing staff with CPR certificates.
 
2013-03-06 08:58:42 AM
Enjoyable thread to read, especially the paramedic versus nurse debate that has spanned nearly the entire thread length. It's rather sad that there is no nationally-accepted set of standards for both occupations and how to administer medical care. Seems like each state has a distinct set of responsiiblities and such for their respective nurses/doctors/etc. Additionally, even the national associations (AHA, AMA, etc) have different standards for CPR and when to administer it.

In short, why can't modern medicine come to one damn conclusion and stick with it? I believe an eventual outcome of the PPACA will be a single-payer system, and hopefully less fragmentation of our medical system as a whole within the US. But that outcome is far, far away. Until then, we'll continue to have 50 states and numerous organizations arguing over who is right and who isn't, which will of course trickle down to the individual-level and arguments over who is right and who is wrong. Fun times...
 
2013-03-06 08:58:57 AM

Theaetetus: Doom MD: Obligation? Do you know what an asshat I'd have to be to refuse to perform CPR on someone on a sidewalk because I had no "obligation" to? Wouldn't something like that be worthy of admonishment by society?

If you're facing admonishment by society for not acting, then you  do have an obligation, by definition. But we as a society have realized that forcing people to do something against their will usually results in a bad outcome. Hence why random passersby do not have an obligation to perform CPR on someone who collapses in front of them.


A women with a nursing license refusing to give CPR is not a random passerby. A person calling 911 but refusing to give CPR because it isn't "policy" is worthy of some choice adjectives too. When I refer to myself in my prior hypothetical it's as an MD.
 
2013-03-06 09:02:09 AM
Anyone pretending there are no moral & ethical gray areas here is deluding themselves. It's important to disentangle legal obligations from moral/ethical obligations as much as possible.

There are probably going to be legal problems for the facility and/or facility employees if there was no DNR on file (as appears to be the case). That doesn't mean they necessarily did anything unethical--i.e., if the woman had made her personal choices to avoid interventions clear to the staff if not in legal paperwork. Obviously, proper paperwork is the best way to make sure your wishes are honored. If no CPR was a unilateral decision that didn't match the patient's wishes (whatever the paperwork status these wishes were), that's the only unambiguously unethical set of circumstances that I can see.

It's also worth mentioning that CPR isn't like what you see on TV. It can be painful & debilitating, and isn't nearly as successful as you might think. There's a reason doctors tend to refuse CPR and other interventions (see here, here & here).

Get your paperwork in order, people.
 
2013-03-06 09:17:35 AM
"Who cares, it's done, will probably be fine."
 
2013-03-06 09:21:28 AM

hardinparamedic: You don't get to play god because you think you can decide who can leave the hospital with a CPC score of 1.


Who is playing god? The person who intervenes with CPR, or the person who stands by?

Yeah. Neither.
 
2013-03-06 09:21:33 AM
It's a retirement community!
 
2013-03-06 09:23:00 AM
3.bp.blogspot.com

be good or we'll put you in a home.
you already put me in a home.
we'll put you in the crooked home we saw on 60 minutes.
 
2013-03-06 09:23:50 AM

Doom MD: Rising_Zan_Samurai_Gunman: hardinparamedic: Apparently, the woman did NOT have a Do Not Resuscitate order or Advanced Directive stating NO CPR.

It doesn't matter if the family was happy with the care or not. If she was negligent, or violated the rules of her nursing practice, she needs to be held accountable for it.

Except its not a nursing facility and the residents are informed of what care will and will not be given when they choose to live there instead of the assisted living facility or the full nursing facility also run by the same organization.
  While I can understand why some people are seemingly upset over what happened, the family is ok with it, so it should all be good.  Just because it is theoretically possible to extend someones life doesn't mean we have to try and extend their life at any point unless they are in a medical facility that is under standards to take all measures unless otherwise specified.   CPR most likely wouldn't have saved her life, and it could have potentially been worse by instead extending it just long enough to die in a hospital a day or two later disoriented and dealing with pain from a few bruised or broken ribs (very possible for an 87 year old getting CPR).

Making the family happy is not the point. The patient was a full code and the nurse refused to treat the patient as such. All the philosophical objections to CPR in the world mean squat if you don't document a dnr/dni status. Even if the patient was desired to be made dnr/dni by the family what makes you so confident this is what the patient wanted? We deal with issues like this constantly in the ICU.


Hang on, you say 'nurse' and 'patient' but this wasn't a hospital or a nursing home. This is an 'independent living facility.' That means that it's an apartment where there's someone available to help you get in/out of the shower, clean your apartment, and deliver food. The facility has no trained medical staff.
"Then why was she called a nurse?"
"Same reason one of the cashiers at a retail store calls themselves the checkout manager. They're a supervisor, but the word manager in their title makes them feel more important."
If this were a hospital, the individual in question would be called an 'orderly' and would be in massive legal trouble if they provided any sort of medical service.
 
2013-03-06 09:26:59 AM

Doom MD: Theaetetus: Doom MD: Obligation? Do you know what an asshat I'd have to be to refuse to perform CPR on someone on a sidewalk because I had no "obligation" to? Wouldn't something like that be worthy of admonishment by society?

If you're facing admonishment by society for not acting, then you  do have an obligation, by definition. But we as a society have realized that forcing people to do something against their will usually results in a bad outcome. Hence why random passersby do not have an obligation to perform CPR on someone who collapses in front of them.

A women with a nursing license refusing to give CPR is not a random passerby. A person calling 911 but refusing to give CPR because it isn't "policy" is worthy of some choice adjectives too. When I refer to myself in my prior hypothetical it's as an MD.


Read the article. She is NOT a licensed nurse. She's the "Resident services coordinator." The facility does not have any medical staff. It's an apartment complex that has people available to help you get into and out of bed, cooks meals and cleans your apartment. That's it.
Or do you expect someone with a doctorate in physics to be responsible for giving CPR at the scene of an accident?
 
2013-03-06 09:28:07 AM
You know, I like what you have done with the place, Butthurt Everywhere is so sublime.

/if only people could turn their ire and butthurt into political action
 
2013-03-06 09:31:19 AM
You do not have the right to live a life by your means and ends, for they shall be given to you by your brethren. You will be expected to follow your family's miniscule traditions, preferences and religions under penalty of banishment. You are hereby awarded the opportunity to grow up in resentment of your own person as you consistently fail to meet parental and societal standards. Finally, you do not have the right to die in the manner you see fit. You are required at Walmart where you will be greeting future generations of Walmart's 3rd shifters. We understand your mind and body have been broken by the ideals and pressures of American societal living. Dependance on our federally funded programs is universally required in order to validate our position as caregiver. Remember, our way of life is only made possible by volunteer membership.
 
2013-03-06 09:34:39 AM
are we STILL beating this dead horse?
 
2013-03-06 09:37:37 AM

Magnus: are we STILL beating this dead horse?


How do you think Tessco's meat got so tender and juicy?
 
2013-03-06 09:39:03 AM
The butcher does CPR?
 
2013-03-06 09:40:30 AM

Magnus: The butcher does CPR?


No, NO! Old people.
 
2013-03-06 09:48:20 AM

Securitywyrm: Doom MD: Theaetetus: Doom MD: Obligation? Do you know what an asshat I'd have to be to refuse to perform CPR on someone on a sidewalk because I had no "obligation" to? Wouldn't something like that be worthy of admonishment by society?

If you're facing admonishment by society for not acting, then you  do have an obligation, by definition. But we as a society have realized that forcing people to do something against their will usually results in a bad outcome. Hence why random passersby do not have an obligation to perform CPR on someone who collapses in front of them.

A women with a nursing license refusing to give CPR is not a random passerby. A person calling 911 but refusing to give CPR because it isn't "policy" is worthy of some choice adjectives too. When I refer to myself in my prior hypothetical it's as an MD.

Read the article. She is NOT a licensed nurse. She's the "Resident services coordinator." The facility does not have any medical staff. It's an apartment complex that has people available to help you get into and out of bed, cooks meals and cleans your apartment. That's it.
Or do you expect someone with a doctorate in physics to be responsible for giving CPR at the scene of an accident?


Ok that's fine and did need some clarification. Im still not ok with the person refusing CPR by saying it was against policy. Was the facility explicitly forbidding staff to perform CPR? I'd feel pretty crappy just standing there and letting someone die were I this person.
 
2013-03-06 09:54:09 AM

ThunderPelvis: A fairly recent poll of doctors found that they'd reject most extreme life-saving measures, including CPR.

Why? Because doctors know that these procedures have a terrible record when it comes to saving lives, and, even on the rare occasions when they do save lives for any meaningful length of time, regularly result in permanent disability.

/don't have time for cite. You have teh google.


Not to mention that CPR in the elderly is pretty brutal according to my doctor husband. He says it often leads to broken ribs among other issues and just puts the person through more pain and misery before they are finally allowed to pass away. I remember him coming home during his residency some days just disturbed cause some family made the hospital "do everything they could do" and he just felt like he was torturing this poor, dying person.
 
2013-03-06 09:58:42 AM

vrax: SarcasticFark: The 'nurse' in question was actually a Resident Services coordinator according to other news reports.

This is much adieu about nothing, imo. The facility wasn't a nursing home by ANY stretch of the imagination; they're not licensed or insured to provide any health-related services; and above all...the family is satisfied with the care that the woman received. End of story.

None of that matters.  The key issue is the call and the fact that they hid behind policy.  Licensing, insurance, etc., none of it was actually in play.  All that was needed was a human who could follow instructions.  This was denied based on policy.  The public doesn't want to hear that policy trumps human life.  It doesn't matter that she may still have died.  There was a case last year where a lifeguard ran out of his "zone" in an attempt to help someone who was drowning.  He was fired because policy.  After which there was a public shiat fit.  This "it's policy" crap, especially when it's made so public, doesn't fly where life in concerned.


It most certainly DOES fly where life is concerned.  Like the lifeguard, the 'nurse' in question had her own circumstances to consider.  Most businesses nowadays forbid their employees to do anything for someone in a medical emergency beyond calling 911.  Walmart and Target immediately come to mind but I'm sure in our current litigious-happy society, most large businesses have these policies in place.

The more you eat the more you fart: Doom MD: Rising_Zan_Samurai_Gunman: hardinparamedic: Apparently, the woman did NOT have a Do Not Resuscitate order or Advanced Directive stating NO CPR.

It doesn't matter if the family was happy with the care or not. If she was negligent, or violated the rules of her nursing practice, she needs to be held accountable for it.

Except its not a nursing facility and the residents are informed of what care will and will not be given when they choose to live there instead of the assisted living facility or the full nursing facility also run by the same organization.
  While I can understand why some people are seemingly upset over what happened, the family is ok with it, so it should all be good.  Just because it is theoretically possible to extend someones life doesn't mean we have to try and extend their life at any point unless they are in a medical facility that is under standards to take all measures unless otherwise specified.   CPR most likely wouldn't have saved her life, and it could have potentially been worse by instead extending it just long enough to die in a hospital a day or two later disoriented and dealing with pain from a few bruised or broken ribs (very possible for an 87 year old getting CPR).

Making the family happy is not the point. The patient was a full code and the nurse refused to treat the patient as such. All the philosophical objections to CPR in the world mean squat if you don't document a dnr/dni status. Even if the patient was desired to be made dnr/dni by the family what makes you so confident this is what the patient wanted? We deal with issues like this constantly in the ICU.

Except that she wasnt a nurse at the facility.  The facility was not licensed for it.

she was NOT operating in the capacity of a nurse..she was just an employee who HAPPENED to have a nursing license.

she wasn't obligated to perform CPR, nor compelled by the nursing board because...wait for it...she wasn't a practicing nurse.


Exactly correct.

SpectroBoy: cretinbob: hardinparamedic: It doesn't matter if the family was happy with the care or not. If she was negligent, or violated the rules of her nursing practice, she needs to be held accountable for it.

She's not a nurse. She had no duty to act. I still haven't heard the 911 recording where she identifies herself as a nurse either. I've just read it.

She is a HUMAN and had a human moral obligation to help a dying old woman with a very simply procedure that she KNOWS HOW TO DO.

If she was willing to stand by and do nothing (because she feared fear getting fired) and watch an old woman die slowly she is a piece of shiat regardless of what her contract says or what the law says.


The so-called 'moral obligation' is the only area open for debate in this whole situation.  I'm not saying that the policies of my workplace would prevent me from giving CPR in the same situation...but I certainly WOULD consider the fact that I would be placing my entire livelihood in jeopardy by doing so.  I can't honestly say that I blame the woman in question if she wasn't willing to lose her job over it.
 
2013-03-06 09:58:53 AM

Magnus: are we STILL beating this dead horse?


It seems so. I thought this was basically finished in the last thread. I said my piece, and still stand by my assessments and opinions as an experienced, now retired, RN.
I certainly do love a good medical profession debate. Very entertaining. We've had:
Trauma Nurse, NICU RN, ICU RN, Paramedic(s), Doctor (you will note I did not place him/her first in line), Radiology Tech, Hospital Telcom, and I would assume several undisclosed paramedicals. Oh, and I forgot the Lawyer. If I didn't mention other active participants, I apologize.

This why I love Fark. Unless everyone is lying about their professions, we don't have the usual assortment of basement dwelling, pseudo-professional "experts". Thank you all for playing.
Oh, and the lady is dead, family is satisfied, the "nurse" is on voluntary leave"
 
2013-03-06 10:08:01 AM
Kum bah yah my lord. Kum bah yah.
 
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