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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
    More: Followup, rage, CPR, home, California Attorney General, Kern County, legal recourse, elder abuse, nurses  
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9310 clicks; posted to Main » on 06 Mar 2013 at 1:46 AM (3 years ago)   |   Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



380 Comments   (+0 »)
   
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2013-03-05 09:53:00 PM  
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.
 
2013-03-05 10:53:36 PM  

me texan: Anyone actually trained in CPR knows you do not perform CPR unless the victim is not breathing.


That's still not entirely true.
 
2013-03-06 12:08:57 AM  

Relatively Obscure: That's still not entirely true.


Putting someone in the rescue position is not performing CPR.
 
2013-03-06 12:14:25 AM  
I have no idea what to make of this.
 
2013-03-06 12:30:01 AM  

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.


Guess what? Those "respirations" that the nurse identiifed? They were ineffective, and agonal respirations - an indication to start CPR.

The woman was in a full cardiac arrest prior to the arrival of EMS crews.

Congratulations. You're defending a woman who failed to act when she should have recognized a peri-arrest condition, and failed to provide care a second year unlicensed extern should have known to provide.
 
2013-03-06 12:31:20 AM  
Of course they're happy.

Odds are, Grandma was a near-vegetable that had drained them both emotionally and financially to the brink of ruin because her body was just too stubborn to die even though the mind had checked out long ago. But, unlike if a beloved family pet's quality of life had degraded to almost nothing, no one could take Grandma to the Doctor and give her a nice sleepytime shot to put her out of her misery, because with humans, life is all about quantity, not quality.
 
2013-03-06 12:35:42 AM  

me texan: Putting someone in the rescue position is not performing CPR.


Assisting for ineffective respirations, and identifying agonal breathing is not placing someone in the rescue position.

FirstNationalBastard: Of course they're happy.

Odds are, Grandma was a near-vegetable that had drained them both emotionally and financially to the brink of ruin because her body was just too stubborn to die even though the mind had checked out long ago. But, unlike if a beloved family pet's quality of life had degraded to almost nothing, no one could take Grandma to the Doctor and give her a nice sleepytime shot to put her out of her misery, because with humans, life is all about quantity, not quality.


Unless that woman had a valid, signed DNR, or had a Doctor at her side telling her not to start CPR, that does not matter. She had a legal duty, if employed as a nurse for that facility, to act in the standard of care with basic competency, per the California Board of Nursing.

Facility policies do not trump State Nursing laws.
 
2013-03-06 12:38:30 AM  
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.
 
2013-03-06 12:44:24 AM  
This is why soylent green.
 
2013-03-06 01:07:29 AM  

hardinparamedic: Congratulations. You're defending a woman who failed to act when she should have recognized a peri-arrest condition, and failed to provide care a second year unlicensed extern should have known to provide.


I've only read one news article on the story and when she called 911 the woman was still breathing.  Up until reading further comments, I was not even aware the woman died.  If there are more details in this story, I cant see them -  FTFA: Please enable browser cookies to read the rest of this story.

Obviously if she was breathing and went to not breathing / cardiac arrest then at that point CPR should be administered.  From what I'd seen before the responder had identified the person as breathing.  Now that I'm reading an article I see the facility had a DNR policy and that everyone is informed when going there and agrees to it before they can be admitted.  I have no idea legally how that will stand in court, but if that's the policy and it was known and agreed upon by the victim then I dont have a problem with them sticking to it and apparently neither does the family.
 
2013-03-06 01:16:46 AM  

Relatively Obscure: me texan: Anyone actually trained in CPR knows you do not perform CPR unless the victim is not breathing.

That's still not entirely true.


For lay rescuers it is.

This lady was not in a nursing home. She lived in an apartment building for old people. It was not a medical facility and had no medical staff. Whether she had a DNR or not is irrelevant until EMS showed up.
Even then if a family member says to ignore it, you have to ignore it. They are pretty worthless.

According to the family, it was her choice to live there and she didn't want her life prolonged.
Good for her. She got what she wanted.

Oh, and the article changed.This has a lot more stuff now.

here is the families statment

"Our mother and grandmother was a remarkable and intelligent woman who was blessed to have a great life of 87 years. It is the wish of our family to honor and celebrate her life at this personal time.
"Like so many seniors, it was our mother's wish to live independently. She was fully aware that Glenwood Gardens did not offer trained medical staff. Even so, she personally selected the senior living community, and our family has come to know the staff and been very pleased with Glenwood Gardens as her home.
"It was our beloved mother and grandmother's wish to die naturally and without any kind of life-prolonging intervention. Our family respects the right of all people to make their own life choices in such cases.
"We regret that this private and most personal time has been escalated by the media. Caregivers, nurses and other medical professionals have very difficult waters to tread in the legal and medical landscape of our country today.
"We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens, and is at peace. We also have no desire, nor is it the nature of our family, to seek legal recourse or try to profit from what is a lesson we can all learn from.
"We wish to focus on our family at this time, and this will be our final comment on this personal matter."


You'll get over it. They did.
 
2013-03-06 01:20:47 AM  

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.
 
2013-03-06 01:24:29 AM  

me texan: I've only read one news article on the story and when she called 911 the woman was still breathing.  Up until reading further comments, I was not even aware the woman died.  If there are more details in this story, I cant see them -  FTFA: Please enable browser cookies to read the rest of this story.


Since you don't know what happens when you  call 911, I'll try to explain in a less harsh manner of events.

When you call 911, you talk to someone who is a certified emergency medical dispatcher in about 95% of the United States, if not APCO or NAED Public Safety Dispatcher certified.  They have a program called Priority Dispatch they use to level the acuity of a call, determine the response requirements - Fire Truck, EMS, Rescue - and whether they respond with lights and sirens or not, and if necessary, provide pre-arrival instructions. Most places use a computerized system called ProQA now, but older dispatch centers and those in rural areas still use the flip card system.

When this "nurse" called 911, the information she gave the dispatcher - collapse with unresponsiveness and ineffective breathing - leads to the 9 Echo 1 Card, which is Cardiac Arrest/Respiratory Arrest - Questionable Life Status card, and tells the dispatcher to initiate the pre-arrival CPR instruction set. Had a physician been on scene, they would have lead into the 37 Delta Card, which specifies an Emergency Response to medically capable personnel.

ProQA and Priority Dispatch systems are evidence based interventions that have been successfully defended in court multiple times, and are signed off on by a physician. This is not something a dispatcher just tells someone to do. In fact, dispatchers are legally prohibited from giving medical instruction outside of the ProQA/PD protocols their medical director has signed off on.

me texan: Obviously if she was breathing and went to not breathing / cardiac arrest then at that point CPR should be administered.  From what I'd seen before the responder had identified the person as breathing.


That's actually not true, and is the result of vague initial reporting.

FTFA Linked:  Firefighters and ambulance personnel arrived at the facility seven minutes after the call came in, Miller said. The county does not know who made the call, he said.The woman had no pulse and wasn't breathing when fire crews found her lying on the floor, Bakersfield Fire Department spokesman Anthony Galagaza added.They started CPR and loaded her onto a gurney. The woman was later declared dead at Mercy Southwest Hospital.

me texan: Now that I'm reading an article I see the facility had a DNR policy and that everyone is informed when going there and agrees to it before they can be admitted.


A DNR policy, in and of itsself, is worthless unless every patient has a properly filled out and signed/notarized DNR form which specifies the scope of resuscitation effort to be undertaken. This is Tennessee's, for example. Verbal orders are not accepted, and the physician must have a signed medical order in the chart for it to be honored. It also has to be in hand and continue in the chain of custody with the body as part of the medical record. Some states WILL allow for a hand-written medical order in absence of a DNR in the chart, but according to the article they did not have one on her.

DNRs are really worth the paper they're printed on. Any question of their validity, and they can be legally ignored. If they are incomplete or lack signatures at any point, they're ignored. And if the family wants you to ignore it, they're ignored.

me texan: I have no idea legally how that will stand in court, but if that's the policy and it was known and agreed upon by the victim then I dont have a problem with them sticking to it and apparently neither does the family.


If she didn't have a DNR in hand OR a physician telling her not to perform CPR right then and there, and - as the situation seems to indicate - a licensed nurse refused to perform CPR on a patient who it was clearly indicated on, that's a violation of the standard of care despite the , and borders on criminal negligence depending on the situation surrounding it. If she failed to recognize ineffective respiration and render aid, she committed incompetence as well as negligence, and her failure to treat lead directly to the arrest state ostensibly.
 
2013-03-06 01:28:25 AM  

cretinbob: 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.


Really? Because every article I've read on the matter identifies her as a "nurse".
 
2013-03-06 01:37:20 AM  
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.
 
2013-03-06 01:41:23 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.


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.
 
2013-03-06 01:44:37 AM  
hardinparamedic <wall of text>

I am sure you have some valid points in there, but I am not reading it.  You've made me regret even having stated an opinion, regardless of how informed or lack thereof I was of the situation.
 
2013-03-06 01:48:27 AM  

cretinbob: She's not a nurse. She had no duty to act.


morally she did.
 
2013-03-06 01:49:28 AM  
When it's someone's time to go, sometimes it's better to just let them go.

This person's family shunted her into a nursing home. She was closing in on 90 years of life. She'd lived a long one, if not a good one. The next few would be filled with pain and loneliness.

Goodbye grandma. May you rest in peace.
 
2013-03-06 01:52:00 AM  

me texan: I am sure you have some valid points in there, but I am not reading it. You've made me regret even having stated an opinion, regardless of how informed or lack thereof I was of the situation.


That really kind of sums up fark.

Give an opinion where you say everyone else is stupid, on a subject that you know nothing about. when given a point by point rebuttal that shows you don't know WTF you're talking about, say you won't read it because....something. Then walk away feeling superior.
 
2013-03-06 01:53:32 AM  

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).
 
2013-03-06 01:57:39 AM  
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.
 
2013-03-06 01:57:49 AM  
Hello everybody, this is fark.com ... your opinions will always go down the drain.
 
2013-03-06 01:58:42 AM  

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. Her employment as a nurse means she is held to the standards of the California Board of Nursing, and required to adhere to the standards of care that board expects, given the capabilities she had at the time. The client-provider relationship alone creates a duty to rescue, and a duty to act.

Facility policy does not trump the State Guidelines for standard of care, and the requirement of a physician order or signed, properly executed DNR/Advanced Directive to be present for CPR and lifesaving care to be withheld.

Rising_Zan_Samurai_Gunman: 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.


And that's good. There will be no civil action, and the family can have their peace. The problem here is that a person either identified herself as a "nurse" falsely, or was a licensed nurse who refused to perform her state's expected standard of care. It doesn't matter, in that case, if her patient's family was happy with the standard of care.

Her actions directly contributed to the death of a patient. If her only justification was "it's our policy", she's about to find out how harsh a medical licensing board can be.

Rising_Zan_Samurai_Gunman: 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).


You're missing the point. By state and federal law, you do not get to make that decision. That patient, through his/her advanced directives and DNR, and a Physician who can justify the witholding of resuscitative care is the only ones who can do so.
 
2013-03-06 01:59:43 AM  

Rising_Zan_Samurai_Gunman: Except its not a nursing facility


irrelevant,

Rising_Zan_Samurai_Gunman: and the residents are informed of what care will and will not be given when they choose to live there


You think they were informed that during a medical emergency the staff would call 911 then refuse to do what 911 told them to do?

Rising_Zan_Samurai_Gunman: CPR most likely wouldn't have saved her life


you know this how?
 
2013-03-06 02:01:52 AM  

hardinparamedic: Her actions directly contributed to the death of a patient.


'Contributed' is a very weasely word here.
 
2013-03-06 02:03:17 AM  

hardinparamedic: You're missing the point. By state and federal law, you do not get to make that decision. That patient, through his/her advanced directives and DNR, and a Physician who can justify the witholding of resuscitative care is the only ones who can do so.


sheesh, I didn't know we had the king o' nurses on fark. who gives a crap, an old person lived in a place where she knew there weren't first responders and shockingly when she needed one, there weren't any and her family is shrugging it off. if you're that worked up about it, make sure your relatives and you lives in a place with actual medical staff on site when they/you get old. otherwise, whatever
 
2013-03-06 02:04:08 AM  
my first thought was that she had let the RN know she was to be no code when its time
 
2013-03-06 02:06:35 AM  
Then get a DNR, jackasses.
 
2013-03-06 02:07:25 AM  
When my 95 year old grandmother was in a car accident, we didn't know she had a DNR (the sister who was in charge of that stuff was in labor when it happened; big clusterfark all around due to pre-eclampsia). So they tried various things to keep her alive for the ~ day it took my father to drive to IN from NY, and when he got there he had them continue since it took another few days for us to get the info. We still had hope at that point so they kept trying.

It ended up being a two week ordeal where she 'improved' then got worse and repeat.

No one can definitively say whether such treatment will work. Best bet is talk over the options with your loved (or un-loved) one ahead of time.
 
2013-03-06 02:07:40 AM  
As I understand it the facility had the residents sign an agreement to their "no cpr" policy. Does that legally absolve them?
 
2013-03-06 02:08:04 AM  

AverageAmericanGuy: 'Contributed' is a very weasely word here.


How so? If this woman was a nurse, her training should have lead her to be able to identify the fact that this woman needed assistance, and her duty to act (if she's receiving a paycheck as a nurse) should have prompted her to render basic emergency aid until the arrival of more trained personnel. Even if this meant assisting respiration through mouth to mouth.

Her failure to act was a direct contributory factor here as a licensed nurse.

tlchwi02: sheesh, I didn't know we had the king o' nurses on fark


How dare I demand high standards out of people who's jobs demand they care for people.

No. I know the shenanigans and horrific treatment that nursing home patients, and many assisted living residents, receive. That's why it's not a stretch to see this person letting someone die.

tlchwi02: who gives a crap


Please never enter healthcare. Never touch a living, breathing creature with that attitude.
 
2013-03-06 02:08:17 AM  
We have plenty of old people on this planet not contributing to the wealth of any nation.  They're not exactly a scarce, pecious resource.  Other people will become old and take their place, eventually.
 
2013-03-06 02:08:28 AM  

hardinparamedic: 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.

Guess what? Those "respirations" that the nurse identiifed? They were ineffective, and agonal respirations - an indication to start CPR.

The woman was in a full cardiac arrest prior to the arrival of EMS crews.

Congratulations. You're defending a woman who failed to act when she should have recognized a peri-arrest condition, and failed to provide care a second year unlicensed extern should have known to provide.


Dude...give it a REST already.

We get it.  You love being a white knight.

the family doesnt care...your indignation over what happened is pointless.
 
2013-03-06 02:09:48 AM  

tlchwi02: sheesh, I didn't know we had the king o' nurses on fark. who gives a crap, an old person lived in a place where she knew there weren't first responders and shockingly when she needed one, there weren't any and her family is shrugging it off. if you're that worked up about it, make sure your relatives and you lives in a place with actual medical staff on site when they/you get old. otherwise, whatever


Like who totally cares about like this. geesh. like an old died n'stuff and like who cares. I don't like get why you people comment on topics that I don't care about or take the time to understand. gosh.
 
2013-03-06 02:10:10 AM  
That's what she said.
pjmedia.com
 
2013-03-06 02:11:35 AM  

The more you eat the more you fart: Dude...give it a REST already.


no kidding.

STOP COMMENTING ON THE TOPIC PEOPLE! JUST SAY THINGS LIKE "WHO CARES" AND MOVE ON!
 
2013-03-06 02:11:37 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.


I've heard the 911 call several times as they repeated it ad nauseum on the news, and she made it quite clear that she was a nurse.

Here's a link that can not make that fact any clearer. The Chyron caption reads "Nurse refuse to perform CPR".
You can hear her say it at 1:14.
http://abcnews.go.com/GMA/video/911-call-audio-retirement-home-nurse -r efuses-woman-18646490
 
2013-03-06 02:12:33 AM  

The more you eat the more you fart: We get it.  You love being a white knight.


Expecting a nurse to act in the standards and basic competence of her profession, according to the rules set forth by the California board of nursing is a white knight?

You made a comment on the last thread that your action has saved "100s" of lives. Can I ask what you do?

The more you eat the more you fart: the family doesnt care...your indignation over what happened is pointless.


My indignation is purely professional. It has nothing to do with the family.
 
2013-03-06 02:12:41 AM  

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.


While I would tend to agree...yelling "STRING HER UP!!!!" because you like looking like a hero/white knight doesn't change the fact that the FAMILY didn't want her resuscitated anyhow.

time to let it go.  If the family of the woman can let it go...you probably should, too.
 
2013-03-06 02:14:15 AM  

The more you eat the more you fart: the FAMILY didn't want her resuscitated anyhow.


that's not what the article that you didn't read says.
 
2013-03-06 02:16:39 AM  

The more you eat the more you fart: While I would tend to agree...yelling "STRING HER UP!!!!" because you like looking like a hero/white knight doesn't change the fact that the FAMILY didn't want her resuscitated anyhow.


Um, okay. Please provide written documentation of that patient's wishes in the form of a legally admissible DNR or Advanced Directive form that is properly filled out and signed by that patient, her proxy, or the physician.

It's not about "being a hero", and I'm not "white knighting" anyone. I'm demanding a healthcare practitioner act within the ethical and legal guidelines of her profession.

And I'm not yelling String her up. This nurse deserves scrutiny, but this is an institutional failure, period. The fact California, which allows Nurse Practitioners to practice independently of a physician, has such a shocking legal loophole in their laws is mind-blowing.
 
2013-03-06 02:17:10 AM  
I just hope they remembered to shoot her in the head before she turned. Becoming a zombie is so undignified.
 
2013-03-06 02:17:35 AM  

log_jammin: The more you eat the more you fart: the FAMILY didn't want her resuscitated anyhow.

that's not what the article that you didn't read says.


REALLY?!

The family's response to the media "outrage"....

"Our mother and grandmother was a remarkable and intelligent woman who was blessed to have a great life of 87 years. It is the wish of our family to honor and celebrate her life at this personal time.
"Like so many seniors, it was our mother's wish to live independently. <b>She was fully aware that Glenwood Gardens did not offer trained medical staff</b>. Even so, she personally selected the senior living community, and our family has come to know the staff and been very pleased with Glenwood Gardens as her home.
<b>"It was our beloved mother and grandmother's wish to die naturally and without any kind of life-prolonging intervention. Our family respects the right of all people to make their own life choices in such cases.</b>
"We regret that this private and most personal time has been escalated by the media. Caregivers, nurses and other medical professionals have very difficult waters to tread in the legal and medical landscape of our country today.
"We understand that the 911 tape of this event has caused concern, but<b> our family knows that mom had full knowledge of the limitations of Glenwood Gardens, and is at peace.
 </b>


Take note of the statements in bold.  Guess you missed that right?
 
2013-03-06 02:18:15 AM  

FirstNationalBastard: Of course they're happy.

Odds are, Grandma was a near-vegetable that had drained them both emotionally and financially to the brink of ruin because her body was just too stubborn to die even though the mind had checked out long ago. But, unlike if a beloved family pet's quality of life had degraded to almost nothing, no one could take Grandma to the Doctor and give her a nice sleepytime shot to put her out of her misery, because with humans, life is all about quantity, not quality.


Yup.

And oh, you're going to perform manual chest compressions on an 87 year old who is in nursing-home-care level of physical degradation?
Look, I've had two grandmothers reach that age and condition-I couldn't even give them a strong HUG without worrying about breaking ribs.  Now, admittably, I'm 240 lbs of construction worker these days, so my "hugs" and my "chest compressions" pack a lot more force than most peoples' (and my medical training is limited to first aid appropriate for use on other oversized construction workers)--but even a 100 lb "hospice aide" would likely only succeed in turning "cardiac arrest" into "cardiac laceration".

Sorry, HardinMedic, if the law says that then the law is an ass.  "In-Hospital", yes.  But this wasn't a hospital-it was a "nursing home".  The chief difference being, I believe, a lack of "cardiac facility" as well as the advanced options available in a full crash cart.
 
2013-03-06 02:18:46 AM  
The lady that died hated all of you and would have eaten you raw with tartar sauce given the opportunity.

So there.
 
2013-03-06 02:19:06 AM  
so was she hot?
 
2013-03-06 02:19:23 AM  
"Our mother and grandmother was a remarkable and intelligent woman who was blessed to have a great life of 87 years. It is the wish of our family to honor and celebrate her life at this personal time.
"Like so many seniors, it was our mother's wish to live independently. She was fully aware that Glenwood Gardens did not offer trained medical staff. Even so, she personally selected the senior living community, and our family has come to know the staff and been very pleased with Glenwood Gardens as her home.
"It was our beloved mother and grandmother's wish to die naturally and without any kind of life-prolonging intervention. Our family respects the right of all people to make their own life choices in such cases.
"We regret that this private and most personal time has been escalated by the media. Caregivers, nurses and other medical professionals have very difficult waters to tread in the legal and medical landscape of our country today.
"We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens, and is at peace.
Key statements MADE BY THE FAMILY in bold.

Everyone, including mr indignant paramedic guy...can now go have a beer and let your blood pressure go back to normal.
 
2013-03-06 02:19:47 AM  

hardinparamedic: ProQA and Priority Dispatch systems are evidence based interventions that have been successfully defended in court multiple times, and are signed off on by a physician. This is not something a dispatcher just tells someone to do. In fact, dispatchers are legally prohibited from giving medical instruction outside of the ProQA/PD protocols their medical director has signed off on.


The facility's policy takes precedence over what the 911 dispatcher says.
 
2013-03-06 02:19:53 AM  

The more you eat the more you fart: 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.

While I would tend to agree...yelling "STRING HER UP!!!!" because you like looking like a hero/white knight doesn't change the fact that the FAMILY didn't want her resuscitated anyhow.

time to let it go.  If the family of the woman can let it go...you probably should, too.


Just read a story about a guy who beat his 2 year old to death.

Far be it from me to form a moral opinion on others' family matters, right?

I mean, if family can let it go...I probably should too, right?
 
2013-03-06 02:20:48 AM  

The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....


And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

I hate the fact that I have to code a 78 year old Alzheimer patient who was long ago confined to a bed, contractured, and has no quality of life. But I don't get to make that decision, and neither does anyone else without the above. I abhor it. And I hope I don't get someone back in that case - as many other people will admit. Life at any costs is utterly cruel. But the alternative is letting people make decisions based on their own personal bias and feelings - decisions which may or may not be the wish of that patient.
 
2013-03-06 02:22:25 AM  

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


State Nursing law and the duty to act takes precedence over what that facility policy says.

To put it another way, if I have a facility policy to knowingly administer a medication when it is contraindicated to do so, and do so anyway because I am following policy and that patient dies, I have just committed, at best, negligent practice. At worst, negligent homicide.

That facility policy won't save you from the state boards.
 
2013-03-06 02:22:42 AM  

The more you eat the more you fart: Take note of the statements in bold.


you're not good at reading comprehension are you? cause what you said isn't the same thing as what they said. CPR isn't "prolonged intervention", and living at a place without nursing staff isn't the same as a DNR order.
 
2013-03-06 02:22:46 AM  
The more you eat the more you fart:
Take note of the statements in bold.  Guess you missed that right?

Well, it didn't spell out "and before we placed her in the care of the facility, we all went to the judge and had a DNR order written and notarized, and reminded the staff to have it always taped to the foot of her bed", therefore, legally it means nada.  Right?
 
2013-03-06 02:23:48 AM  

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


Then why call 911 in the first place?
 
2013-03-06 02:26:42 AM  

hardinparamedic: AverageAmericanGuy: 'Contributed' is a very weasely word here.

How so? If this woman was a nurse, her training should have lead her to be able to identify the fact that this woman needed assistance, and her duty to act (if she's receiving a paycheck as a nurse) should have prompted her to render basic emergency aid until the arrival of more trained personnel. Even if this meant assisting respiration through mouth to mouth.

Her failure to act was a direct contributory factor here as a licensed nurse.


It's a way to pin responsibility on this woman without saying she is responsible for the death.

Everything is contributory to this woman's death. The water temperature in the shower. The alarm clock that woke her from slumber. The walker she hit on her fall to the floor. The question is whether she is responsible in this case, not whether her involvement contributed to the woman's death.

You think yes. Others think no. She's dead, so her opinion is mute (get it? cuz she's dead silent. LOL). And her next of kin say they are satisfied with the level of care.

California says:
2727.5. Liability for emergency care
A person licensed under this chapter who in good faith renders emergency care at the scene of an emergency which occurs outside both the place and the course of that person's employment shall not be liable for any civil damages as the result of acts or omissions by that person in rendering the emergency care.

So unless she was acting in a grossly negligent manner, her responsibility has been fulfilled.

The code goes on to describe 'gross negligence':
1442. Gross Negligence
As used in Section 2761 of the code, "gross negligence" includes an extreme departure from the standard of care which, under similar circumstances, would have ordinarily been exercised by a competent registered nurse. Such an extreme departure means the repeated failure to provide nursing care as required or failure to provide care or to exercise ordinary precaution in a single situation which the nurse knew, or should have known, could have jeopardized the client's health or life.

Since the nursing home had a policy of not performing CPR, you'd be hard pressed to argue that her actions constituted 'an extreme departure from the standard of care' another nurse would have performed given that those nurses would also, presumably, follow the policy.
 
2013-03-06 02:27:37 AM  

hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

I hate the fact that I have to code a 78 year old Alzheimer patient who was long ago confined to a bed, contractured, and has no quality of life. But I don't get to make that decision, and neither does anyone else without the above. I abhor it. And I hope I don't get someone back in that case - as many other people will admit. Life at any costs is utterly cruel. But the alternative is letting people make decisions based on their own personal bias and feelings - decisions which may or may not be the wish of that patient.


I'm sure breaking all their ribs is *definitely* the most ethical, humane thing to do.
 
2013-03-06 02:28:00 AM  
and as it turns out, as I was writing that, Hardin confirmed it...RIGHT.    It's all about the paperwork.

He's had to deal with these lawyers before, I see.

But is a nonlicensed nurse held to the same standards as a licensed paramedic?  These "state boards", do they have jurisdiction here?
 
2013-03-06 02:29:40 AM  

The more you eat the more you fart: 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.

While I would tend to agree...yelling "STRING HER UP!!!!" because you like looking like a hero/white knight doesn't change the fact that the FAMILY didn't want her resuscitated anyhow.

time to let it go.  If the family of the woman can let it go...you probably should, too.


So, since the family is ok with it, we should be too? Thats your standard?

If I run over a hobo, and nobody knows about, its totally cool in your book? What if I find orphans without any living family members, and hack them to pieces? I mean, if they don't have a family, there isn't anybody left to get upset about it, right?
 
2013-03-06 02:30:18 AM  
ThunderPelvis:
I'm sure breaking all their ribs is *definitely* the most ethical, humane thing to do.

As Hardin has pointed out, "sensible" and "legal" diverge radically when we're talking about this subject...
 
2013-03-06 02:32:27 AM  

ThunderPelvis: I'm sure breaking all their ribs is *definitely* the most ethical, humane thing to do.


watching them choke and struggle for a breath of air while you flip through the company policy manual is ethical and humane thing to do.
 
2013-03-06 02:32:58 AM  
Lots of idiocy on this thread.  Sounds like this "nurse" was screwed no matter which way she went.  Give CPR lose job, face lawsuit.  Don't give CPR face the law.  It is like when they arrested that woman that played Mary Ann from Gilligan's island for having a joint, I was like, WTF. she's pushing 70 and if she wanted a joint leave her alone.
 
2013-03-06 02:33:03 AM  
Eh, when your patient is beating the typical lifespan by fifteen years, this sort of falls under "eh, guess I could have handled that better" rather than "Oh, no!  Tragedy!  Negligence!  Vile calumny upon thee!"

//CPR on an 87-year-old human will, typically, kill them outright.  Remember that properly-performed CPR frequently results in broken ribs on a  healthy patient.
 
2013-03-06 02:33:25 AM  

hardinparamedic: me texan: Putting someone in the rescue position is not performing CPR.

Assisting for ineffective respirations, and identifying agonal breathing is not placing someone in the rescue position.

FirstNationalBastard: Of course they're happy.

Odds are, Grandma was a near-vegetable that had drained them both emotionally and financially to the brink of ruin because her body was just too stubborn to die even though the mind had checked out long ago. But, unlike if a beloved family pet's quality of life had degraded to almost nothing, no one could take Grandma to the Doctor and give her a nice sleepytime shot to put her out of her misery, because with humans, life is all about quantity, not quality.

Unless that woman had a valid, signed DNR, or had a Doctor at her side telling her not to start CPR, that does not matter. She had a legal duty, if employed as a nurse for that facility, to act in the standard of care with basic competency, per the California Board of Nursing.

Facility policies do not trump State Nursing laws.


I will point out, again, that there's no evidence Colleen was employed as a nurse.  She told the dispatcher she was a nurse and the media has identified her as a nurse.  But for all we know, her job was gardening.

The place was not a nursing home, but an unregulated "independent living center."  As explained elsewhere, that's sort of like a hotel with intensive concierge service; it's not a medical facility.  TFA says the family and Granny knew there were no "trained medical staff" available.

Finally, even the Board of Nursing does not require a nurse to put herself in harm's way in order to aid a client.  Colleen faced losing her job if she violated policy.  She chose her job, and she had a right to do so.
 
2013-03-06 02:33:42 AM  

hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.


Except that you are WRONG.

You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am.

If you aren't aware that certain nurses in several states are legally allowed to make this determination, then I dont know what to tell you...except that in NO state is a medic legally able to do so.
 
2013-03-06 02:34:25 AM  
There's a difference between "nursing home" and "independent living facility"  She was at the latter, and they generally don't provide medical care.  It's more helping them with daily activities, cleaning and checking on them so they can live in their own place until they die.  The old bag and her family knew the policy, and were fine with it.  Case closed.  Stop grandstanding.
 
2013-03-06 02:35:16 AM  

tlchwi02: hardinparamedic: You're missing the point. By state and federal law, you do not get to make that decision. That patient, through his/her advanced directives and DNR, and a Physician who can justify the witholding of resuscitative care is the only ones who can do so.

sheesh, I didn't know we had the king o' nurses on fark. who gives a crap, an old person lived in a place where she knew there weren't first responders and shockingly when she needed one, there weren't any and her family is shrugging it off. if you're that worked up about it, make sure your relatives and you lives in a place with actual medical staff on site when they/you get old. otherwise, whatever



If you really don't care, then why are you posting in this thread?
 
2013-03-06 02:35:39 AM  

Diogenes The Cynic: The more you eat the more you fart: 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.

While I would tend to agree...yelling "STRING HER UP!!!!" because you like looking like a hero/white knight doesn't change the fact that the FAMILY didn't want her resuscitated anyhow.

time to let it go.  If the family of the woman can let it go...you probably should, too.

So, since the family is ok with it, we should be too? Thats your standard?

If I run over a hobo, and nobody knows about, its totally cool in your book? What if I find orphans without any living family members, and hack them to pieces? I mean, if they don't have a family, there isn't anybody left to get upset about it, right?


Now, I'm not a doctor or a lawyer, but I am pretty sure being murdered and dying of natural causes are different in the eyes of medicine, the law, and (if that's your thing) God.
 
2013-03-06 02:36:50 AM  

AverageAmericanGuy: So unless she was acting in a grossly negligent manner, her responsibility has been fulfilled.


The Good Samaritan law you linked does not apply in the United States civil system if the person had a duty to rescue - i.e. they were being paid and on duty at the time as a licensed healthcare provider, and there was a client-patient relationship.

Even if her job was just to come in for an hour and hand out medicine, if she was an LPN or RN, she had a legal duty to act.

AverageAmericanGuy: Since the nursing home had a policy of not performing CPR, you'd be hard pressed to argue that her actions constituted 'an extreme departure from the standard of care' another nurse would have performed given that those nurses would also, presumably, follow the policy.


Facility policy does not trump the standard of care for a nursing licensee. That is determined by the board of Nursing, based on their level.

ThunderPelvis: I'm sure breaking all their ribs is *definitely* the most ethical, humane thing to do.


Take it up with the State you live in, the American Heart Association/ILCOR, and whatever biomedical ethics board oversees your respective profession.

Ishidan: and as it turns out, as I was writing that, Hardin confirmed it...RIGHT.    It's all about the paperwork.

He's had to deal with these lawyers before, I see.


Unfortunately, a large part of it is the way laws are written. Even if I have a DNR in hand, and it is missing one date, or one signature, the law says I have to consider it invalid. The risk of error is too great, as it results in certain death.

Any healthcare provider will tell you there are patients that they abhor doing CPR and working. They don't want to do it. But it's part of their job.

Ishidan: But is a nonlicensed nurse held to the same standards as a licensed paramedic?


If she was an LPN or RN, she is licensed. Even if she's certified - actually a nursing assistant, the board still has jurisdiction over her certification. Although, if she was actually a Nursing Assistant, she would not be held to the same standard to act in the least.

As far as nurses being like paramedics - that's kind of a complex issue. Different schools of thought, different methodologies of training.

Paramedics specialize in emergency and critical care, especially in the venue of transport, and have to learn to generalize. Nurses generalize in advanced care, and specialize in their respective clinical fields out in practice.

Ishidan: These "state boards", do they have jurisdiction here?


They are the all knowing, all powerful Wizard.
 
2013-03-06 02:36:56 AM  

AverageAmericanGuy: When it's someone's time to go, sometimes it's better to just let them go.

This person's family shunted her into a nursing home. She was closing in on 90 years of life. She'd lived a long one, if not a good one. The next few would be filled with pain and loneliness.

Goodbye grandma. May you rest in peace.


january 2004, this is what was decided on my moms mother. she would have been 100 on this past feb 3rd.
 
2013-03-06 02:38:42 AM  

The more you eat the more you fart: hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

Except that you are WRONG.

You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am.

If you aren't aware that certain nurses in several states are legally allowed to make this determination, then I dont know what to tell you...except that in NO state is a medic legally able to do so.


Also, from what I understand is that if I am not trained to preform CPR correctly I am not to do so.  It is more than pounding on a chest.  Of course, I'm from a "flyover" state and it varies from state to state.
 
2013-03-06 02:38:46 AM  
So should I still be outraged or not?
 
2013-03-06 02:39:59 AM  

fusillade762: So should I still be outraged or not?


Only if you're a politicianor lawyer that can make some money out of this.
 
2013-03-06 02:40:41 AM  

Bigdogdaddy: fusillade762: So should I still be outraged or not?

Only if you're a politicianor lawyer that can make some money out of this.


politicon or
 
2013-03-06 02:40:52 AM  

The more you eat the more you fart: You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am.

If you aren't aware that certain nurses in several states are legally allowed to make this determination, then I dont know what to tell you...except that in NO state is a medic legally able to do so.


What level of medical training is that which allows you to determine that, without performing an assessment or any interventions, that death in the field is certain and resuscitation is futile. Or to withhold resuscitation measures without a DNR or physicians order, or specific standing, protocol-based criteria, despite the fact doing so can be seen as practicing medicine?

Because, I can show you my criteria. Tennessee State Protocol 601 - Withholding Life Support/Terminating Resusctiation in the Field.
 
2013-03-06 02:41:24 AM  

Bigdogdaddy: Bigdogdaddy: fusillade762: So should I still be outraged or not?

Only if you're a politicianor lawyer that can make some money out of this.

politicon or


CRAP!  I give up.
 
2013-03-06 02:41:45 AM  

Jim_Callahan: Eh, when your patient is beating the typical lifespan by fifteen years, this sort of falls under "eh, guess I could have handled that better" rather than "Oh, no!  Tragedy!  Negligence!  Vile calumny upon thee!"

//CPR on an 87-year-old human will, typically, kill them outright.  Remember that properly-performed CPR frequently results in broken ribs on a  healthy patient.


I get all that. What I don't get is why so many seem to misunderstand why anyone might be disturbed by the story we've gotten so far...

Look, it would be one thing if the nurse and the 911 operator were having a debate about best medical practices...and the nurse decided to err on the side of humaneness, rather than take a risky and potentially unrewarding, drastic measure for their client.

But, that's not really what the story is about, is it? Tell me you get that...
 
2013-03-06 02:41:48 AM  
I think there's a difference between a medical facility stating it doesn't explicitly provide medical care and a bystander who happened to be a nurse refusing to help.

Remember when Jerry and Co. went to jail for not helping a guy getting mugged in the series finale of Seinfeld?
 
2013-03-06 02:42:23 AM  
Where's Bronymedic, he should be in this discussion...
 
2013-03-06 02:42:40 AM  

BarkingUnicorn: The place was not a nursing home, but an unregulated "independent living center."


andychrist420: There's a difference between "nursing home" and "independent living facility" She was at the latter, and they generally don't provide medical care.


you guys think you're making some sort of point by saying this, but it is completely irrelevant.

If a bagger at a grocery store called 911 because a customer was dieing then refused to perform CPR when asked by the 911 operator because it was against company policy, no one would be saying "well he wasn't at a nursing home so the customer should just expect to die".
 
2013-03-06 02:42:46 AM  

log_jammin: cretinbob: She's not a nurse. She had no duty to act.

morally she did.


Your morals do not create my duties. If your morals say abortion is murder, I have no duty to carry a fetus to term.

Get it?
 
2013-03-06 02:42:59 AM  
So, anyone know what the inheritance amount is?
 
2013-03-06 02:43:22 AM  

Bigdogdaddy: The more you eat the more you fart: hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

Except that you are WRONG.

You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am.

If you aren't aware that certain nurses in several states are legally allowed to make this determination, then I dont know what to tell you...except that in NO state is a medic legally able to do so.

Also, from what I understand is that if I am not trained to preform CPR correctly I am not to do so.  It is more than pounding on a chest.  Of course, I'm from a "flyover" state and it varies from state to state.


Flyover state, huh? I believe it is your job to drop to your knees and pray. Remember to make a show of it so that everyone around you will know that you are morally superior to them, even those actually doing something about the situation.
 
2013-03-06 02:43:34 AM  

hardinparamedic:
It does not matter if that woman was a licensed nurse in the employ of that capacity in that "assisted living" facility. Her employment as a nurse means she is held to the standards of the California Board of Nursing, and required to adhere to the standards of care that board expects, given the capabilities she had at the time. The client-provider relationship alone creates a duty to rescue, and a duty to act.

Facility policy does not trump the State Guidelines for standard of care, and the requirement of a physician order or signed, properly executed DNR/Advanced Directive to be present for CPR and lifesaving care to be withheld.


So far, there has been no identification of who actually made the call, and there has been no actual evidence presented that she is a licensed nurse.  Also, it was NOT an assisted living facility. It was an independent living facility which doesn't have to meet the standards of an Assisted living facility.  I've been trying to find the exact standards, but searches for ILCs in California turns up only non-residential organizations aimed towards the disabled, were 51% of the employees and board are disabled.  Its not clear if this was that type of ILC or another one that I can't find through google.
However,  the article states that the woman selected the facility knowing that there were not "trained medical staff" on hand, and all indications given by family are that she wanted no intervention.

Rising_Zan_Samurai_Gunman: 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.

And that's good. There will be no civil action, and the family can have their peace. The problem here is that a person either identified herself as a "nurse" falsely, or was a licensed nurse who refused to perform her state's expected standard of care. It doesn't matter, in that case, if her patient's family was happy with the standard of care.

Her actions directly contributed to the death of a patient. If her only justification was "it's our policy", she's about to find out how harsh a medical licensing board can be.


Correction - the woman took no actions which contributed to the death of the patient.  Her inaction beyond placing the call may have delayed care to the woman, but once again, the information at this time indicates that the employees involved, or at least the one who made the initial call (the article indicates two different employees were on the call) was not a licensed nurse.  The license status of the second employee on the call is also unknown.

You're missing the point. By state and federal law, you do not get to make that decision. That patient, through his/her advanced directives and DNR, and a Physician who can justify the witholding of resuscitative care is the only ones who can do so.

  And the information provided by the family so far indicated that the woman's directives were to not take any extraordinary measures to extend her life.  As an independent living facility its probable there is no physician on staff to place any sort of order.  The only description of Independent Living Facility I've been able to find for California is a non-residential situation, so it may be a community center where all of the "residents" are independent but live nearby.


log_jammin: Rising_Zan_Samurai_Gunman: and the residents are informed of what care will and will not be given when they choose to live there

You think they were informed that during a medical emergency the staff would call 911 then refuse to do what 911 told them to do?


  They were likely told they would call 911 but take no additional measures.

Rising_Zan_Samurai_Gunman: CPR most likely wouldn't have saved her life

you know this how?


  Reports are that she died of a massive stroke and had been diagnosed with a disease of the blood vessels supplying the brain, so CPR would have at best, left her a vegetable.
 
2013-03-06 02:43:56 AM  

Bigdogdaddy: Also, from what I understand is that if I am not trained to preform CPR correctly I am not to do so.


when under the instruction of someone trained to instruct you how to do it, you are.
 
2013-03-06 02:44:55 AM  

hardinparamedic: cretinbob: 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.

Really? Because every article I've read on the matter identifies her as a "nurse".


Yes, but if you read the linked article, you'll see that she has been identified as a residential manager. Yes, apprently she identified herself as a nurse, but she isn't.

Wait, the article changed again......

I'll find it.....

Anway she died of a massive stroke, so all the CPR in the world wouldn't have fixed that anyway.
CPR is not a magic wand to wave over someone and they come back to life.
Life is terminal. Everyone dies. It's OK. That's how you get to go to heaven.
If there should be a discussion here it's that.

//an echo response would be cardiac and respiratory arrest, witnessed with CPR in progress. This would have been a Delta response which is still an emergency response.
 
2013-03-06 02:45:49 AM  

ladyfortuna: Where's Bronymedic, he should be in this discussion..


here. :P
 
2013-03-06 02:47:11 AM  

fusillade762: So should I still be outraged or not?


No. It's fake outrage by people who think they can live forever


BAKERSFIELD, Calif. - Glenwood Gardens is an independent living facility, which by law is not licensed to provide medical care to any of its residents.
We are conducting an internal review to determine all of the facts about what occurred while waiting for the paramedics, who arrived moments later. Our associate who was involved was serving in the capacity of a Resident Services Director, not as a nurse.
We have communicated our deepest sympathies and condolences to this resident's family on the passing of their loved one.
 
2013-03-06 02:47:28 AM  

log_jammin: Bigdogdaddy: Also, from what I understand is that if I am not trained to preform CPR correctly I am not to do so.

when under the instruction of someone trained to instruct you how to do it, you are.


Citation please
 
2013-03-06 02:47:44 AM  

BarkingUnicorn: Your morals do not create my duties. If your morals say abortion is murder, I have no duty to carry a fetus to term.

Get it?


so unless you have a legal obligation then you can't be bothered. got it.


Rising_Zan_Samurai_Gunman: Reports are that she died of a massive stroke and had been diagnosed with a disease of the blood vessels supplying the brain, so CPR would have at best, left her a vegetable.

We asked her if CPR would have done any good in this case.
"it could have made a difference. Would it have made a difference in this particular situation? We don't have the answer to that, but have patients survived in a similar situation," said Shain.



I'd suggest that next time you read your own article.
 
2013-03-06 02:48:53 AM  

cretinbob: That's how you get to go to heaven.


lol
 
2013-03-06 02:50:04 AM  

hardinparamedic: AverageAmericanGuy: So unless she was acting in a grossly negligent manner, her responsibility has been fulfilled.

The Good Samaritan law you linked does not apply in the United States civil system if the person had a duty to rescue - i.e. they were being paid and on duty at the time as a licensed healthcare provider, and there was a client-patient relationship.


That would actually be the Nursing Practice Act, not the Good Samaritan law.

http://www.rn.ca.gov/regulations/npa.shtml
 
2013-03-06 02:50:45 AM  

Bigdogdaddy: Citation please


citation that 911 dispatchers are trained to provide instructions on how to perform CPR during emergencies? cause that's a pretty major part of their job. Or are you claiming that the 911 operator was telling to woman to do something illegal by asking her to perform 911?
 
2013-03-06 02:52:28 AM  

cretinbob: Our associate who was involved was serving in the capacity of a Resident Services Director, not as a nurse.


you do understand someone can be a licensed nurse yet "serve in the capacity of" another function don't you?
 
2013-03-06 02:53:22 AM  

log_jammin: BarkingUnicorn: The place was not a nursing home, but an unregulated "independent living center."

andychrist420: There's a difference between "nursing home" and "independent living facility" She was at the latter, and they generally don't provide medical care.

you guys think you're making some sort of point by saying this, but it is completely irrelevant.

If a bagger at a grocery store called 911 because a customer was dieing then refused to perform CPR when asked by the 911 operator because it was against company policy, no one would be saying "well he wasn't at a nursing home so the customer should just expect to die".


If the bagger is not trained in CPR, he should not do it, and could actually be liable if the person is injured further.  Anything else?
 
2013-03-06 02:54:03 AM  

The more you eat the more you fart: hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

Except that you are WRONG.

You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am.

If you aren't aware that certain nurses in several states are legally allowed to make this determination, then I dont know what to tell you...except that in NO state is a medic legally able to do so.


Wow, as a nurse I am embarrassed for you.  You must not be an emergency nurse which automatically disqualifies you from the "I can decide if I should continue CPR" crowd.  I would LOVE to see your State's Nurse practice act because I have never heard this.  Most of what nurses can do are centered on identifying problems a patient is having.  If you did not have a patient hooked up to a monitor and rigor mortis was not setting in, I'd say you were playing with fire telling people to stop what they are doing.

In short: Citation needed.
 
2013-03-06 02:54:06 AM  

Bigdogdaddy: The more you eat the more you fart: hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

Except that you are WRONG.

You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am.

If you aren't aware that certain nurses in several states are legally allowed to make this determination, then I dont know what to tell you...except that in NO state is a medic legally able to do so.

Also, from what I understand is that if I am not trained to preform CPR correctly I am not to do so.  It is more than pounding on a chest.  Of course, I'm from a "flyover" state and it varies from state to state.


Correct.  If you dont know how to do it...at the least its gonna be ineffective, and at the worst, can actually make a bad situation even worse.

Also, I would suggest hardinparamedic stops trying to speak about the state board of nursing like he actually has authority to do so, or that he even knows wtf their rules are...considering that he isn't even a nurse.
 
2013-03-06 02:54:51 AM  
"Lorraine Bayless' family said she "personally selected" Glenwood Gardens independent living facility in Bakersfield knowing there were not "trained medical staff" and that she wanted to "die naturally...without any kind of life-prolonging intervention." "

My dad was dying of cancer, but weak and frail that he was, he got himself up and dressed and to his chair on his last day. To make a long story short, he collapsed, I called 911. I did not perform CPR and he had a DNR. Crushing his ribs might have kept him alive, what? A week or so more? Robbed of his independence from the damage caused by such actions and very likely in more severe pain?? I would love to have my dad back, I miss him terribly and I second-guess my actions to this day, 9yrs later, even though I know I did the right thing. It was painful to go through, but the death he would have preferred was there for him. Yes, we have all sorts of BS legal shiat to worry about these days, but it sounds to me like this family and nurse were abiding by what was right for the woman and her wishes. May Ms. Bayless rest in peace, may her family be left in peace in this sad time, and can we all please learn a bit from their common sense?
  
"Bayless' family reiterated in their statement that they had no qualms with the care Bayless received.

"We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens and is at peace," the statement from Bayless' family read."
 
2013-03-06 02:54:59 AM  
hardinparamedic:

As far as nurses being like paramedics - that's kind of a complex issue. Different schools of thought, different methodologies of training.

Paramedics specialize in emergency and critical care, especially in the venue of transport, and have to learn to generalize. Nurses generalize in advanced care, and specialize in their respective clinical fields out in practice.


Just wanted to reinforce this.  RN here.  Nurses (in general) are more experienced in "longer" term care than nurses.  Unless the RN is working in an ED or on a medivac I would not think their emergency medicine care is that much better than a paramedic's.  Nurses and paramedics, for the most part, serve different spectrums of the medical world.  They each have their place and are specialized for their specific job.

As for the original topic, I'm still trying to absorb all the information before making a decision.  Although, as a nurse, I would find it difficult to just refuse treatment.  Providing medical care or treatment is just second nature to a lot of people in the medical professions.  You kinda go on "autopilot" in those emergency situations.  So, for some reason, I feel like there's some disconnect in the story or something not being reported.  It just isn't adding up.
 
2013-03-06 02:55:13 AM  

log_jammin: Bigdogdaddy: Citation please

citation that 911 dispatchers are trained to provide instructions on how to perform CPR during emergencies? cause that's a pretty major part of their job. Or are you claiming that the 911 operator was telling to woman to do something illegal by asking her to perform 911?


If someone  was trapped in a burning car and I would put my life in danger should I be required to drag them out?  One can't be required to do anything they do not feel like doing.

But hey, if it makes you feel better, you win.  Have a good evening.
 
2013-03-06 02:55:56 AM  
Did the lady have any estate / savings? Maybe the family's outrage was softenedby a Hawaiian vacation looming on the horizon.

Kinda doubt this is the case, but stranger things have happened...

/Don't really care; not going to dig for an answer.
//Still, I wouldn't put my parent in that facility.
 
2013-03-06 02:56:57 AM  
Bumblefark:Look, it would be one thing if the nurse and the 911 operator were having a debate about best medical practices...and the nurse decided to err on the side of humaneness, rather than take a risky and potentially unrewarding, drastic measure for their client.

But, that's not really what the story is about, is it? Tell me you get that...


I get that people want to require medical staff to save lives when they can, but I think that requiring people to perform CPR, which is a pretty risky no-guarantee procedure that inevitably results in injury, for any reason is at best pushing it a bit.  If it was a matter of the woman being on artificial respiration that had come unplugged and the staff nurse refusing to plug it back in, sure, outrage, string 'em up, but this... nah.  A care nurse overriding the 911 dispatcher as regards her own attempt to hail-mary past the grim reaper, I'm not feeling the rage here.

As to the person sounding callous on the phone... medical personnel, when not actually talking to a patient, are  incredibly blunt.  Hospital staff are even worse.  I can't imagine continuing care, where your patient  always dies in your care, makes you any more inclined to be sensitive to the public's wilting-flower delicacy  outside their actual hearing.  This doesn't necessarily make them actually bad people.
 
2013-03-06 02:58:04 AM  
Hey whaddaya know, another article showing the actual TRANSCRIPT of the call.
http://www.bakersfieldcalifornian.com/local/breaking-news/x738926964 /E xcerpts-from-the-Glenwood-911-call

So, speaking as-as I've mentioned-a nonlawyer, nonmedic J .Random Goon, here are facts I can glean.

1.  The patient collapsed in a public area in full view of multiple staff members and multiple other patients, and had a witnessed respiratory arrest during the course of the call.
2.  The caller (herein referred to as "caller", not "nurse", for reasons soon to be explained) promptly called for both 911 support and her boss,  as well as other coworkers within screaming distance.
3.  During the course of the call, the caller identified herself as a "nurse", but without using a proper rank name such as LPN, RN, RNA, etc.  Therefore we cannot determine the caller's licensure status.
4.  During the course of the call, the caller was not aided by ANY other facility employee within sight of the incident, and was directly ordered by her supervisor not to obey Dispatcher commands to start CPR-not for the least of which, no doubt, because of the resulting bone-crushing sights and sounds and their results on the other clients.  Facility policy was clearly not to turn "fell down, passed out, carted away by ambulance, never came back" into "fell down, passed out, nurse mashed her flat, then ambulance came."
5.  The Dispatcher attempted to order the Caller to have ANY passerby-regardless of training in CPR or other basic lifesaving, medical licensure, legal connection to the facility, or otherwise-begin CPR via telephone instruction.

Discuss.
 
2013-03-06 02:59:17 AM  

andychrist420: If the bagger is not trained in CPR, he should not do it, and could actually be liable if the person is injured further. Anything else?


that's not true.
 
2013-03-06 02:59:23 AM  
I'm sitting here typing this from a Brookedale facility exactly like the one in the news right now and i'm getting a kick....

The majority of you haven't a damn clue what you are talking about, so kindly STFU.

/ALF does not equal medical facility.
 
2013-03-06 02:59:44 AM  

Maximer: hardinparamedic:

As far as nurses being like paramedics - that's kind of a complex issue. Different schools of thought, different methodologies of training.

Paramedics specialize in emergency and critical care, especially in the venue of transport, and have to learn to generalize. Nurses generalize in advanced care, and specialize in their respective clinical fields out in practice.

Just wanted to reinforce this.  RN here.  Nurses (in general) are more experienced in "longer" term care than nurses.  Unless the RN is working in an ED or on a medivac I would not think their emergency medicine care is that much better than a paramedic's.  Nurses and paramedics, for the most part, serve different spectrums of the medical world.  They each have their place and are specialized for their specific job.

As for the original topic, I'm still trying to absorb all the information before making a decision.  Although, as a nurse, I would find it difficult to just refuse treatment.  Providing medical care or treatment is just second nature to a lot of people in the medical professions.  You kinda go on "autopilot" in those emergency situations.  So, for some reason, I feel like there's some disconnect in the story or something not being reported.  It just isn't adding up.


I would tend to agree.  This is more of an ethical dilemma than a legal one.  Don't misread, there may very well be legal action taken against this individual.
 
2013-03-06 02:59:54 AM  

The more you eat the more you fart: Bigdogdaddy: The more you eat the more you fart: hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

Except that you are WRONG.

You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am.

If you aren't aware that certain nurses in several states are legally allowed to make this determination, then I dont know what to tell you...except that in NO state is a medic legally able to do so.

Also, from what I understand is that if I am not trained to preform CPR correctly I am not to do so.  It is more than pounding on a chest.  Of course, I'm from a "flyover" state and it varies from state to state.

Correct.  If you dont know how to do it...at the least its gonna be ineffective, and at the worst, can actually make a bad situation even worse.

Also, I would suggest hardinparamedic stops trying to speak about the state board of nursing like he actually has authority to do so, or that he even knows wtf their rules are...considering that he isn't even a nurse.


Thank you. I know that's the way it used to be when I took CPR years ago (although my certification expired long ago).  Things change over the years.
 
2013-03-06 03:00:14 AM  

log_jammin: cretinbob: Our associate who was involved was serving in the capacity of a Resident Services Director, not as a nurse.

you do understand someone can be a licensed nurse yet "serve in the capacity of" another function don't you?


You do know that since the facility was not a licensed medical facility it doesn't matter, right? A nurse can only practice under a physicians license.

log_jammin: citation that 911 dispatchers are trained to provide instructions on how to perform CPR during emergencies? cause that's a pretty major part of their job. Or are you claiming that the 911 operator was telling to woman to do something illegal by asking her to perform 911?


Oh god yes. Around here they have to be EMTs, firefighters or police officers as well. Yes, CPR intructions are part of pre-arrivals.
 
2013-03-06 03:01:05 AM  

Nuclear Pancake: I'm sitting here typing this from a Brookedale facility exactly like the one in the news right now and i'm getting a kick....

The majority of you haven't a damn clue what you are talking about, so kindly STFU.

/ALF does not equal medical facility.


In other words: I am too lazy to contribute, and you are all doo doo heads.
 
2013-03-06 03:01:11 AM  

Bigdogdaddy: If someone was trapped in a burning car and I would put my life in danger should I be required to drag them out?


I would say you have a legal as well as a moral obligation to do more than just watch.
 
2013-03-06 03:02:53 AM  

Ishidan: Hey whaddaya know, another article showing the actual TRANSCRIPT of the call.
http://www.bakersfieldcalifornian.com/local/breaking-news/x738926964 /E xcerpts-from-the-Glenwood-911-call

So, speaking as-as I've mentioned-a nonlawyer, nonmedic J .Random Goon, here are facts I can glean.

1.  The patient collapsed in a public area in full view of multiple staff members and multiple other patients, and had a witnessed respiratory arrest during the course of the call.
2.  The caller (herein referred to as "caller", not "nurse", for reasons soon to be explained) promptly called for both 911 support and her boss,  as well as other coworkers within screaming distance.
3.  During the course of the call, the caller identified herself as a "nurse", but without using a proper rank name such as LPN, RN, RNA, etc.  Therefore we cannot determine the caller's licensure status.
4.  During the course of the call, the caller was not aided by ANY other facility employee within sight of the incident, and was directly ordered by her supervisor not to obey Dispatcher commands to start CPR-not for the least of which, no doubt, because of the resulting bone-crushing sights and sounds and their results on the other clients.  Facility policy was clearly not to turn "fell down, passed out, carted away by ambulance, never came back" into "fell down, passed out, nurse mashed her flat, then ambulance came."
5.  The Dispatcher attempted to order the Caller to have ANY passerby-regardless of training in CPR or other basic lifesaving, medical licensure, legal connection to the facility, or otherwise-begin CPR via telephone instruction.

Discuss.


I'm going to refer back to my original opinion in the first thread about this.

The dispatcher was a spaz.
 
2013-03-06 03:03:48 AM  

cretinbob: You do know that since the facility was not a licensed medical facility it doesn't matter, right? A nurse can only practice under a physicians license.


so you're saying it was illeagl for her to perform CPR??? really???

cretinbob: Oh god yes.


so why isn't the dispatcher getting fired for her illegal conduct? Oh that's right. because she was doing exactly what she was supposed to do.
 
2013-03-06 03:03:48 AM  

log_jammin: andychrist420: If the bagger is not trained in CPR, he should not do it, and could actually be liable if the person is injured further. Anything else?

that's not true.


I imagine it varies by state.  I know in my state that good samaritan (however you spell that) protections only apply if you have BAT or other actual current CPR certification.  If you just randomly start trying to administer without a cert you can in fact be held liable in civil court for the resulting injuries.

Albeit, samaritan immunity does cover non-CPR aid like moving people out of traffic and so on.
 
2013-03-06 03:05:11 AM  

log_jammin: Bigdogdaddy: If someone was trapped in a burning car and I would put my life in danger should I be required to drag them out?

I would say you have a legal as well as a moral obligation to do more than just watch.


OK, I said I was done.  I work for a company and someone gets hurt.  We have people trained to do first aid, CPR and whatever they can do to help somone here until medical professionals arrive.  I am told NOT to assist because I am not properly trained in even cleaning up the contaminated area. They do not want untrained personnel doing these things. Should I be arrested if I do what I am told by the company?
 
2013-03-06 03:05:20 AM  
The more you eat the more you fart:

Also, I would suggest hardinparamedic stops trying to speak about the state board of nursing like he actually has authority to do so, or that he even knows wtf their rules are...considering that he isn't even a nurse.

One of the most annoying aspects of the medical profession is that every profession (i.e. doctor, RN, LPN, CNA, PA, EMT, Paramedic, etc.) think they know better or know more than every other profession in the field.  They also all seem to know how to do each other's jobs.

The medical profession is a place of huge egos unfortunately.  It's one of the major drawbacks to me.
 
2013-03-06 03:05:22 AM  

hardinparamedic: Unless that woman had a valid, signed DNR, or had a Doctor at her side telling her not to start CPR, that does not matter. She had a legal duty, if employed as a nurse for that facility, to act in the standard of care with basic competency, per the California Board of Nursing.

Facility policies do not trump State Nursing laws.


True.  Had just this exact thing happen Monday.  100yo, coded him for 3 hours, broke every rib.  Made it ICU to code 2 more times before finally passing.  Life would have sucked if they live r/t rib fractures, pain, brain anoxia.  Difference was that family insisted on all measures to make the pt live even if they were miserable doing it.
 
2013-03-06 03:06:40 AM  
Nuclear Pancake:
/ALF does not equal medical facility.
...must...not...make...80s...tv...joke...
 
2013-03-06 03:07:59 AM  

hardinparamedic: AverageAmericanGuy: 'Contributed' is a very weasely word here.

How so? If this woman was a nurse, her training should have lead her to be able to identify the fact that this woman needed assistance, and her duty to act (if she's receiving a paycheck as a nurse) should have prompted her to render basic emergency aid until the arrival of more trained personnel. Even if this meant assisting respiration through mouth to mouth.

Her failure to act was a direct contributory factor here as a licensed nurse.

tlchwi02: sheesh, I didn't know we had the king o' nurses on fark

How dare I demand high standards out of people who's jobs demand they care for people.

No. I know the shenanigans and horrific treatment that nursing home patients, and many assisted living residents, receive. That's why it's not a stretch to see this person letting someone die.

tlchwi02: who gives a crap

Please never enter healthcare. Never touch a living, breathing creature with that attitude.


It is you that should Not have entered Healthcare in the first place if this is your attitude. Your callous unprofessionalism when representing your self as an EMS first responder is disgusting at best. Lashing out at posters on a public form is certainly against union policies here, which is why I am glad you do not work for any EMS crew in our health region.

Not only that, but you make some serious assumptions, and in your desire to rely on heuristics, you shamelessly flame, and call for the firing of a woman who has not officially been recognized as a nurse with any standing license in any of the articles, including the ones you linked.

Perhaps before you decide to become so enflamed about an issue that you cannot truly pass first hand judgement on, you should consider respecting the feelings of the family above your desire to seek a reason to pass sanctimonious judgement on others.

You should consider this issue closed, and find better issues to focus on, considering you are also not investigating, or are part of any investigative body that is looking in to the woman's legal status to provide CPR or not, nor will you ever be.
 
2013-03-06 03:08:01 AM  

Ishidan: Nuclear Pancake:
/ALF does not equal medical facility.
...must...not...make...80s...tv...joke...


HA!
 
2013-03-06 03:08:35 AM  

hardinparamedic: The more you eat the more you fart: You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am.

If you aren't aware that certain nurses in several states are legally allowed to make this determination, then I dont know what to tell you...except that in NO state is a medic legally able to do so.

What level of medical training is that which allows you to determine that, without performing an assessment or any interventions, that death in the field is certain and resuscitation is futile. Or to withhold resuscitation measures without a DNR or physicians order, or specific standing, protocol-based criteria, despite the fact doing so can be seen as practicing medicine?

Because, I can show you my criteria. Tennessee State Protocol 601 - Withholding Life Support/Terminating Resusctiation in the Field.


Quote from MY state board of nursing:

"

In the event of an unwitnessed patient or resident cardiac arrest, the nurse is expected to immediately conduct a sequential assessment of the patient or resident and to initiate CPR without delay unless there is a valid DNR order or  allof the following clinical signs are present:

1. No response when the patient or resident is tapped on the shoulder and asked, "Are you all right?"

2.  No evidence of active respiration or respiratory effort after observation for at least 30 seconds.

3.  No pulse as determined by palpation of the carotid or auscultation of the apical pulse for not less than 30 seconds.

4.  Dilated bilateral pupils that are unresponsive to bright light.

The assessment above must be performed by appropriately licensed nursing personnel."

Also:

"The Board of Nursing has no "laundry list" of tasks/skills a nurse can perform. Such lists tend to limit practice. Scope of practice is a fluid concept. It changes as knowledge and technology expand. Nurses must possess the knowledge, skill, and ability to perform their duties, therefore, scope of practice comes down to the competency of the individual nurse. "

translation:  the state board in my state give BROAD leeway to its nurses, and leaves most decisions up to the individual nurse;  as long as they have a medically-justified reason for their actions, they are in the clear.
 
2013-03-06 03:09:50 AM  

log_jammin: BarkingUnicorn: The place was not a nursing home, but an unregulated "independent living center."

andychrist420: There's a difference between "nursing home" and "independent living facility" She was at the latter, and they generally don't provide medical care.

you guys think you're making some sort of point by saying this, but it is completely irrelevant.

If a bagger at a grocery store called 911 because a customer was dieing then refused to perform CPR when asked by the 911 operator because it was against company policy, no one would be saying "well he wasn't at a nursing home so the customer should just expect to die".


The point is that a nursing home would have a duty to render medical services while a grocery store would not.  Another point is that a grocery store might employ a nurse as a bagger, in which case the employee has no nurse's duty to a customer.
 
2013-03-06 03:10:27 AM  

BarkingUnicorn: log_jammin: cretinbob: She's not a nurse. She had no duty to act.

morally she did.

Your morals do not create my duties. If your morals say abortion is murder, I have no duty to carry a fetus to term.

Get it?


THIS. x 100,000,000.

Read this and understand it.
 
2013-03-06 03:10:50 AM  

qitty: I did not perform CPR and he had a DNR.


Yes, these are exactly the same situation.
 
2013-03-06 03:13:11 AM  

CaitoStreet: Lashing out at posters on a public form is certainly against union policies here, which is why I am glad you do not work for any EMS crew in our health region.


Lulz.
 
2013-03-06 03:14:28 AM  
Derp thick..... cannot... see or hear do to thick derp........

Woman should have had DNR. Seems like this was her wish as well as her families wish. Leave it alone. I'm sure lawyers will make much cash either way. What is important? Quality of life, or keeping a 78 yo woman alive (or what passes in a hospital) for a nominal amount of time so the f*cking health care mega corporations can squeeze a few more pennies out of her.
If I'm in that position, not only do I prefer no cpr, .357 to brainstem is my choice.
Keep arguing, derp feeds the fark.
 
2013-03-06 03:14:34 AM  

Jim_Callahan: I imagine it varies by state.


you're right. it's not as cut and dried as I thought.
 
2013-03-06 03:15:51 AM  

thorthor: Woman should have had DNR.


But didn't.
 
2013-03-06 03:17:45 AM  

Bigdogdaddy: OK, I said I was done. I work for a company and someone gets hurt. We have people trained to do first aid, CPR and whatever they can do to help somone here until medical professionals arrive. I am told NOT to assist because I am not properly trained in even cleaning up the contaminated area. They do not want untrained personnel doing these things. Should I be arrested if I do what I am told by the company?


that's not even remotely comparable to this situation.

1. cleaning up contamination when you're not trained is not the same as refusing to perform CPR under instruction of a person trained to tell you how to perform CPR.

2. who said anything about arrest?
 
2013-03-06 03:19:16 AM  

thorthor: Seems like this was her wish



That sounds like a binding contract to me.
 
2013-03-06 03:20:40 AM  

BarkingUnicorn: The point is that a nursing home would have a duty to render medical services while a grocery store would not. Another point is that a grocery store might employ a nurse as a bagger, in which case the employee has no nurse's duty to a customer.


so I'll add you to the "If I'm not legally obligated then I can't be bothered" camp.
 
2013-03-06 03:21:52 AM  
if you & your family has not had to provide 24hr at home care for an elderly person unable to do for themselves you should STFU about it. your income is gone, your sleep is minimal, you have to provide care that should be given by several attendants multiple times per day. upkeep of hygiene, using the toilet, you name it, you get to do it. you still have to keep up with your bills & household chores while taking care of their bills, legal needs, taxes, banking etcetera.

if you're really lucky your relative will be mentally ill so you not only have the repetition of things every day, you'll also enjoy sarcasm, insult and all sorts of verbal abuse along with whatever farked up things that go along with their instability.

people that think it's terrible to put a loved one into a assisted center should also realize how demanding it is to get a person in a wheelchair out to the car for frequent doctors visits. it's not easy and it eats up the day. and when you get home you still have to fix meals and get chores done.

not everyone is cut out to be a caregiver to begin with. most people that work with ill people do so because it's a calling. it takes a lot of patience, training and more sympathy/empathy than most people have. and those people get to go home at the end of their shift.

dealing with someone who is a type A personality that is bitter because they've lost their independence is demanding. they lash out at those taking care of them because there is no one else for them to vent at. not all old people are nice and sweet. some are miserable and horrible: if they were dsyfunctional and mentally unstable when they were young they are even worse later.
 
2013-03-06 03:22:24 AM  

log_jammin: Bigdogdaddy: If someone was trapped in a burning car and I would put my life in danger should I be required to drag them out?

I would say you have a legal as well as a moral obligation to do more than just watch.


that's not true.

/wee, this is fun
//you might have an obligation to try to get help, but none to put your own life in danger.
///thanks for playing
 
2013-03-06 03:22:41 AM  

The more you eat the more you fart: You're a medic. Not a nurse. You do not have the level of medical training that I do. And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective. You, as a medic, are not licensed to make this determination. I am.


images.encyclopediadramatica.se

Yes I can, and I have done so many times. I still have to consult with a physician, just like you do, but I can decide myself if the 95 year old demetia patient who has been down for 15 minutes without CPR (and had the smoothest asystole I've ever seen) needs to have a resucitation attempt or not.
And yes, I've successfully resuscitated a 91 year old because they didn't have a DNR, knowing that they'd die within a few hours anyway.
I've been with hundreds of people at their deaths. That's why I'm not afraid and can respect another persons wishes.


No log_jammin. She doesn't have a legal duty to act, nurse or not. She was stupid to say she is a nurse either way. I'm going with overzealous staffer and she's not really a nurse, but it made her feel important to say that she was. The second part doesn't even make sense. The dispatcher attempted to get the caller to do CPR. That's all they have to do. I did find a link to the call but I haven't listened yet.


lyanna96: True. Had just this exact thing happen Monday. 100yo, coded him for 3 hours, broke every rib. Made it ICU to code 2 more times before finally passing. Life would have sucked if they live r/t rib fractures, pain, brain anoxia. Difference was that family insisted on all measures to make the pt live even if they were miserable doing it.


That's the conversation that needs to come out of this. Now the family has a huge bill for what was a futile effort to begin with, but hey, profits right?
 
2013-03-06 03:23:46 AM  
And let me make the distinction that an 87 year old is not the same as a 37 year old or 67 year old.....
 
2013-03-06 03:23:53 AM  

hardinparamedic: me texan: Putting someone in the rescue position is not performing CPR.

Assisting for ineffective respirations, and identifying agonal breathing is not placing someone in the rescue position.

FirstNationalBastard: Of course they're happy.

Odds are, Grandma was a near-vegetable that had drained them both emotionally and financially to the brink of ruin because her body was just too stubborn to die even though the mind had checked out long ago. But, unlike if a beloved family pet's quality of life had degraded to almost nothing, no one could take Grandma to the Doctor and give her a nice sleepytime shot to put her out of her misery, because with humans, life is all about quantity, not quality.

Unless that woman had a valid, signed DNR, or had a Doctor at her side telling her not to start CPR, that does not matter. She had a legal duty, if employed as a nurse for that facility, to act in the standard of care with basic competency, per the California Board of Nursing.

Facility policies do not trump State Nursing laws.


Well the odd part is in calling 911.  If she's DNR, there's no calling 911, right?
 
2013-03-06 03:23:57 AM  

The more you eat the more you fart: In the event of an unwitnessed patient or resident cardiac arrest, the nurse is expected to immediately conduct a sequential assessment of the patient or resident and to initiate CPR without delay unless there is a valid DNR order or allof the following clinical signs are present:


you do realize that says the nurse must perform CPR unless there is a DNR or the patient is dead, don't you?
 
2013-03-06 03:26:42 AM  

hardinparamedic: ladyfortuna: Where's Bronymedic, he should be in this discussion..

here. :P


Ah.  Withdrawal symptoms.
 
2013-03-06 03:26:58 AM  

andychrist420: that's not true.

/wee, this is fun
//you might have an obligation to try to get help, but none to put your own life in danger.
///thanks for playing


I was under the impression that getting help is more than standing there and watching. Thanks for setting me straight.
 
2013-03-06 03:27:44 AM  
I have a friend who works in a nursing home.  She told me that DNRs are great, and it really doesn't matter if they have a DNR or not when it comes to major events.  She told me that basically, at some point, everyone in the nursing home (not all at once) is considered 'a slow walk'.  Meaning, that person or the family may want every possible step taken to extend that old person's life just a little bit longer, but the nursing staff doesn't have an unlimited amount of medical supplies, so if someone is bad health to begin with, and not a DNR, and something like a heart attack hits, there is no rushing to their room.  It's going to be a slow stride to the room, hoping that the patient has died before the nursing staff has gotten there.  They'd rather use medical supplies on those who have a life expectancy longer than just a couple of days.

I have only one professional experience dealing with the elderly and their end of life care.  I was working Emergency Response for a home health service.  I worked in a small call center on weekend nights.  Basically, I was the only one there because there really wasn't the phone traffic on Friday and Saturday night between midnight and 5am (and being the only one there, after watching the sexual harassment video, I called my boss to let her know and followed it up with "Just who the hell could I possibly sexually harass?").  Most annoying call was a woman who was in tears.  Her great grandmother had died and was calling to cancel the service.  She blamed us for not doing enough to save her great grandmother.  I pulled up the file in the system to make note that the client had died.  As I was making notes she kept biatching at me that my company failed to keep her great grandmother alive.  I asked her: "Your great grandmother was 102 years old and has a long list of medical problems, I'm not sure anyone could have kept her alive any longer."  Then I asked her if she should be some what relieved that her great grandmother was no longer in any form of pain.  She called me a heartless bastard who was an employee of a heartless corporation.  I told my boss that.  She said "I don't care.  The contract ended because the client died and the client's family hasn't gotten to the acceptance stage of acceptance.  You didn't cause that contract to expire and it's going to be a few decades before that woman will qualify for our services, long enough for no one to care about what you asked her."
 
2013-03-06 03:28:30 AM  
The more you eat the more you fart: hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

"And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

Except that you are WRONG.

You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am".


WRONG!!!!

A lowly (Since that's the way you feel) Paramedic and a Nurse work under a Doctors supervision.

Only a Doctor can say when to stop efforts.
 
2013-03-06 03:29:21 AM  

Maximer: The more you eat the more you fart:

Also, I would suggest hardinparamedic stops trying to speak about the state board of nursing like he actually has authority to do so, or that he even knows wtf their rules are...considering that he isn't even a nurse.

One of the most annoying aspects of the medical profession is that every profession (i.e. doctor, RN, LPN, CNA, PA, EMT, Paramedic, etc.) think they know better or know more than every other profession in the field.  They also all seem to know how to do each other's jobs.

The medical profession is a place of huge egos unfortunately.  It's one of the major drawbacks to me.


Same for me.  However, I don't stand around at the scene of auto accidents and tell the EMT's and paramedics what to do (even though I very well COULD being as I "out-rank" them according to state law as I am a level II-A trauma nurse)...so having some random "medic" on the internet who went to school at some vocational or technical college for 12 months tell me what the laws are that govern MY profession is nothing short of laughable.  Translation:  if I wanted to be a dick...if I rolled up on to hardinparamedic's accident scene, even if I was in TN where he is, and said "You WILL do this..." etc he would be legally required to follow MY order...as TN would respect my trauma nurse status, and he would be held legally responsible for disobeying MY order as a medical professional..NOT the other way around.

I have a master's plus 30 in my field.  No medic will EVER be able to "order" me to do anything of a medical nature.  Period.

ALL that being said...working with dumbasses with huge egos, or the people who play "heroic white knight" when a situation doesnt call for it is HIGHLY annoying.

the woman died of a stroke.  end of story.  All the CPR by all the white knights in the world wouldnt have saved her.  She was dead when she hit the ground..her respiratory center in her brain stem just hadn't gotten the message yet.
 
2013-03-06 03:29:45 AM  

Relatively Obscure: thorthor: Woman should have had DNR.

But didn't.


It's just that simple.  We wouldn't even be discussing this if she had a DNR order on file.  Instead, we have a situation where a 911 dispatcher was doing everything they could to attempt to help save a person's life with useless drones on the other end of the phone simply quoting policy.  The bottom line is that it doesn't matter what the caller was with regard to profession, what shocks people is their callous indifference to the situation.  I could side with the staff if they were offering a medically sound rebuttal during the conversation, but they didn't.  They didn't care about anything but policy.  These are people who should be working with inanimate objects, which, I suppose, is what they ended up with.
 
2013-03-06 03:30:01 AM  

cretinbob: No log_jammin. She doesn't have a legal duty to act, nurse or not.


you said a nurse can only practice under a physician license and the only reason I can see you making that point is if you were trying to say she couldn't legally preform CPR since she wasn't under a physicians license at the time. is that what you were trying to say? if not please explain why you brought that up.
 
2013-03-06 03:30:22 AM  

Relatively Obscure: thorthor: Woman should have had DNR.

But didn't.


So punish her negligence and disregard her family so someone can be sued and possibly lose her job. Yep that's better. Did you even read my entire comment? Are you a farking ambulance chaser? Have you ever sat with a terminally ill or extremely elderly and frail human who states repeatedly "I just want to die/end the pain?" Let me know if you have and you still think you are right in defending a f*cking piece of paper over the individuals or families wishes.
This godamn belief that all life is sacred and must be saved, circumstances aside, is frankly the opinion of a mental deficiant.
 
2013-03-06 03:32:44 AM  

The more you eat the more you fart: so having some random "medic" on the internet who went to school at some vocational or technical college for 12 months tell me what the laws are that govern MY profession is nothing short of laughable.


oh wow!

please. quit your job immediately. you don't belong there.
 
2013-03-06 03:33:17 AM  
Yes I can, and I have done so many times. I still have to consult with a physician, just like you do,


Are you stupid or do you just not read well?

I do NOT have to consult with a physician to make that determination.  You are incorrect, and lack appropriate knowledge to give opinion on my job.  Nice try though.
 
2013-03-06 03:34:18 AM  
I'm not surprised that this happened in Bakersfield.
 
2013-03-06 03:35:14 AM  
The more you eat the more you fart:

Same for me.  However, I don't stand around at the scene of auto accidents and tell the EMT's and paramedics what to do (even though I very well COULD being as I "out-rank" them according to state law as I am a level II-A trauma nurse)...so having some random "medic" on the internet who went to school at some vocational or technical college for 12 months tell me what the laws are that govern MY profession is nothing short of laughable.  Translation:  if I wanted to be a dick...if I rolled up on to hardinparamedic's accident scene, even if I was in TN where he is, and said "You WILL do this..." etc he would be legally required to follow MY order...as TN would respect my trauma nurse status, and he would be held legally responsible for disobeying MY order as a medical professional..NOT the other way around.

I have a master's plus 30 in my field.  No medic will EVER be able to "order" me to do anything of a medical nature.  Period.

ALL that being said...working with dumbasses with huge egos, or the people who play "heroic white knight" when a situation doesnt call for it is HIGHLY annoying.

the woman died of a stroke.  end of story.  All the CPR by all the white knights in the world wouldnt have saved her.  She was dead when she hit the ground..her respiratory center in her brain stem just hadn't gotten the message yet.


Yep, pretty much this.
 
2013-03-06 03:35:27 AM  

The more you eat the more you fart: Are you stupid or do you just not read well?


he obviously must be one of those people with a huge ego. unlike you of course. where does that lowly peon get off disagreeing with a NURSE of all people! he should know his place.
 
2013-03-06 03:35:46 AM  

CBFLATLINE: The more you eat the more you fart: hardinparamedic: The more you eat the more you fart: REALLY?!

The family's response to the media "outrage"....

"And, as someone who has saved "hundreds of lives", you should know that the only legally and ethically acceptable reasons to withhold lifesaving intervention from a patient is if they have a signed DNR order, or you have a physician telling you to.

Except that you are WRONG.

You're a medic.  Not a nurse.  You do not have the level of medical training that I do.  And legally, I am able to determine whether or not lifesaving measures should be taken or not...or whether or not they would be effective.  You, as a medic, are not licensed to make this determination.  I am".

WRONG!!!!

A lowly (Since that's the way you feel) Paramedic and a Nurse work under a Doctors supervision.

Only a Doctor can say when to stop efforts.


INCORRECT.

DAMN there are some ignorant farkers on here...
 
2013-03-06 03:37:47 AM  

log_jammin: The more you eat the more you fart: Are you stupid or do you just not read well?

he obviously must be one of those people with a huge ego. unlike you of course. where does that lowly peon get off disagreeing with a NURSE of all people! he should know his place.


Having an ego, and correcting someone REPEATEDLY who pretends to know what they are talking about even when they are clearly wrong are not the same things.

Nice try.
 
2013-03-06 03:39:09 AM  
Frankly, if I ever roll by an accident scene, unless there seems to be a child or someone in severe stress, before EMS has arrived I just keep on going.  I know many people will think that I'm an asshole, but honestly, most people in the medical profession are like that.  There's just too much risk and liability to helping someone when not on the job.

In nursing school they actually highly recommended that we do not stop and help on the scenes of an accident because of the risk associated with it.  It's quite sad, but maybe we should have a look at our legal system?
 
2013-03-06 03:41:15 AM  

log_jammin: The more you eat the more you fart: Are you stupid or do you just not read well?

he obviously must be one of those people with a huge ego. unlike you of course. where does that lowly peon get off disagreeing with a NURSE of all people! he should know his place.


Everyone has the right (and moral obligation) to disagree with someone of higher medical training than themselves when they feel it puts the patient at risk.  However, my main gripe is that sometimes they go overboard with it.  The blame can be equally spread.
 
2013-03-06 03:43:11 AM  

Maximer: It's quite sad, but maybe we should have a look at our legal system?


Yeah, we'll have some lawyers get right on that.
 
2013-03-06 03:43:47 AM  

Ishidan: Hey whaddaya know, another article showing the actual TRANSCRIPT of the call.
http://www.bakersfieldcalifornian.com/local/breaking-news/x738926964 /E xcerpts-from-the-Glenwood-911-call

So, speaking as-as I've mentioned-a nonlawyer, nonmedic J .Random Goon, here are facts I can glean.

1.  The patient collapsed in a public area in full view of multiple staff members and multiple other patients, and had a witnessed respiratory arrest during the course of the call.
2.  The caller (herein referred to as "caller", not "nurse", for reasons soon to be explained) promptly called for both 911 support and her boss,  as well as other coworkers within screaming distance.
3.  During the course of the call, the caller identified herself as a "nurse", but without using a proper rank name such as LPN, RN, RNA, etc.  Therefore we cannot determine the caller's licensure status.
4.  During the course of the call, the caller was not aided by ANY other facility employee within sight of the incident, and was directly ordered by her supervisor not to obey Dispatcher commands to start CPR-not for the least of which, no doubt, because of the resulting bone-crushing sights and sounds and their results on the other clients.  Facility policy was clearly not to turn "fell down, passed out, carted away by ambulance, never came back" into "fell down, passed out, nurse mashed her flat, then ambulance came."
5.  The Dispatcher attempted to order the Caller to have ANY passerby-regardless of training in CPR or other basic lifesaving, medical licensure, legal connection to the facility, or otherwise-begin CPR via telephone instruction.

Discuss.


Well, that's kinda what we're doing.

You missed one thing:  the nurse, Colleen, was the third employee to whom that 911 dispatcher was passed.  She didn't place the call.
 
2013-03-06 03:43:50 AM  

Maximer: Frankly, if I ever roll by an accident scene, unless there seems to be a child or someone in severe stress, before EMS has arrived I just keep on going.  I know many people will think that I'm an asshole, but honestly, most people in the medical profession are like that.  There's just too much risk and liability to helping someone when not on the job.

In nursing school they actually highly recommended that we do not stop and help on the scenes of an accident because of the risk associated with it.  It's quite sad, but maybe we should have a look at our legal system?


I stop at every accident that I see.  Yes, it opens me up to liability that is greater than your average LPN or BSN due to my trauma nurse status, but I can't just roll by.  I have seen some awful things for sure, but have 23 roadside saves to my credit...people who would have, without any doubt, be dead if it were not for immediate medical intervention by someone who knew what they were doing.

I agree about the legal system.  I've ALWAYS said since my early days as an LPN that nursing is one of the FEW professions where literally EVERYONE is out to fark you.  doctors, families, patients, OTHER NURSES, CNA's, janitors, etc.  EVERYONE actively tries to find how "that nurse" farked up and nail them to the wall for it.

Still, I LOVE my job, and wouldnt EVER do anything else.
 
2013-03-06 03:44:08 AM  

The more you eat the more you fart: Having an ego, and correcting someone REPEATEDLY who pretends to know what they are talking about even when they are clearly wrong are not the same things.


as someone who has corrected you repeatedly in this thread, trust me, I know the difference.
 
2013-03-06 03:45:03 AM  
"The medical profession is a place of huge egos unfortunately. It's one of the major drawbacks to me".

Pot, meet kettle.
 
2013-03-06 03:45:25 AM  

Maximer: (and moral obligation)


according to some in this thread, there is no such thing.
 
2013-03-06 03:48:01 AM  

The more you eat the more you fart: nursing is one of the FEW professions where literally EVERYONE is out to fark you. doctors, families, patients, OTHER NURSES, CNA's, janitors, etc. EVERYONE actively tries to find how "that nurse" farked up and nail them to the wall for it.


Have you ever considered the possibility that it's not everyone else, and that it may just be you that is the problem? because going by your comments here, I'd say that would be a good bet.
 
2013-03-06 03:48:05 AM  

log_jammin: Bigdogdaddy: If someone was trapped in a burning car and I would put my life in danger should I be required to drag them out?

I would say you have a legal as well as a moral obligation to do more than just watch.


In some states, but not all, you have a legal duty to notify emergency services of an emergency before you break out the marshmallows.

Your morality does not oblige me to do anything. So we tell Christians here on Fark.
 
2013-03-06 03:48:11 AM  
The more you eat the more you fart:

Still, I LOVE my job, and wouldnt EVER do anything else.

Yep, this.  Although, we all have our rough days.  I work in NICU.  Lost one today.  Although, this is not completely unexpected in NICU it always sucks when it happens.

So, of course, late-night farking is called for... and of course... a nursing thread.  Yay!
 
2013-03-06 03:49:59 AM  

BarkingUnicorn: Your morality does not oblige me to do anything. So we tell Christians here on Fark.


hence my "so I'll add you to the "If I'm not legally obligated then I can't be bothered" camp" comment.
 
2013-03-06 03:50:57 AM  

Maximer: log_jammin: The more you eat the more you fart: Are you stupid or do you just not read well?

he obviously must be one of those people with a huge ego. unlike you of course. where does that lowly peon get off disagreeing with a NURSE of all people! he should know his place.

Everyone has the right (and moral obligation) to disagree with someone of higher medical training than themselves when they feel it puts the patient at risk.  However, my main gripe is that sometimes they go overboard with it.  The blame can be equally spread.


Agreed.  I have nearly gotten fired for loudly disagreeing with a physician over a situation I KNEW was bad, and the physician wasn't hearing it.

The short version:  She had given a patient a prescription of an SSRI without noticing the patient was ALREADY taking prozac.  Three days later, the woman was running fever, having muscle spasms, etc.

I took it to the doctor, and told her I suspected the patient of having seratonin syndrome.  The physician disagreed, and told me she thought the woman had the flu.

5 hours later, after her second seizure, I went to the medical director with my complaint about the physician not listening.  They ran some tests, and confirmed that the patient indeed had seratonin syndrome, which is usually fatal.

So yeah, I completely agree with a bit of "checks and balances", but taken too far, it become just silly...like a 911 dispatcher telling a nurse to do CPR on a patient that died of a stroke because the medic doesnt possess the medical knowledge to realize that it wouldnt make a bit of difference at all.

the dispatcher was reading off a script.  Plain and simple.  Its the medical version of tech support from someone in India reading a script that tells you to turn off your computer and wait 30 seconds before turning it back on.  The person who knows better on the other end is going "Its NOT gonna fix the problem you dumbfark!"  Same thing in this situation..except its medical in nature.
 
2013-03-06 03:52:29 AM  

CBFLATLINE: "The medical profession is a place of huge egos unfortunately. It's one of the major drawbacks to me".

Pot, meet kettle.


He is completely wrong, as well, with that "Trauma Nurse" bullshiat, but ill be happy to post the applicable Tennessee code when I get on a desktop.
 
2013-03-06 03:53:04 AM  

log_jammin: andychrist420: that's not true.

/wee, this is fun
//you might have an obligation to try to get help, but none to put your own life in danger.
///thanks for playing

I was under the impression that getting help is more than standing there and watching. Thanks for setting me straight.


You're welcome.  And I never said do nothing.  That was you projecting your pseudo outrage against my opinion.  If you call 911, flag down a passing motorist, whatever, your (non-legal) obligation to get help has been met.  At no time are you under any legal obligation to put your life and well being in danger to help another person.  But go ahead, tell me what an awful person I am.

/going to bed
//you should too.  you're not making sense
 
2013-03-06 03:53:12 AM  

Maximer: The more you eat the more you fart:

Still, I LOVE my job, and wouldnt EVER do anything else.

Yep, this.  Although, we all have our rough days.  I work in NICU.  Lost one today.  Although, this is not completely unexpected in NICU it always sucks when it happens.

So, of course, late-night farking is called for... and of course... a nursing thread.  Yay!


more power to you...I cant do NICU.  It's bad enough when we get an MVA with a little kid involved as it is...

as a pediatrician once told me "If you work in the NICU, its not a question of IF you will get sued...its WHEN and how often."
 
2013-03-06 03:54:24 AM  

hardinparamedic: You're missing the point. By state and federal law, you do not get to make that decision. That patient, through his/her advanced directives and DNR, and a Physician who can justify the witholding of resuscitative care is the only ones who can do so.


You mean when she in, by accounts, sound mind, chose to live there and signed her own lease and made her own decision to live there having been explained and had a chance to review the policies of the apartment building?  I too would have a difficult time standing by but it wasn't my choice, it wasn't the "nurse"s choice and it wasn't yours.

From the family's statement it sounds like she made her intentions clear and everyone involved respected it.  I intend to respect her choice and the family's privacy in this time of grief as well and move on.

/Feel free to call me every name in the book and argue to your heart's content.  I won't be returning to this thread.
 
2013-03-06 03:54:31 AM  

log_jammin: The more you eat the more you fart: Having an ego, and correcting someone REPEATEDLY who pretends to know what they are talking about even when they are clearly wrong are not the same things.

as someone who has corrected you repeatedly in this thread, trust me, I know the difference.


You haven't corrected me on anything, dipshiat.
 
2013-03-06 03:55:19 AM  

Maximer: The more you eat the more you fart:

Also, I would suggest hardinparamedic stops trying to speak about the state board of nursing like he actually has authority to do so, or that he even knows wtf their rules are...considering that he isn't even a nurse.

One of the most annoying aspects of the medical profession is that every profession (i.e. doctor, RN, LPN, CNA, PA, EMT, Paramedic, etc.) think they know better or know more than every other profession in the field.  They also all seem to know how to do each other's jobs.

The medical profession is a place of huge egos unfortunately.  It's one of the major drawbacks to me.


Beware of True Believers in anything:  Christianity, atheism, social responsibility, vegetarianism, motherhood, whatever.  They're all utterly convinced of their righteousness and everyone else's ignorance.
 
2013-03-06 03:55:23 AM  

andychrist420: That was you projecting your pseudo outrage against my opinion.


actually no. you responded to a comment not directed towards you.
 
2013-03-06 03:55:41 AM  

hardinparamedic: CBFLATLINE: "The medical profession is a place of huge egos unfortunately. It's one of the major drawbacks to me".

Pot, meet kettle.

He is completely wrong, as well, with that "Trauma Nurse" bullshiat, but ill be happy to post the applicable Tennessee code when I get on a desktop.


Oh really?  there are SEVERAL nurses in this thread that I'm MORE than sure could vouch for what I said being absolutely true.

"trauma nurse"?  you do realize such a thing exists right? lmao!
 
2013-03-06 03:59:06 AM  
The more you eat the more you fart:

more power to you...I cant do NICU.  It's bad enough when we get an MVA with a little kid involved as it is...

as a pediatrician once told me "If you work in the NICU, its not a question of IF you will get sued...its WHEN and how often."


Yeah, NICU definitely isn't for everyone.  And, after a while, all the loses start to take a toll.  I don't know how much longer I'll be doing it.  I think I'm getting to the end of my stretch on it... but who knows?  It's the ones like today where we were making good movement then "boom", just like that, we lose them.  *sigh*

And, unfortunately, you're right about the "getting sued" thing.  I've been lucky, but it's going to happen.  What a lot of people don't understand is that NICU patients are the weakest of the weakest and can go south on a second's notice.  Everyone in NICU is fully committed (you have to be if you want to work there) but medicine is as much an art as it is a science and sometimes the art doesn't work out exactly as planned.  But, of course, a lawsuit is in order.  It pushes a lot of great and competent people out of the field.
 
2013-03-06 03:59:23 AM  

The more you eat the more you fart: You haven't corrected me on anything, dipshiat.


remember when you said that putting her in a facility without nursing staff was the same thing as a DNR? and implied that CPR is the same as "prolonged intervention"? boy I do. good times.
 
2013-03-06 04:02:43 AM  

hardinparamedic: ladyfortuna: Where's Bronymedic, he should be in this discussion..

here. :P


Aha! I knew I greened you for a reason.

Don't you love Fark when a subject matter expert (like yourself) has to respond to morans with a degree from BarcaLounger U who watched too much ER?

This country is infected with people with more opinion than smarts.
 
2013-03-06 04:04:19 AM  

hardinparamedic: CBFLATLINE: "The medical profession is a place of huge egos unfortunately. It's one of the major drawbacks to me".

Pot, meet kettle.

He is completely wrong, as well, with that "Trauma Nurse" bullshiat, but ill be happy to post the applicable Tennessee code when I get on a desktop.


Ok..HERE is my ego:

sorry, but I'm not gonna take medical advice from some guy who barely made it out of high school and went to a vocational school to become a "medic".

I have a master's +30 in my field, and am licensed by my state as a "Trauma Nurse, MSN, Level 2-A" which means I out-rank you in skill, knowledge, and practical application by an order of magnitude.

dont act like you know better than I do what my job is, because you dont.  You dont even have basic anatomy/physiology classes under your belt for your "medic" status.

It's extremely rare for me to pull out the "you are ignorant" card, but in YOUR case, this warrants it.

YOU trying to tell ME that you know better than I do is like a radio shack employee trying to tell a nuclear engineer that they know more about building a nuclear bomb because they have minimal experience with electronics.

You need a reality check.
 
2013-03-06 04:05:21 AM  

log_jammin: The more you eat the more you fart: You haven't corrected me on anything, dipshiat.

remember when you said that putting her in a facility without nursing staff was the same thing as a DNR? and implied that CPR is the same as "prolonged intervention"? boy I do. good times.


No..I dont.  because I never said EITHER of those things.
 
2013-03-06 04:07:00 AM  

log_jammin: Maximer: (and moral obligation)

according to some in this thread, there is no such thing.


There is, but it applies only to the person who holds the moral tenet.

Or shall we let employers deny birth control to employees?  You're doing the same farking thing that you deplore in the Catholic Church, Hobby Lobby, et. al.
 
2013-03-06 04:08:26 AM  

Maximer: The more you eat the more you fart:

more power to you...I cant do NICU.  It's bad enough when we get an MVA with a little kid involved as it is...

as a pediatrician once told me "If you work in the NICU, its not a question of IF you will get sued...its WHEN and how often."

Yeah, NICU definitely isn't for everyone.  And, after a while, all the loses start to take a toll.  I don't know how much longer I'll be doing it.  I think I'm getting to the end of my stretch on it... but who knows?  It's the ones like today where we were making good movement then "boom", just like that, we lose them.  *sigh*

And, unfortunately, you're right about the "getting sued" thing.  I've been lucky, but it's going to happen.  What a lot of people don't understand is that NICU patients are the weakest of the weakest and can go south on a second's notice.  Everyone in NICU is fully committed (you have to be if you want to work there) but medicine is as much an art as it is a science and sometimes the art doesn't work out exactly as planned.  But, of course, a lawsuit is in order.  It pushes a lot of great and competent people out of the field.


Well, you have MY respect for sure.

I agree, lawsuits DO push a lot of good people out.

I had to do a rotation in the NICU, and was actually surprised how FAST those little kiddos can go south.  From "juuust fine" to "there's nothing we can do" in seconds...literally.

I already know...I'm not cut out for it.  I'll stick to the ER/trauma department.
 
2013-03-06 04:09:18 AM  

cretinbob: lyanna96: True. Had just this exact thing happen Monday. 100yo, coded him for 3 hours, broke every rib. Made it ICU to code 2 more times before finally passing. Life would have sucked if they live r/t rib fractures, pain, brain anoxia. Difference was that family insisted on all measures to make the pt live even if they were miserable doing it.

That's the conversation that needs to come out of this. Now the family has a huge bill for what was a futile effort to begin with, but hey, profits right?


No.  Not profits.  (See earlier post in original article about my opinion on this attitude.)

The MDs kept asking the family if they could stop trying to resuscitate, the family continually insisted they continue.
 
2013-03-06 04:09:43 AM  

The more you eat the more you fart: log_jammin: The more you eat the more you fart: You haven't corrected me on anything, dipshiat.

remember when you said that putting her in a facility without nursing staff was the same thing as a DNR? and implied that CPR is the same as "prolonged intervention"? boy I do. good times.

No..I dont.  because I never said EITHER of those things.


02:17:35 AM
 
2013-03-06 04:11:28 AM  

log_jammin: BarkingUnicorn: Your morality does not oblige me to do anything. So we tell Christians here on Fark.

hence my "so I'll add you to the "If I'm not legally obligated then I can't be bothered" camp" comment.


People do many things without being legally obliged to do them.  They do things because things make them feel good.
 
2013-03-06 04:11:47 AM  

BarkingUnicorn: Or shall we let employers deny birth control to employees?


So if we say there is a moral obligation to try to save someones life who is dieing in front of us, we must also say it's ok for employers to deny birth control?

really?
 
2013-03-06 04:13:34 AM  
pics2.city-data.com
Armpit of the State - Bakersfield
http://www.youtube.com/watch?v=LB9UO4QT2Y8

/hotter than hell
 
2013-03-06 04:14:58 AM  

BarkingUnicorn: People do many things without being legally obliged to do them. They do things because things make them feel good.


when my newborn woke up at 3 am crying and with a shiatty diaper, I didn't get up and change him and feed him because it "felt good" or because I wanted to. I did it because it was the right thing to do.

People don't help others just because it benefits themselves.
 
2013-03-06 04:16:05 AM  

log_jammin: The more you eat the more you fart: log_jammin: The more you eat the more you fart: You haven't corrected me on anything, dipshiat.

remember when you said that putting her in a facility without nursing staff was the same thing as a DNR? and implied that CPR is the same as "prolonged intervention"? boy I do. good times.

No..I dont.  because I never said EITHER of those things.

02:17:35 AM


That's weird bc I never said its the same as a DNR, not did I ever state that cpr is a prolonged intervention.

Let me explain this to you SLOWLY so you will understand:

the woman IS a nurse...meaning she has a license.  HOWEVER, she is not employed at the facility AS a nurse.

that means, she is NOT covered or even ALLOWED to act as a nurse in that facility, because as an LPN or RN, there is no DOCTOR in the facility for her to practice under.

Therefore, the fact that she holds a nursing license is irrelevant, and the rules of the state board of nursing DO NOT APPLY TO HER IN THIS SITUATION BECAUSE SHE WASN'T EMPLOYED AS A NURSE BY THE FACILITY AND THERE IS NOT PHYSICIAN OVER HER....making it ILLEGAL for her to practice nursing there, despite the fact that she has a license.

WTF is wrong with you that you can't comprehend this?!?!?!?!

Dumbass motherfarkers and your inability to comprehend because you dont know how the nursing profession actually farking WORKS because you ARENT A NURSE.
 
2013-03-06 04:16:29 AM  

Torion!: [pics2.city-data.com image 422x359]
Armpit of the State - Bakersfield
http://www.youtube.com/watch?v=LB9UO4QT2Y8

/hotter than hell


Well, at least there's something everyone can agree upon.
 
2013-03-06 04:17:34 AM  

log_jammin: andychrist420: That was you projecting your pseudo outrage against my opinion.

actually no. you responded to a comment not directed towards you.


Except you quoted me, so it was directed towards me.  I made a comment that your statement was wrong, and you decided to make an assumption.  Whether it was directed to me or not is irrelevant.  Is this a "speak only when spoken to" forum?  Didn't know I was in the presence of royalty.
 
2013-03-06 04:18:22 AM  

log_jammin: BarkingUnicorn: Or shall we let employers deny birth control to employees?

So if we say there is a moral obligation to try to save someones life who is dieing in front of us, we must also say it's ok for employers to deny birth control?

really?


If you don't want to be a hypocrite, yes.
 
2013-03-06 04:19:12 AM  

andychrist420: log_jammin: andychrist420: That was you projecting your pseudo outrage against my opinion.

actually no. you responded to a comment not directed towards you.

Except you quoted me, so it was directed towards me.  I made a comment that your statement was wrong, and you decided to make an assumption.  Whether it was directed to me or not is irrelevant.  Is this a "speak only when spoken to" forum?  Didn't know I was in the presence of royalty.


You aren't.  He's just one DUMB motherfarker.  Arguing with him is like banging your head on the wall....he too stupid to realize HOW stupid he is.
 
2013-03-06 04:22:25 AM  
We are having the opposite of this story around here. Grandpa is 88, had leukemia, and is refusing chemo. Most of the family is harping at him about how selfish they think he is, trying to convince him to receive treatment. Grandpa says, "If it's my time, let me go. Don't torture me on the way out." They all roll their eyes and talk to him like he's an infant. I'm on team Grandpa. It's the end of HIS life; let him decide. Much like the woman who died in TFA. Her family indicated that this is what she wanted.
 
2013-03-06 04:22:25 AM  

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.


Though, wouldn't signing the agreement, of which all parties were aware , and accepting of the facilities policy not to perform CPR, be a tacit directive?  Not familiar with the legalities, just curious.
 
2013-03-06 04:24:51 AM  

msbav8r: 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.

Though, wouldn't signing the agreement, of which all parties were aware , and accepting of the facilities policy not to perform CPR, be a tacit directive?  Not familiar with the legalities, just curious.


YES.

Assisted living is NOT a nursing home.  Read my previous statement as to WHY the woman on the 911 tape isn't gonna be found guilty.

EVERYONE here who is a nurse will get it right away.
 
2013-03-06 04:25:38 AM  

log_jammin: BarkingUnicorn: People do many things without being legally obliged to do them. They do things because things make them feel good.

when my newborn woke up at 3 am crying and with a shiatty diaper, I didn't get up and change him and feed him because it "felt good" or because I wanted to. I did it because it was the right thing to do.

People don't help others just because it benefits themselves.


Did I say "just because?"  You did the right thing because doing right makes you feel good.  Also, leaving babby in shiatty diapers would get you thrown in jail, where you would not feel good  because your spouse ripped you genitals off before you were arrested.

Yes, people help others because it makes them feel good.  And there's nothing wrong with that.  It's the only thing we can completely rely upon to make people help others.  You might not have a spouse, and you might not get caught leaving babby in shiatty diapers.  But the drive to feel good is inescapable.
 
2013-03-06 04:27:07 AM  

andychrist420: Except you quoted me, so it was directed towards me.


seriously. just go to bed like you said you were.
 
2013-03-06 04:27:28 AM  
Okay, I think I started to post this in the earlier thread regarding this story but I think I abandoned that post because I didn't think it was really the same thing, but now it seems it is.

3.bp.blogspot.com

This is actually very similar to an episode of All in the Family.

It was one of the later seasons. Edith was working at the Sunshine Home (a nursing home) and she was with a woman she had made friends with when she died.

She started to get help, but the woman was ready to die and just wanted someone there with her when she did (her family never visited her), so Edith sat by her bed and the woman died peacefully with Edith by her side.

When the dead woman's family found out (the same family that never visited her), they were OUTRAGED and Edith got fired.

Aw, jeez.
 
2013-03-06 04:31:45 AM  

The more you eat the more you fart: making it ILLEGAL for her to practice nursing there, despite the fact that she has a license.


Performing emergency CPR on a dieing woman is not "practicing nursing". I would think with your supposed "23 roadside saves" you would know this.
 
2013-03-06 04:33:19 AM  

log_jammin: The more you eat the more you fart: making it ILLEGAL for her to practice nursing there, despite the fact that she has a license.

Performing emergency CPR on a dieing woman is not "practicing nursing". I would think with your supposed "23 roadside saves" you would know this.


As I've said, if she wasn't practicing nursing then she had no duty to perform CPR against her employer's orders.
 
2013-03-06 04:36:44 AM  

log_jammin: The more you eat the more you fart: making it ILLEGAL for her to practice nursing there, despite the fact that she has a license.

Performing emergency CPR on a dieing woman is not "practicing nursing". I would think with your supposed "23 roadside saves" you would know this.


you really ARE stupid.  Good GOD.

It IS practicing nursing if you are doing so as a matter of course of your job, and since she wasn't employed there as a nurse, and wasn't ACTING as a nurse (because it would be illegal for her to do so), she has no OBLIGATION as a nurse to do CPR as demanded by her board of nursing.

CPR in a hospital = practicing nursing
CPR on the roadside = good samaritan

NOT the same thing, dumbfark.

A layperson cannot be compelled to perform CPR, and since she wasn't acting in the capacity as a nurse, she is a defacto layperson...making her licensed nurse status a non-issue.

seriously..you need to stfu.
 
2013-03-06 04:37:45 AM  

BarkingUnicorn: If you don't want to be a hypocrite, yes.


um no. not even remotely in the same ball park.

BarkingUnicorn: Did I say "just because?"


pretty much. you also go on to pretty much say "just because" in the rest of your post. like in the very next sentence where you say "You did the right thing because doing right makes you feel good."

And I'm telling you i didn't do it because it made me feel good. I did something I didn't want to do because as a new father I had a moral obligation to do something that most definitely didn't make me feel good at all. something that was the exact opposite of what would make me feel good, like going back to sleep in my warm bed. nor was it a case of doing what I didn't want to do because of fear of legal reprisal.
 
2013-03-06 04:38:52 AM  

BarkingUnicorn: log_jammin: The more you eat the more you fart: making it ILLEGAL for her to practice nursing there, despite the fact that she has a license.

Performing emergency CPR on a dieing woman is not "practicing nursing". I would think with your supposed "23 roadside saves" you would know this.

As I've said, if she wasn't practicing nursing then she had no duty to perform CPR against her employer's orders.


YOU are correct.
I keep trying to tell his dumbass that, but for some reason, it isnt sinking in.

Not working as a nurse = not obligated as a nurse.
 
2013-03-06 04:39:23 AM  
Let me point out a few things
1. This is an "Independent living facility.' See that word 'independent?' It's not a nursing home. It's an apartment complex that has a lot of amenities provided such as someone to help you get around your apartment, cook meals and other assistance.
2. The facility does not have 'trained medical staff.' The term 'nurse' is also used for orderlies who provide the sponge baths and change bedpans, note the difference between 'nurse' and 'registered nurse.'
3. If I have a doctorate of physics, and I refuse to render aid to someone has been stabbed, am I guilty of "Professional neglect unbecoming a doctor?" No, because I'm not that kind of doctor. The staff at this facility are not 'that kind of nurse.'
4. A 911 dispatcher does not have the authority to issue orders to anyone. They aren't police officers, they're just highly trained employees at a call center.
 
2013-03-06 04:40:54 AM  

Securitywyrm: Let me point out a few things
1. This is an "Independent living facility.' See that word 'independent?' It's not a nursing home. It's an apartment complex that has a lot of amenities provided such as someone to help you get around your apartment, cook meals and other assistance.
2. The facility does not have 'trained medical staff.' The term 'nurse' is also used for orderlies who provide the sponge baths and change bedpans, note the difference between 'nurse' and 'registered nurse.'
3. If I have a doctorate of physics, and I refuse to render aid to someone has been stabbed, am I guilty of "Professional neglect unbecoming a doctor?" No, because I'm not that kind of doctor. The staff at this facility are not 'that kind of nurse.'
4. A 911 dispatcher does not have the authority to issue orders to anyone. They aren't police officers, they're just highly trained employees at a call center.


I agree with everything except that the 911 dispatchers ARENT "highly trained".

they have AT MOST 6 months at a vocational "college"
 
2013-03-06 04:44:30 AM  

The more you eat the more you fart: making her licensed nurse status a non-issue.


I never said it was. Not once did I say she should have preformed CPR because she was a nurse.

I said she should have preformed CPR because shes a human being watching another human being die in front of her.


The more you eat the more you fart: seriously..you need to stfu.


you're such a pleasant person. no wonder you get along with your colleagues so well.
 
2013-03-06 04:48:15 AM  

The more you eat the more you fart: I agree with everything except that the 911 dispatchers ARENT "highly trained".

they have AT MOST 6 months at a vocational "college"


so you going to shiat on firemen next?
 
2013-03-06 04:50:26 AM  

log_jammin: BarkingUnicorn: If you don't want to be a hypocrite, yes.

um no. not even remotely in the same ball park.

BarkingUnicorn: Did I say "just because?"

pretty much. you also go on to pretty much say "just because" in the rest of your post. like in the very next sentence where you say "You did the right thing because doing right makes you feel good."

And I'm telling you i didn't do it because it made me feel good. I did something I didn't want to do because as a new father I had a moral obligation to do something that most definitely didn't make me feel good at all. something that was the exact opposite of what would make me feel good, like going back to sleep in my warm bed. nor was it a case of doing what I didn't want to do because of fear of legal reprisal.


"Pretty much?" You've changed too many diapers in the middle of the night, dad; it's made you punch-drunk.  All you had to do was re-read my original words, which I left in my reply,  to know that I pretty much did NOT say, "just because."

You wanted two conflicting things:  to stay in your warm bed and to fulfill your moral obligation.  Either would make you feel good (if you can sleep while a babby's crying).  You chose the one that made you feel better; the one that  made you feel the most good.

That is how people always act.  There's no shame in admitting that you're just like everyone else.  Just like Colleen, who had to choose between her job and CPR.
 
2013-03-06 04:51:23 AM  

log_jammin: The more you eat the more you fart: making her licensed nurse status a non-issue.

I never said it was. Not once did I say she should have preformed CPR because she was a nurse.

I said she should have preformed CPR because shes a human being watching another human being die in front of her.


The more you eat the more you fart: seriously..you need to stfu.

you're such a pleasant person. no wonder you get along with your colleagues so well.


1.  the other human being dying infront of her would not have been able to be saved even if she collapsed infront of a neurosurgeon.  she was dead before her body hit the floor, the respiratory center in her brain stem had just not ceased functioning yet.  Doing CPR on her would have been absolutely pointless.  The nurse, who wasn't acting as a nurse at the time, acted appropriately.  end of story.

2.  Actually, my reputation at work is one of being someone that can absolutely be relied upon when the chips are down to make rational, well-informed decisions.  Also, EVERY physician I work with has stated at one time that they hope and pray *I* am on duty should they ever need the trauma center.  Also, I'm known as the guy that gets along with literally everyone...which means my frustration with you is more than likely based upon your refusal to admit that you are too ignorant to make informed opinions about what is going on, but its more about your continued proselytizing as though you actually KNOW what you are talking about when I have proven NUMEROUS times that you are full of shiat.

Translation:  YOU are the common denominator in this. Not me.
 
2013-03-06 04:52:29 AM  

log_jammin: BarkingUnicorn: If you don't want to be a hypocrite, yes.

um no. not even remotely in the same ball park.


The famous first words of a hypocrite!
 
2013-03-06 04:52:35 AM  

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.
 
2013-03-06 04:52:39 AM  

log_jammin: The more you eat the more you fart: I agree with everything except that the 911 dispatchers ARENT "highly trained".

they have AT MOST 6 months at a vocational "college"

so you going to shiat on firemen next?


Firemen dont go around acting like they possess more medical knowledge/skill than a trauma nurse with a master's degree.
 
2013-03-06 04:55:16 AM  

The more you eat the more you fart: BarkingUnicorn: log_jammin: The more you eat the more you fart: making it ILLEGAL for her to practice nursing there, despite the fact that she has a license.

Performing emergency CPR on a dieing woman is not "practicing nursing". I would think with your supposed "23 roadside saves" you would know this.

As I've said, if she wasn't practicing nursing then she had no duty to perform CPR against her employer's orders.

YOU are correct.
I keep trying to tell his dumbass that, but for some reason, it isnt sinking in.

Not working as a nurse = not obligated as a nurse.


I started saying it two days ago, when this story broke.  Therefore I am Hitler. :-)

I also speculated that nursing boards do not require a nurse to do herself harm in order to aid a client; i.e.,get herself fired for insubordination.   Can you shed any light on that?
 
2013-03-06 04:56:19 AM  
Heck, even doctors don't want CPR: RadioLab Bitter End Podcast
 
2013-03-06 04:58:34 AM  

The more you eat the more you fart: would not have been able to be saved even if she collapsed infront of a neurosurgeon. she was dead before her body hit the floor


IIRC someone posted a link earlier thinking that's what the article said, when in actually it said CPR could have made a difference.

http://www.kget.com/news/local/story/Doctor-says-Glenwood-Gardens-re si dent-suffered/-Q89tciw1k2qUGi8Xl8kGQ.cspx

We asked her if CPR would have done any good in this case.
"it could have made a difference. Would it have made a difference in this particular situation? We don't have the answer to that, but have patients survived in a similar situation," said Shain.


so yeah. obviously she was dead when she hit the floor. But even if that were true we only know that now, and is irrelevant when it comes to what happened at the time.

The more you eat the more you fart: The nurse, who wasn't acting as a nurse at the time, acted appropriately. end of story.


well you see, I, and others, disagree with that. In your mind this makes us lesser beings or "white knights" or something for disagreeing with you.

The more you eat the more you fart: Actually, my reputation at work is one of being someone that can absolutely be relied upon when the chips are down to make rational, well-informed decisions.


of course it is sugar. of course it is.
 
2013-03-06 04:58:38 AM  

thorthor: Relatively Obscure: thorthor: Woman should have had DNR.

But didn't.

So punish her negligence and disregard her family so someone can be sued and possibly lose her job. Yep that's better. Did you even read my entire comment? Are you a farking ambulance chaser? Have you ever sat with a terminally ill or extremely elderly and frail human who states repeatedly "I just want to die/end the pain?" Let me know if you have and you still think you are right in defending a f*cking piece of paper over the individuals or families wishes.
This godamn belief that all life is sacred and must be saved, circumstances aside, is frankly the opinion of a mental deficiant.


I said what about any of that?  Oh, nothing.  Still, she didn't, whether she should have or not.  Also, you might want to preview a little more closely before breaking out "mental deficiant" again.
 
2013-03-06 05:01:07 AM  
I owe you an apology , Farts. When I get off this transport ill explaik
 
2013-03-06 05:01:21 AM  

BarkingUnicorn: You wanted two conflicting things: to stay in your warm bed and to fulfill your moral obligation. Either would make you feel good (if you can sleep while a babby's crying). You chose the one that made you feel better; the one that made you feel the most good.


ok man.
 
2013-03-06 05:03:28 AM  

hardinparamedic: I owe you an apology , Farts. When I get off this transport ill explaik


Well, there's a sentence you don't read every day.
 
2013-03-06 05:04:24 AM  

The more you eat the more you fart: Firemen dont go around acting like they possess more medical knowledge/skill than a trauma nurse with a master's degree.


no one claimed to have more medical knowledge or more skill than a trauma nurse with a masters degree. You just seem to operate under the mistaken assumption that a trauma nurse with a masters degree can never misinterpret what someone said or can just be wrong about something.
 
2013-03-06 05:05:00 AM  

TommyymmoT: hardinparamedic: I owe you an apology , Farts. When I get off this transport ill explaik

Well, there's a sentence you don't read every day.


Indeed.  Nice use of "explaik." :-)

Really, hardin seems quite decent, if a bit opinionated.  Fark needs more like him.
 
2013-03-06 05:05:26 AM  

TommyymmoT: hardinparamedic: I owe you an apology , Farts. When I get off this transport ill explaik

Well, there's a sentence you don't read every day.


no doubt. Now i'm curious to know what hes going to explaik.
 
2013-03-06 05:05:38 AM  

BarkingUnicorn: The more you eat the more you fart: BarkingUnicorn: log_jammin: The more you eat the more you fart: making it ILLEGAL for her to practice nursing there, despite the fact that she has a license.

Performing emergency CPR on a dieing woman is not "practicing nursing". I would think with your supposed "23 roadside saves" you would know this.

As I've said, if she wasn't practicing nursing then she had no duty to perform CPR against her employer's orders.

YOU are correct.
I keep trying to tell his dumbass that, but for some reason, it isnt sinking in.

Not working as a nurse = not obligated as a nurse.

I started saying it two days ago, when this story broke.  Therefore I am Hitler. :-)

I also speculated that nursing boards do not require a nurse to do herself harm in order to aid a client; i.e.,get herself fired for insubordination.   Can you shed any light on that?


the nursing boards generally have a list of things they call "best practices" and another list of "Standards of Care".

If she was actually working as a nurse, this would fall under "professional standards of care" and DEPENDING ON WHAT LICENSE she held, could have indeed compelled her to start CPR.

Nurses are OFTEN up against the "employer vs board" wall...and I've known quite a few, including myself, that quit a job because the standards at the facility were in direct conflict with the nursing board's standard of care requirements for my license.

However, nothing has come out about what type of nursing license this lady held.  If she has an RN or BSN, then she is legally able to determine that CPR would not be effective and could withhold performing it even though the standard of care says to do it.

the reason is because ALL state boards of nursing recognize that nurses, especially those with a bachelor's degree or above, possess FAR more knowledge than most people realize they do...and the boards give them GREAT leeway in the application of that knowledge.  As long as they can give a reasonable medical justification for their actions, the state boards WILL side with the nurse.

a BSN (Bachelor of Science in Nursing) is a FIVE and a half year degree.  NOT a four year.  BSN's have VAST amounts of medical knowledge, and are allowed to apply it based upon their skill and knowledge and experience...as long as the nurse can articulate a medically justifiable reason.

More highly trained nurses are allowed even MORE leeway, and sometimes even "fall off" the standards of care list, and the Nurse Practice Act may not apply to them because they are beyond the scope of what the typical nurse is capable of.

a master's degree in nursing is roughtly equivalent to a doctorate's degree in most other subjects, as it takes 9.5 years to obtain....5.5 years for bachelor's in nursing, 2 years clinical practice, 2 years additional university.
 
2013-03-06 05:08:35 AM  

BarkingUnicorn: TommyymmoT: hardinparamedic: I owe you an apology , Farts. When I get off this transport ill explaik

Well, there's a sentence you don't read every day.

Indeed.  Nice use of "explaik." :-)

Really, hardin seems quite decent, if a bit opinionated.  Fark needs more like him.


I never said he wasn't a decent person...

I myself have had to eat crow in occasion.  No one is perfect, and I have made mistakes in the past based upon misinformation.

However, log_jammin is taking ignorance to a whole new level in this thread.
 
2013-03-06 05:09:50 AM  

log_jammin: The more you eat the more you fart: Firemen dont go around acting like they possess more medical knowledge/skill than a trauma nurse with a master's degree.

no one claimed to have more medical knowledge or more skill than a trauma nurse with a masters degree. You just seem to operate under the mistaken assumption that a trauma nurse with a masters degree can never misinterpret what someone said or can just be wrong about something.


Because I'm not the one wrong about this.  YOU are.
 
2013-03-06 05:14:11 AM  

hardinparamedic: I owe you an apology , Farts. When I get off this transport ill explaik



I suspect I know what for, but I assure you I will make no attempt to rub your nose in it.

I have made mistakes myself, and am aware it takes a big person to apologize when a mistake is made.
 
2013-03-06 05:19:48 AM  

The more you eat the more you fart: If she was actually working as a nurse, this would fall under "professional standards of care" and DEPENDING ON WHAT LICENSE she held, could have indeed compelled her to start CPR.

Nurses are OFTEN up against the "employer vs board" wall...and I've known quite a few, including myself, that quit a job because the standards at the facility were in direct conflict with the nursing board's standard of care requirements for my license.


So we're back to whether Colleen's job was nursing.  I can't imagine why a facility that didn't provide nursing care would have  a nursing job.  I surmise that she was a nurse who had a non-nursing job.  It's noteworthy that her employer hasn't specified what her job is.

Will a board discipline a nurse who is in a nursing job for adhering to her employer's standards when they conflict with the board's  standard of care?  Will a board say, "Find another job or lose your license" or something of that sort? Or is that decision up to the nurse?
 
2013-03-06 05:20:18 AM  
The best place for an old decrepit bag is in a bad.
 
2013-03-06 05:23:22 AM  

The more you eat the more you fart: BarkingUnicorn: TommyymmoT: hardinparamedic: I owe you an apology , Farts. When I get off this transport ill explaik

Well, there's a sentence you don't read every day.

Indeed.  Nice use of "explaik." :-)

Really, hardin seems quite decent, if a bit opinionated.  Fark needs more like him.

I never said he wasn't a decent person...

I myself have had to eat crow in occasion.  No one is perfect, and I have made mistakes in the past based upon misinformation.

However, log_jammin is taking ignorance to a whole new level in this thread.


I was merely voicing my opinion of hardin.  You're pretty decent, too.

Log_jammin is a new father, up in the middle of the night changing diapers.  The  brain damage that causes is evident. :-)
 
2013-03-06 05:24:45 AM  

The more you eat the more you fart: hardinparamedic: I owe you an apology , Farts. When I get off this transport ill explaik


I suspect I know what for, but I assure you I will make no attempt to rub your nose in it.

I have made mistakes myself, and am aware it takes a big person to apologize when a mistake is made.


And there we go with the fat jokes...
 
2013-03-06 05:25:44 AM  

The 4chan Psychiatrist: 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.


When you listen to the entire, uncut call, it's completely obvious that nobody on staff made any sort of medical determination as to the status of the patient.  It was a 100% issue of liability even though the 911 dispatcher addressed the liability issue.  The dispatcher was surprisingly cool and understanding, but firm during the entire call.  Whomever up thread referred to her as a "spaz" is a farkin' moron.  The people at the facility chose to be useless.  Nobody should be surprised that people who aren't lobotomized are a bit stunned upon hearing the call.
 
2013-03-06 05:26:48 AM  

log_jammin: The more you eat the more you fart: would not have been able to be saved even if she collapsed infront of a neurosurgeon. she was dead before her body hit the floor

IIRC someone posted a link earlier thinking that's what the article said, when in actually it said CPR could have made a difference.

http://www.kget.com/news/local/story/Doctor-says-Glenwood-Gardens-re si dent-suffered/-Q89tciw1k2qUGi8Xl8kGQ.cspx

We asked her if CPR would have done any good in this case.
"it could have made a difference. Would it have made a difference in this particular situation? We don't have the answer to that, but have patients survived in a similar situation," said Shain.


No, it would not have.  Sorry, but the person in the article is WRONG, and so are you.

so yeah. obviously she was dead when she hit the floor. But even if that were true we only know that now, and is irrelevant when it comes to what happened at the time.

The more you eat the more you fart: The nurse, who wasn't acting as a nurse at the time, acted appropriately. end of story.

well you see, I, and others, disagree with that. In your mind this makes us lesser beings or "white knights" or something for disagreeing with you.


No, it makes you a lesser being for not being able to understand that NOTHING would have saved this woman, even when someone who possesses FAR more knowledge than you do outright TELLS you that it's a fact, and you continue to argue otherwise because it would have made you FEEL better to do CPR regardless.

The more you eat the more you fart: Actually, my reputation at work is one of being someone that can absolutely be relied upon when the chips are down to make rational, well-informed decisions.

of course it is sugar. of course it is.


I see.  so you work in the same hospital that I do?  I can cut and paste from a letter of recommendation from one of the ER nurses I work with if you like...or hell, I'll do it anyhow just to prove the point....names and addresses and such omitted of course:

"

I am happy to recommend <name omitted> as an excellent nurse. Since earning my BSN in 1982, I've had the privilege of working with many excellent nurses but it would be hard to think of a stronger, more competent nurse than <name omitted>. We worked together at Our Lady of the Lake Regional Medical Center in the Adolescent Psych Unit for 2008-2010, and the ED for 2010 to the present.

<name omitted> is intelligent and insightful, having an amazing recall for anatomy and physiology, medications, lab values, and pathology, etc. well beyond the normal scope for even most MSN nurses. He is a hard-worker and a team-player. He frequently went above and beyond helping his coworkers, including the mental health techs, with patient care he was not required to do. For this he was well-liked and appreciated. <name omitted> has an easy-going, friendly manner and connects well with his coworkers and patients. I admired his ability to make meaningful connections with a population of difficult adolescents in the psychiatric unit, and his ability to perform at a level of perfection I have never before witnessed under extraordinarily stressful situations in the emergency department."

suck on THAT.
 
2013-03-06 05:29:35 AM  

BarkingUnicorn: The more you eat the more you fart: If she was actually working as a nurse, this would fall under "professional standards of care" and DEPENDING ON WHAT LICENSE she held, could have indeed compelled her to start CPR.

Nurses are OFTEN up against the "employer vs board" wall...and I've known quite a few, including myself, that quit a job because the standards at the facility were in direct conflict with the nursing board's standard of care requirements for my license.

So we're back to whether Colleen's job was nursing.  I can't imagine why a facility that didn't provide nursing care would have  a nursing job.  I surmise that she was a nurse who had a non-nursing job.  It's noteworthy that her employer hasn't specified what her job is.

Will a board discipline a nurse who is in a nursing job for adhering to her employer's standards when they conflict with the board's  standard of care?  Will a board say, "Find another job or lose your license" or something of that sort? Or is that decision up to the nurse?


She was a nurse in a non-nursing job.  The facility named the position in which she was hired, but i forget what it was...but it was NOT a medical or nursing position.

to your second question:  yes.  the state board WILL tell the nurse they are expected to follow the standards of practice according to the licensing board's requirements...regardless of what the FACILITY says...because the facility isnt the entity responsible for issuing their nursing license..the state board is.
 
2013-03-06 05:30:36 AM  

vrax: The 4chan Psychiatrist: 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.

When you listen to the entire, uncut call, it's completely obvious that nobody on staff made any sort of medical determination as to the status of the patient.  It was a 100% issue of liability even though the 911 dispatcher addressed the liability issue.  The dispatcher was surprisingly cool and understanding, but firm during the entire call.  Whomever up thread referred to her as a "spaz" is a farkin' moron.  The people at the facility chose to be useless.  Nobody should be surprised that people who aren't lobotomized are a bit stunned upon hearing the call.


I think one must be a little out of touch with reality, a.k.a. "lobotomized," to be stunned by the call.  "It aint what we don't know that gets us in trouble, it's what we think we know that aint so," said Mark Twain.
 
2013-03-06 05:34:13 AM  

BarkingUnicorn: vrax: The 4chan Psychiatrist: 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.

When you listen to the entire, uncut call, it's completely obvious that nobody on staff made any sort of medical determination as to the status of the patient.  It was a 100% issue of liability even though the 911 dispatcher addressed the liability issue.  The dispatcher was surprisingly cool and understanding, but firm during the entire call.  Whomever up thread referred to her as a "spaz" is a farkin' moron.  The people at the facility chose to be useless.  Nobody should be surprised that people who aren't lobotomized are a bit stunned upon hearing the call.

I think one must be a little out of touch with reality, a.k.a. "lobotomized," to be stunned by the call.  "It aint what we don't know that gets us in trouble, it's what we think we know that aint so," said Mark Twain.


Well, if you look at it from the perspective that people do shiatty things all the time, then sure.
 
2013-03-06 05:38:31 AM  

The more you eat the more you fart: log_jammin: The more you eat the more you fart: would not have been able to be saved even if she collapsed infront of a neurosurgeon. she was dead before her body hit the floor

IIRC someone posted a link earlier thinking that's what the article said, when in actually it said CPR could have made a difference.

http://www.kget.com/news/local/story/Doctor-says-Glenwood-Gardens-re si dent-suffered/-Q89tciw1k2qUGi8Xl8kGQ.cspx

We asked her if CPR would have done any good in this case.
"it could have made a difference. Would it have made a difference in this particular situation? We don't have the answer to that, but have patients survived in a similar situation," said Shain.

No, it would not have.  Sorry, but the person in the article is WRONG, and so are you.

so yeah. obviously she was dead when she hit the floor. But even if that were true we only know that now, and is irrelevant when it comes to what happened at the time.

The more you eat the more you fart: The nurse, who wasn't acting as a nurse at the time, acted appropriately. end of story.

well you see, I, and others, disagree with that. In your mind this makes us lesser beings or "white knights" or something for disagreeing with you.

No, it makes you a lesser being for not being able to understand that NOTHING would have saved this woman, even when someone who possesses FAR more knowledge than you do outright TELLS you that it's a fact, and you continue to argue otherwise because it would have made you FEEL better to do CPR regardless.

The more you eat the more you fart: Actually, my reputation at work is one of being someone that can absolutely be relied upon when the chips are down to make rational, well-informed decisions.

of course it is sugar. of course it is.

I see.  so you work in the same hospital that I do?  I can cut and paste from a letter of recommendation from one of the ER nurses I work with if you like...or hell, I'll do it anyhow just to prove the point....names and addresses and such omi ...


Never have I seen so much insecurity so openly displayed on Fark.  OTOH, you agree with me that people do things because things make them feel better, so there's that in your favor.

/you wrote that letter, shoved it under her nose, smiled, and said, "Do you disagree with anything? Good; just sign here, then, and thank you for your trouble."
 
2013-03-06 05:40:52 AM  
Insecurity? no.

proof of action?  yes.
 
2013-03-06 05:42:35 AM  
BarkingUnicorn:

Well, for full disclosure, the nurse that wrote that an I dated briefly in 2008. lol
 
2013-03-06 05:45:29 AM  

vrax: BarkingUnicorn: vrax: The 4chan Psychiatrist: 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.

When you listen to the entire, uncut call, it's completely obvious that nobody on staff made any sort of medical determination as to the status of the patient.  It was a 100% issue of liability even though the 911 dispatcher addressed the liability issue.  The dispatcher was surprisingly cool and understanding, but firm during the entire call.  Whomever up thread referred to her as a "spaz" is a farkin' moron.  The people at the facility chose to be useless.  Nobody should be surprised that people who aren't lobotomized are a bit stunned upon hearing the call.

I think one must be a little out of touch with reality, a.k.a. "lobotomized," to be stunned by the call.  "It aint what we don't know that gets us in trouble, it's what we think we know that aint so," said Mark Twain.

Well, if you look at it from the perspective that people do shiatty things all the time, then sure.


"Do shiatty things" is the archetypical job description.  Would it make you feel better to imagine that the same people might have done more for this woman if they weren't at work?  Then do so.
 
2013-03-06 05:53:16 AM  

The more you eat the more you fart: Insecurity? no.

proof of action?  yes.


Not even proof of cutting and pasting action.  But the need to prove yourself is the very definition of insecurity.  I'm getting a kick out of yours.

/you wrote it
//she dumped you
 
2013-03-06 05:54:54 AM  
Actually, she emailed it, but yeah, she dumped me. lol

hey...happens to the best of us :) lol
 
2013-03-06 05:59:46 AM  

The more you eat the more you fart: Actually, she emailed it, but yeah, she dumped me. lol

hey...happens to the best of us :) lol


Yep, even the best of the insecure get dumped.

/She emailed it back to you,  after correcting her name which you misspelled.
 
2013-03-06 06:00:04 AM  

The more you eat the more you fart: log_jammin:

so you going to shiat on firemen next?

Firemen dont go around acting like they possess more medical knowledge/skill than a trauma nurse with a master's degree.


Pardon me if I've lost track of who does what, but which 911 dispatcher in this thread has been making any claims to possess more medical knowledge or skill than you?  I think that jab was more a poke at your casual disdain for dispatchers, medics and from what I've seen in other threads, police officers too.
 
2013-03-06 06:00:59 AM  
How about employing an EMT instead of a "nurse".
 
2013-03-06 06:02:13 AM  

BarkingUnicorn: vrax: BarkingUnicorn: vrax: The 4chan Psychiatrist: 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.

When you listen to the entire, uncut call, it's completely obvious that nobody on staff made any sort of medical determination as to the status of the patient.  It was a 100% issue of liability even though the 911 dispatcher addressed the liability issue.  The dispatcher was surprisingly cool and understanding, but firm during the entire call.  Whomever up thread referred to her as a "spaz" is a farkin' moron.  The people at the facility chose to be useless.  Nobody should be surprised that people who aren't lobotomized are a bit stunned upon hearing the call.

I think one must be a little out of touch with reality, a.k.a. "lobotomized," to be stunned by the call.  "It aint what we don't know that gets us in trouble, it's what we think we know that aint so," said Mark Twain.

Well, if you look at it from the perspective that people do shiatty things all the time, then sure.

"Do shiatty things" is the archetypical job description.  Would it make you feel better to imagine that the same people might have done more for this woman if they weren't at work?  Then do so.


Why would I play make believe in their favor, when we have the simple fact that, based on policy, they chose to do nothing?
 
2013-03-06 06:11:10 AM  

vrax: BarkingUnicorn: vrax: BarkingUnicorn: vrax: The 4chan Psychiatrist: 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.

When you listen to the entire, uncut call, it's completely obvious that nobody on staff made any sort of medical determination as to the status of the patient.  It was a 100% issue of liability even though the 911 dispatcher addressed the liability issue.  The dispatcher was surprisingly cool and understanding, but firm during the entire call.  Whomever up thread referred to her as a "spaz" is a farkin' moron.  The people at the facility chose to be useless.  Nobody should be surprised that people who aren't lobotomized are a bit stunned upon hearing the call.

I think one must be a little out of touch with reality, a.k.a. "lobotomized," to be stunned by the call.  "It aint what we don't know that gets us in trouble, it's what we think we know that aint so," said Mark Twain.

Well, if you look at it from the perspective that people do shiatty things all the time, then sure.

"Do shiatty things" is the archetypical job description.  Would it make you feel better to imagine that the same people might have done more for this woman if they weren't at work?  Then do so.

Why would I play make believe in their favor, when we have the simple fact that, based on policy, they chose to do nothing?


I said do it if it would make you feel better, unless believing that people do shiatty things all the time makes you feel better still.  But then you're out of touch with reality again; maybe that makes you feel as good as possible.

Whatever you do, you will do it because it makes you feel better.
 
2013-03-06 06:17:46 AM  

BarkingUnicorn: vrax: BarkingUnicorn: vrax: BarkingUnicorn: vrax: The 4chan Psychiatrist: 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.

When you listen to the entire, uncut call, it's completely obvious that nobody on staff made any sort of medical determination as to the status of the patient.  It was a 100% issue of liability even though the 911 dispatcher addressed the liability issue.  The dispatcher was surprisingly cool and understanding, but firm during the entire call.  Whomever up thread referred to her as a "spaz" is a farkin' moron.  The people at the facility chose to be useless.  Nobody should be surprised that people who aren't lobotomized are a bit stunned upon hearing the call.

I think one must be a little out of touch with reality, a.k.a. "lobotomized," to be stunned by the call.  "It aint what we don't know that gets us in trouble, it's what we think we know that aint so," said Mark Twain.

Well, if you look at it from the perspective that people do shiatty things all the time, then sure.

"Do shiatty things" is the archetypical job description.  Would it make you feel better to imagine that the same people might have done more for this woman if they weren't at work?  Then do so.

Why would I play make believe in their favor, when we have the simple fact that, based on policy, they chose to do nothing?

I said do it if it would make you feel better, unless believing that people do shiatty things all the time makes you feel better still.  But then you're out of touch with reality again; maybe that makes you feel as good as possible.

Whatever you do, you will do it because it makes you feel better.


Late night drinking, eh?
 
2013-03-06 06:21:42 AM  

Glendale: Then get a DNR, jackasses.


As a lawyer, let me just say:  THIS.  Or spell out what measures you do want, in the alternative.
In writing, with multiple copies per your state's formal requirements.

It's STILL not a guarantee of your end-of-life experience...docs routinely ignore them, partly because of the public's "nobody should ever die, ever" reaction on display in this case...but it's better than nothing.
 
2013-03-06 06:23:53 AM  

The more you eat the more you fart: suck on THAT.


someone you worked with wrote a nice letter about you in an effort to help you go to another job?

yeah you sure showed me...
 
2013-03-06 06:28:06 AM  

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?
 
2013-03-06 06:31:57 AM  

The more you eat the more you fart: log_jammin: The more you eat the more you fart: I agree with everything except that the 911 dispatchers ARENT "highly trained".

they have AT MOST 6 months at a vocational "college"

so you going to shiat on firemen next?

Firemen dont go around acting like they possess more medical knowledge/skill than a trauma nurse with a master's degree.


Just to be a bit contrarian, you have to be careful about those generalizations.

I worked years ago with a bunch first responders with very good skills and knowledge pertinent to this situation, and a trauma nurse who was VERY good at knife/gunshot surgery, but couldn't do CPR to save someone's life (literally, heh.)

She also, after 12 years in the Reserves, qualifying on a shooting range, and digging numerous actual bullets out of people during surgery, didn't really understand that the bullet came out of a cartridge when you pulled the trigger.

Very good nurse, as I said...people can have very odd gaps in their knowledge base, I find.
 
2013-03-06 06:32:37 AM  
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.
 
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  
Licensed Vocational Nurse - LVN
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Brookdale Senior Living Inc. (BSL) a publicly traded company (NYSE: BKD)

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Job Number:
70675
Job Type: Full Time
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Fax: 661-588-7446
The LVN provides residents with nursing services and administers medications and treatments in accordance with physicians' orders within state licensure regulations.
Key responsibilities include:

* Assisting in maintaining a physical, social, and psychological environment in the best interests of residents
* Monitoring residents within state licensure regulations; may supervise and direct resident assistants
* 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
* Must have solid ability to interact and build relationships with older adults
* Must have strong organizational and analytical skills
* Must have strong team building and mentoring skills
* Must have working knowledge of Title 22 for the state of CA
* Must enjoy working with the senior population
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Brookdale Senior Living is an EOE-(Equal Opportunity Employer) and drug free work place.
 
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.
 
2013-03-06 10:09:16 AM  

me texan: hardinparamedic <wall of text>

I am sure you have some valid points in there, but I am not reading it.  You've made me regret even having stated an opinion, regardless of how informed or lack thereof I was of the situation.


I appreciate a well-referenced and well-written post. Thanks, hardinparamedic, and please feel free to respond in a similar manner to any of my posts.

/It's nice to leave a Fark thread a little better informed than when I entered it.
 
2013-03-06 10:42:56 AM  
The moral of the story is, BE REALLY CLEAR WITH EVERYONE ABOUT YOUR END OF LIFE WISHES. I did community outreach with seniors, and many of them had signs with their DNR wishes prominently posted in their homes that first responders couldn't miss. Others had med-id necklaces. If you want to just go when it's time, you need to tell people.
 
2013-03-06 10:46:00 AM  
How come the woman did not have a DNAR or DNR or NO CODE or Comfort Measures Only or some such euphemism for "I wanna go naturally," on her chart?  If she did then the 911 call was unnecessary.  If she did not and the nurse in question knew of her wishes then the nurse acted appropriately; she will still lose her job, but she did the right thing.  If the old woman did not have such an order then the nurse might still have acted appropriately.  More than likely the nurse acted appropriately for such a facility. I'm gonna get a tat if I live to be over 70 that says NO CPR on my tit.  Another 17 years on this lousy planet is about all I think I can take anyway.
 
2013-03-06 10:48:37 AM  

Would this be the same, then, if a visitor to the facility had collapsed and was barely breathing.

Or, perhaps a resident who was maybe 55 or 60?

All well and good to say that she was old and such.   At what point does this policy apply?  Only to those 71.5 and over and a resident?

If you have an 85 year old resident and an 85 year old visitor (from outside the facility) with that patient, and they both collapse, what is done then?

 
2013-03-06 10:53:04 AM  
hardinparamedic:


I respect what you said, and I too, hope for more...constructive...dialog with you from now on.

For the record, to earn an MSN, it takes the normal 128 credit hours of classes, PLUS 500 hours of hands-on training...then an additional 18 hours of physiology/pathophysiology and 21 hours of chemistry and additional biology courses, and 18 hours of Nurse Educator classes.

To earn Trauma Nurse status/licenses, the path goes like this:

BSN ->TNCC (trauma nursing core course) while working in an ER ->CEN (certified emergency nurse) certification -> work for at LEAST two years in an emergency medicine setting -> earn your MSN.

This adds up to more than 10 full years of education, 90% of being hand-on, and even a brand-new trauma nurse will have more than 2,000 hours of actual hands-on experience.

The debate at hand...whether this nurse acted ethically or morally, is NOT what I was arguing, NOR was I stating what *I* would do in that situation.  Personally speaking, I'd say "fark you" to the facility director and do whatever I thought was RIGHT....fark everyone else.

A LOT of my job consists of knowing the rules and knowing when to play "by the book" and knowing when to say "fark the rules....this needs to be done to save this person."

In addition to an area of specialization, MSN nurses are also allowed to suture, perform certain minor surgical procedures, prescribe most medications, prescribe courses of treatment, make a diagnosis, etc.

I am sure you are a very good paramedic.  The education aspect I was only arguing because I think a lot of people underestimate the skill that someone who is a nurse possesses.  As an MSN trauma nurse, otherwise known as an ENP in my state, I hold many certifications (including psych)....as do all of the other ENP's where I work, however, I am the only MALE enp that works in my hospital.

Do I PERSONALLY have a problem with what this woman did?  Yes.  Professionally?  Not from what I've read thusfar.  Would I have made the same decision?  There's no way i can answer that.  It would depend on what I personally witnesses or saw, and the result of an assessment that i would have personally performed at the time.  I cannot, and would not be able to say what I would have done without that.

I typically am "by the book" but part of my skill involves being able to be CREATIVE in the application of the knowledge I possess in the course of doing my job.  There are often situations where a "by the book" solution just doesn't cut it...or doesn't work....and you have to "think outside the box" and figure out how to get the job done.

When I was an LPN, I worked in LTC settings, and I too saw things like you eluded to.  I will never put anyone I know in an LTC facility as a result of things I saw.  And yes, I reported them when i saw them.

for the record, I have a DNR order...because I know better.  Allow me a dignified death at the least...I dont want my ribs broken and to be manhandled or mauled as I am taking my last breaths.

the truth is...and I have EXTENSIVE experience with this....CPR that has to be performed for longer than a few minutes is usually (more than 90% of the time) ineffective....and if the person DOES "survive" they suffer from anoxic brain syndrome, if they even regain consciousness at all.

That is why most of the ED personnel that I work with have DNR's signed, even though most of us are in our 20's and 30's.

I apologize for my rudeness as well...its not characteristic of me, and I hope you can accept my apology because it is sincere.
 
2013-03-06 11:29:14 AM  

SarcasticFark: 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.


I understand your view, but the moral imperative seems clear to me.

If you know CPR and refuse to save a human life because you might need to find a new job then you are not a good nurse or a good person. I understand how a person could make such a choice, but I certainly could not be friends with that person.
 
2013-03-06 11:30:45 AM  
Man, I wish I had access to the fark.com access logs.  It would make threads like this some much more fun in retrospect.
 
2013-03-06 11:47:44 AM  

The more you eat the more you fart: hardinparamedic:

 I am the only MALE enp that works in my hospital.


Ha. Feel like an oddity? I went through the same in 1982-86. No men. I was often mistaken for an "orderly". The upside is that you are treated like a peer by the medical staff. First names and all that. That's the male realm that my female co-workers could not, or would not cross. It was automatically assumed, and I believed it too, that I would move into management too.

As I moved to CC and ED, and a new hospital, suddenly there was 8 other male RN's to cramp my style! Balloon deflates.


You defended yourself well in here. Maybe a bit vitriolic, but I agree with most of what you said. Given the education and position you hold, I can deduce that you are younger than my 57 yrs. As you move on in age, I do hope that you will maintain your passion. The main problem of our profession, and others in the field, is loosing that passion and burning out. You know some of them don't you? Most of my peers were counting the days to retirement (if they made it).

Thats what happened to me after 30 years, and I'm glad I'm out. Lots of pressure.


As to having a relationship with another nurse, my advice is not to. Shop talk. Find someone outside your profession, like I did. 28 yrs happily married!

Cheers!

/in Canada btw.

 
2013-03-06 11:49:18 AM  
Farkin hit "post comment" instead of fixing the big spaces first.
/old(er)
 
2013-03-06 11:50:31 AM  

tlchwi02: hardinparamedic: You're missing the point. By state and federal law, you do not get to make that decision. That patient, through his/her advanced directives and DNR, and a Physician who can justify the witholding of resuscitative care is the only ones who can do so.

sheesh, I didn't know we had the king o' nurses on fark. who gives a crap, an old person lived in a was placed by her family into a place where she they knew there weren't first responders and shockingly when she needed one, there weren't any and her family is shrugging it off. if you're that worked up about it, make sure your relatives and you lives in a place with actual medical staff on site when they/you get old. otherwise, whatever


It more than likely wasn't the old lady's choice to live at that particular home. Perhaps she was a banshee to the kids and grandkids while she was still around. That could be why they give exactly zero farks that she's dead.
 
2013-03-06 12:10:13 PM  
How big was the check?
 
2013-03-06 12:23:06 PM  

Dumski: 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.


Slight correction, I'm a former radiography student. I pulled out of my course for a multitude of reasons. It's extremely hard to work in a hospital environment, and I have a lot of respect for those who do.

While I did perform well during my placements, I found it hard to emotionally seperate myself from the work during the weekends I had off. The time spent assisting on neo-natal was utterly brutal in this regard. If you can hack it, great. I recognized that I could not.
 
2013-03-06 12:27:08 PM  

Dumski: The more you eat the more you fart: hardinparamedic:
 I am the only MALE enp that works in my hospital.
Ha. Feel like an oddity? I went through the same in 1982-86. No men. I was often mistaken for an "orderly". The upside is that you are treated like a peer by the medical staff. First names and all that. That's the male realm that my female co-workers could not, or would not cross. It was automatically assumed, and I believed it too, that I would move into management too.As I moved to CC and ED, and a new hospital, suddenly there was 8 other male RN's to cramp my style! Balloon deflates.
You defended yourself well in here. Maybe a bit vitriolic, but I agree with most of what you said. Given the education and position you hold, I can deduce that you are younger than my 57 yrs. As you move on in age, I do hope that you will maintain your passion. The main problem of our profession, and others in the field, is loosing that passion and burning out. You know some of them don't you? Most of my peers were counting the days to retirement (if they made it).Thats what happened to me after 30 years, and I'm glad I'm out. Lots of pressure.
As to having a relationship with another nurse, my advice is not to. Shop talk. Find someone outside your profession, like I did. 28 yrs happily married!Cheers!/in Canada btw.


For the record, i just turned 36.

Yeah, i sometimes feel out of place , but i truly love what i do.

Ive dated a few nurses, only had "shop talk" issues with one or two. However, im currently engaged to a clinical psychologist. She's a blast :)
 
2013-03-06 12:29:52 PM  

log_jammin: me texan: I am sure you have some valid points in there, but I am not reading it. You've made me regret even having stated an opinion, regardless of how informed or lack thereof I was of the situation.

That really kind of sums up fark.

Give an opinion where you say everyone else is stupid, on a subject that you know nothing about. when given a point by point rebuttal that shows you don't know WTF you're talking about, say you won't read it because....something. Then walk away feeling superior.


I'd usually agree, but wall'o'text quoting is just about the hardest to reply to, so this may not be a prime example of that mentality.

/Seriously. People. Number your points or something, don't type  into the quote, it makes it hell to reply and gives you ten emails to reply to.
//It's Fark, it's not supposed to be work to reply.
 
2013-03-06 01:32:21 PM  

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

State Nursing law and the duty to act takes precedence over what that facility policy says.

To put it another way, if I have a facility policy to knowingly administer a medication when it is contraindicated to do so, and do so anyway because I am following policy and that patient dies, I have just committed, at best, negligent practice. At worst, negligent homicide.

That facility policy won't save you from the state boards.


Food for thought: Was she working in the capacity of a nurse at the time? If the answer is no then does she have an obligation still?

I suspect that, legally, that is where it hinges but I do not know.
 
2013-03-06 02:35:32 PM  
One question. Where the hell do you live Fart that you have saved 23 people in car accidents, that you just happened to drive by, at the age of 36? Do people not have steering wheels on the their cars where you live? Am I the only one who thinks that is super weird?
 
2013-03-06 02:55:16 PM  
SpectroBoy:

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.


Actually, this death was blessedly fast.

I'll say it again:  your morality does not create my obligation.  To claim it does puts you in bed with all the other morality legislators.  I wonder how many who are clamoring for new laws over this case also oppose gay marriage or abortion.
 
2013-03-06 02:57:34 PM  

MPAVictoria: One question. Where the hell do you live Fart that you have saved 23 people in car accidents, that you just happened to drive by, at the age of 36? Do people not have steering wheels on the their cars where you live? Am I the only one who thinks that is super weird?


Even *I* thought it was weird..especially considering that at LEAST 8 of those were in the span of only about 3 months.  My gf at the time even made the comment "Let me know when you're gonna be on the road, because people seem to get into bad accidents around you, and I dont wanna be driving while you are."

A few of the bad ones:  A motorcyclist who lost control for some reason I STILL cant figure out no matter how many times I replay it in my head.  We was wearing one of those "skull cap" type helmets and face-planted at 45 mph...the roadway effectively belt-sanding his face away down to the level of his eye sockets.

A chevy s-10 hit by an 18 wheeler.  the front right tire of the truck ending up on TOP of the s-10, crushing the guy who was driving.

motorcyclist and passenger swerved into the side of a car in the next lane on the interstate bridge, causing them to wipe out at 65mph.  Driver was D.O.I...the passenger...his wife...unfortunately lived for a few minutes, despite obviously fatal cranial trauma.

I'd go on, but you get the idea.

/drivers in this city are NOTORIOUSLY piss-poor.  I myself have been hit 4 times...all from behind...and ALL while I was stopped at a red light.  The worse one was by an 18 wheeler who never even hit the brakes.  Broke my c-4 vertebrae and left me temporarily paralyzed from the neck down for 3 months until surgeons could remove the bone fragments and the swelling went down enough to decompress my spinal cord.
 
2013-03-06 02:57:50 PM  
It's weird only if you live somewhere that makes sense.  The closer you get to a large inner city, the more likely his statement may be true.  People are dumb-arsier the closer they have to live to each other.  They like to call it "keeping it real".  *grin*

In Maine I've almost never seen the crap that I've seen in NYC.  There was much more of a tendency to be kind to your neighbors and help each other out.  In NYC, it's major headlines if someone is honest or helpful.
 
2013-03-06 02:59:38 PM  
Sorry for typos....im exhausted.  Time for a nap.
 
2013-03-06 03:00:57 PM  

The more you eat the more you fart: MPAVictoria: One question. Where the hell do you live Fart that you have saved 23 people in car accidents, that you just happened to drive by, at the age of 36? Do people not have steering wheels on the their cars where you live? Am I the only one who thinks that is super weird?

Even *I* thought it was weird..especially considering that at LEAST 8 of those were in the span of only about 3 months.  My gf at the time even made the comment "Let me know when you're gonna be on the road, because people seem to get into bad accidents around you, and I dont wanna be driving while you are."

A few of the bad ones:  A motorcyclist who lost control for some reason I STILL cant figure out no matter how many times I replay it in my head.  We was wearing one of those "skull cap" type helmets and face-planted at 45 mph...the roadway effectively belt-sanding his face away down to the level of his eye sockets.

A chevy s-10 hit by an 18 wheeler.  the front right tire of the truck ending up on TOP of the s-10, crushing the guy who was driving.

motorcyclist and passenger swerved into the side of a car in the next lane on the interstate bridge, causing them to wipe out at 65mph.  Driver was D.O.I...the passenger...his wife...unfortunately lived for a few minutes, despite obviously fatal cranial trauma.

I'd go on, but you get the idea.

/drivers in this city are NOTORIOUSLY piss-poor.  I myself have been hit 4 times...all from behind...and ALL while I was stopped at a red light.  The worse one was by an 18 wheeler who never even hit the brakes.  Broke my c-4 vertebrae and left me temporarily paralyzed from the neck down for 3 months until surgeons could remove the bone fragments and the swelling went down enough to decompress my spinal cord.


Jesus man. I am 29 and I have NEVER *Knock on wood* passed by anything like that.

lyanna96: It's weird only if you live somewhere that makes sense.  The closer you get to a large inner city, the more likely his statement may be true.  People are dumb-arsier the closer they have to live to each other.  They like to call it "keeping it real".  *grin*

In Maine I've almost never seen the crap that I've seen in NYC.  There was much more of a tendency to be kind to your neighbors and help each other out.  In NYC, it's major headlines if someone is honest or helpful.


I live in a city of over a million people.
 
2013-03-06 03:01:22 PM  
Hey fart, GET SOME SLEEP!  You've been up all night!
 
2013-03-06 03:04:51 PM  

lyanna96: Hey fart, GET SOME SLEEP!  You've been up all night!


I know.  But hey...I'm a nurse remember....I'm used to it. lol
 
2013-03-06 03:13:34 PM  
MPAVictoria:
Jesus man. I am 29 and I have NEVER *Knock on wood* passed by anything like that.

Oh, like I said, I could go on.

and I didnt pass by those wrecks.  I was THERE...and stopped to try and do whatever i could to help.  Let's just say I've SAVED 23.  I've stopped at far more.

one of the saves:  guy ran off the road on Hwy 69 (yeah yeah, I know...its highway 69) right past the Gator Stop (anyone in s. Louisiana would know where this is) in a blue single cab silverado.  Early 20's type, probably going WAY too fast for the curve and ran off the road, clipping a few trees on the way.

Front of the truck ended up in the bayou, the roof was folded in like a sardine can in reverse.  He was pinned inside.  A fireman and myself were first on the scene.  I jumped in the bed of the truck and kicked out the back window so that i could get to the guy while the fireman jumped up on the cowl of the truck that was still above the water in an attempt to pull the roof back out so we could extricate him from the truck.

The guy was talking, but not making any sense.  I noticed he had a speaker box resting by the back right side of his head.  I felt around the box before trying to move him, and realized the speaker box had punched about a 2-inch hole in his skull when it flew up from behind him and cracked him in the head...apparently the corner of the box got him with enough force to actually punch a hole.

We had VERY little choice, as the truck was clearly sliding towards the water, so as I ripped off the sleeve of my shirt to tie around the guy's head to close the hole so we could move him, the fireman managed to pull the roof back finally.  Right about then, EMS arrives with 8 or 9 guys.  I tell em whats up, and they brought out a more rigid bandage for his head and called air med.

guy lived as far as I know...or at least he was still talking in babbles when they took him to the helicopter.
 
2013-03-06 03:16:03 PM  
Can't believe this thread is still going, and people are still making dumb statements without reading the article.  There is no issue here.  Everyone involved is fine with what happened, except for maybe the employee, and that's only because a bunch of internet morons are trying to make a big deal/feel superior about it.

We should all thank Fart, not just for what he does, but also for providing the voice of reason and logic in this thread.  Not to denigrate anyone else, but Fart made this thread his biatch.  Must have been a slow night in the ER.  And as a hospital frequent flyer, (~11 months since 2004) people like him are the ones that get shiat done.  They know their job and don't take any shiat.  People like you have saved my life on multiple occasions.
 
2013-03-06 03:19:04 PM  

andychrist420: Can't believe this thread is still going, and people are still making dumb statements without reading the article.  There is no issue here.  Everyone involved is fine with what happened, except for maybe the employee, and that's only because a bunch of internet morons are trying to make a big deal/feel superior about it.

We should all thank Fart, not just for what he does, but also for providing the voice of reason and logic in this thread.  Not to denigrate anyone else, but Fart made this thread his biatch.  Must have been a slow night in the ER.  And as a hospital frequent flyer, (~11 months since 2004) people like him are the ones that get shiat done.  They know their job and don't take any shiat.  People like you have saved my life on multiple occasions.


I have no idea why you've needed saving multiple times, but hopefully you wont need it anymore lol.

thanks for the compliment.  However, should you need us and happen to be in South Louisiana...we'll be there for you :)
 
2013-03-06 03:29:17 PM  

The more you eat the more you fart: andychrist420: Can't believe this thread is still going, and people are still making dumb statements without reading the article.  There is no issue here.  Everyone involved is fine with what happened, except for maybe the employee, and that's only because a bunch of internet morons are trying to make a big deal/feel superior about it.

We should all thank Fart, not just for what he does, but also for providing the voice of reason and logic in this thread.  Not to denigrate anyone else, but Fart made this thread his biatch.  Must have been a slow night in the ER.  And as a hospital frequent flyer, (~11 months since 2004) people like him are the ones that get shiat done.  They know their job and don't take any shiat.  People like you have saved my life on multiple occasions.

I have no idea why you've needed saving multiple times, but hopefully you wont need it anymore lol.

thanks for the compliment.  However, should you need us and happen to be in South Louisiana...we'll be there for you :)


Hopefully.  I had viral encephalitis, and almost died twice, was in a coma for 6 weeks.  Then 2 pressure sores and bone infection (due to Doctor negligence, nurses tried telling him, he was indifferent) and other major life threatening invasive surgeries.  This thread is seriously making me consider a DNR, although my wife would probably not like that.  She has this idea we're going to live a long life together, but I know that my life expectancy has been cut significantly, and I'm fine with that.
 
2013-03-06 03:31:41 PM  

The more you eat the more you fart: andychrist420: Can't believe this thread is still going, and people are still making dumb statements without reading the article.  There is no issue here.  Everyone involved is fine with what happened, except for maybe the employee, and that's only because a bunch of internet morons are trying to make a big deal/feel superior about it.

We should all thank Fart, not just for what he does, but also for providing the voice of reason and logic in this thread.  Not to denigrate anyone else, but Fart made this thread his biatch.  Must have been a slow night in the ER.  And as a hospital frequent flyer, (~11 months since 2004) people like him are the ones that get shiat done.  They know their job and don't take any shiat.  People like you have saved my life on multiple occasions.

I have no idea why you've needed saving multiple times, but hopefully you wont need it anymore lol.

thanks for the compliment.  However, should you need us and happen to be in South Louisiana...we'll be there for you :)


If he's in Louisiana, he doesn't need an ER; he needs a psychiatric hospital.
 
2013-03-06 03:36:02 PM  

andychrist420: The more you eat the more you fart: andychrist420: Can't believe this thread is still going, and people are still making dumb statements without reading the article.  There is no issue here.  Everyone involved is fine with what happened, except for maybe the employee, and that's only because a bunch of internet morons are trying to make a big deal/feel superior about it.

We should all thank Fart, not just for what he does, but also for providing the voice of reason and logic in this thread.  Not to denigrate anyone else, but Fart made this thread his biatch.  Must have been a slow night in the ER.  And as a hospital frequent flyer, (~11 months since 2004) people like him are the ones that get shiat done.  They know their job and don't take any shiat.  People like you have saved my life on multiple occasions.

I have no idea why you've needed saving multiple times, but hopefully you wont need it anymore lol.

thanks for the compliment.  However, should you need us and happen to be in South Louisiana...we'll be there for you :)

Hopefully.  I had viral encephalitis, and almost died twice, was in a coma for 6 weeks.  Then 2 pressure sores and bone infection (due to Doctor negligence, nurses tried telling him, he was indifferent) and other major life threatening invasive surgeries.  This thread is seriously making me consider a DNR, although my wife would probably not like that.  She has this idea we're going to live a long life together, but I know that my life expectancy has been cut significantly, and I'm fine with that.


Well damn dude...im sorry to hear all that.  Your life of cipro and/or levaquin and pain killers has to be rough.

I'll say this much.  I'm 36 and in pretty darn good health (minus some occasional severe pain due to the afformentioned previously broken neck) and I have a DNR signed, with a copy given to each an every one of my immediate family.

Why?  because I know better.
 
2013-03-06 03:37:48 PM  
BarkingUnicorn:
If he's in Louisiana, he doesn't need an ER; he needs a psychiatric hospital.


That's okay...I also hold certification as a MHNP due to my previous experience/training.  He would be good to go *wink*
 
2013-03-06 03:48:44 PM  

The more you eat the more you fart: andychrist420: The more you eat the more you fart: andychrist420: Can't believe this thread is still going, and people are still making dumb statements without reading the article.  There is no issue here.  Everyone involved is fine with what happened, except for maybe the employee, and that's only because a bunch of internet morons are trying to make a big deal/feel superior about it.

We should all thank Fart, not just for what he does, but also for providing the voice of reason and logic in this thread.  Not to denigrate anyone else, but Fart made this thread his biatch.  Must have been a slow night in the ER.  And as a hospital frequent flyer, (~11 months since 2004) people like him are the ones that get shiat done.  They know their job and don't take any shiat.  People like you have saved my life on multiple occasions.

I have no idea why you've needed saving multiple times, but hopefully you wont need it anymore lol.

thanks for the compliment.  However, should you need us and happen to be in South Louisiana...we'll be there for you :)

Hopefully.  I had viral encephalitis, and almost died twice, was in a coma for 6 weeks.  Then 2 pressure sores and bone infection (due to Doctor negligence, nurses tried telling him, he was indifferent) and other major life threatening invasive surgeries.  This thread is seriously making me consider a DNR, although my wife would probably not like that.  She has this idea we're going to live a long life together, but I know that my life expectancy has been cut significantly, and I'm fine with that.

Well damn dude...im sorry to hear all that.  Your life of cipro and/or levaquin and pain killers has to be rough.

I'll say this much.  I'm 36 and in pretty darn good health (minus some occasional severe pain due to the afformentioned previously broken neck) and I have a DNR signed, with a copy given to each an every one of my immediate family.

Why?  because I know better.


Throw in a wheelchair, and it can be downright miserable.  Luckily I'm in California, which is a medical marijuana state.  Like cpr, it's not a magical remedy, but it sure does help with pain and misery.
 
2013-03-06 03:50:33 PM  
andychrist420:

Which is why I, as a medical professional, am FOR the medical use of pot.

Sometimes, you gotta say "fark the rules...do what's right".
 
2013-03-06 04:03:35 PM  
I bet she's a CNA, and the press heard "nursing assistant" and assumed that was a kind of nurse.
 
2013-03-06 04:17:30 PM  
As a paramedic, I encounter this predicament once in a while. The problem with this situation is that as a nurse, she has a duty to act .  If the person does not have a DNR, resuscitative efforts are given. As medical professionals,we are always trained to err on the side of the patient. That duty to act  supersedes the facility she works for. She opened herself for that liability.  I won't be surprised if she loses her license.
 
2013-03-06 04:30:29 PM  

audioguy16: As a paramedic, I encounter this predicament once in a while. The problem with this situation is that as a nurse, she has a duty to act .  If the person does not have a DNR, resuscitative efforts are given. As medical professionals,we are always trained to err on the side of the patient. That duty to act  supersedes the facility she works for. She opened herself for that liability.  I won't be surprised if she loses her license.



Nurse practice acts declare what a nurse is legally able to do in each state.  They do not declare what a nurse must do in every situation.

Facility rules supersede nurse practice acts so long as they do not cause a nurse to act out of scope.  It's a lot like how the States are not supposed to pass laws that supersede the fed.

an ex:  In some states I can insert a flexible feeding tube called a dobhoff.  In those states, in some facilities, it is against facility policy to let a nurse do that even though the state NPAs do not prohibit it.  (as an example that removes a lot of the emotion here.)

There are a lot of 'ifs' in the information around this story and people filling in the blanks.  My 'ifs':

If this is an actual CA nurse
If the nurse was an employee of the assisted living home (not a medical facility in the traditional sense)
If the residents and facility were a 'no heroic measures' kind of place
then I don't have a problem with the nurse not providing CPR, and if I was employed there I would not have either

I understand a lot of folks emotion and quoting rules and regulations, however it's not nearly so simple.
 
2013-03-06 04:44:07 PM  

BafflerMeal: audioguy16: As a paramedic, I encounter this predicament once in a while. The problem with this situation is that as a nurse, she has a duty to act .  If the person does not have a DNR, resuscitative efforts are given. As medical professionals,we are always trained to err on the side of the patient. That duty to act  supersedes the facility she works for. She opened herself for that liability.  I won't be surprised if she loses her license.


Nurse practice acts declare what a nurse is legally able to do in each state.  They do not declare what a nurse must do in every situation.

Facility rules supersede nurse practice acts so long as they do not cause a nurse to act out of scope.  It's a lot like how the States are not supposed to pass laws that supersede the fed.

an ex:  In some states I can insert a flexible feeding tube called a dobhoff.  In those states, in some facilities, it is against facility policy to let a nurse do that even though the state NPAs do not prohibit it.  (as an example that removes a lot of the emotion here.)

There are a lot of 'ifs' in the information around this story and people filling in the blanks.  My 'ifs':

If this is an actual CA nurse
If the nurse was an employee of the assisted living home (not a medical facility in the traditional sense)
If the residents and facility were a 'no heroic measures' kind of place
then I don't have a problem with the nurse not providing CPR, and if I was employed there I would not have either

I understand a lot of folks emotion and quoting rules and regulations, however it's not nearly so simple.


It is simple.  It's just policy.
 
2013-03-06 04:51:58 PM  

SpectroBoy: SarcasticFark: 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.

I understand your view, but the moral imperative seems clear to me.

If you know CPR and refuse to save a human life because you might need to find a new job then you are not a good nurse or a good person. I understand how a person could make such a choice, but I certainly could not be friends with that person.


And while I understand how you couldn't be friends with someone like that, I also understand that it's entirely possible that the 'nurse' in question could possibly NEED that job more than you or I know at this point.  Perhaps that job helps her provide much needed health insurance and money to keep her own family afloat.  To put it in perspective: in my current situation, I certainly WOULD risk my job in order to save a life.  However, if I had a sick child or family member at home that depended upon my insurance or income, there is NO WAY I would risk my own family to help anyone.

It's so easy to judge while on the outside looking in.
 
2013-03-06 05:37:20 PM  
At the risk of sounding like an asshole, the nurse (or whatever she is) could have just administered CPR, just not quite as robustly as she might have for a younger, healthier person, the old lady would have died anyway, and we wouldn't be talking about this now.

Doing something that really isn't good enough is not the same as doing nothing. Seems to me if you call yourself a nurse, you do something. You don't just call 911 and then tell the operator that the "rules" command you to sit there and do nothing whatsoever while a person dies right in front of you. She (the nurse) obviously isn't too smart, or this would have occurred to her. Better to try (albeit not very hard) and fail to save the life of an old lady than to be singled out, worldwide, as someone who just sits back and watches somebody die. It's on a public record now. I wouldn't want to be her looking for a job as a nurse anytime soon. Nor would I want to be her patient.
 
2013-03-06 05:49:26 PM  
This all could have been avoided if she waited until after the granny died before making the call. If it was policy to not help why call at all until she was cold?
 
2013-03-06 06:14:58 PM  
this thread hurt me.
 
2013-03-06 06:17:30 PM  

pacified: this thread hurt me.


The previous one was worse.
 
2013-03-06 06:34:52 PM  

Smelly Pirate Hooker: At the risk of sounding like an asshole, the nurse (or whatever she is) could have just administered CPR, just not quite as robustly as she might have for a younger, healthier person, the old lady would have died anyway, and we wouldn't be talking about this now.

Doing something that really isn't good enough is not the same as doing nothing. Seems to me if you call yourself a nurse, you do something. You don't just call 911 and then tell the operator that the "rules" command you to sit there and do nothing whatsoever while a person dies right in front of you. She (the nurse) obviously isn't too smart, or this would have occurred to her. Better to try (albeit not very hard) and fail to save the life of an old lady than to be singled out, worldwide, as someone who just sits back and watches somebody die. It's on a public record now. I wouldn't want to be her looking for a job as a nurse anytime soon. Nor would I want to be her patient.


Or you could RTFA.  The policy of this independent living center (not medical facility) was medical help was not provided other than calling 911.  She, and her family knew this going in, and were fine with it.  This is a non-story, except for the internet moralists/white knights
 
2013-03-06 06:52:19 PM  

andychrist420: Smelly Pirate Hooker: At the risk of sounding like an asshole, the nurse (or whatever she is) could have just administered CPR, just not quite as robustly as she might have for a younger, healthier person, the old lady would have died anyway, and we wouldn't be talking about this now.

Doing something that really isn't good enough is not the same as doing nothing. Seems to me if you call yourself a nurse, you do something. You don't just call 911 and then tell the operator that the "rules" command you to sit there and do nothing whatsoever while a person dies right in front of you. She (the nurse) obviously isn't too smart, or this would have occurred to her. Better to try (albeit not very hard) and fail to save the life of an old lady than to be singled out, worldwide, as someone who just sits back and watches somebody die. It's on a public record now. I wouldn't want to be her looking for a job as a nurse anytime soon. Nor would I want to be her patient.

Or you could RTFA.  The policy of this independent living center (not medical facility) was medical help was not provided other than calling 911.  She, and her family knew this going in, and were fine with it.  This is a non-story, except for the internet moralists/white knights


I did read it.

It's irrelevant what the family thinks about how all this shakes out. I doubt their opinion is going to matter much if this nurse is dragged before whatever state board licenses her. They don't really have anything to lose here, other than their grandma, and that's a done deal.

And it probably doesn't matter what the "policy" of the center is, either. If the center goes to bat for this nurse against whatever state entity might want to discipline her, I'll be really surprised. I'm guessing if they feel they have to, they'll throw her under the bus and feel no regret whatsoever.

Maybe it won't come to that. Hopefully, it won't.

And apparently it isn't a non-story. It's been all over the place as a story for several days now.

I'm just saying, if I was a nurse and I had to choose between A) Being the nurse who got fired for performing CPR on an old lady even though the policy says not to and B) Being the nurse who everybody thinks is a horrible person for not doing anything and prompting a 911 operator to beg me to grab someone off the street to do it, I'd choose A.
 
2013-03-06 07:09:06 PM  

Smelly Pirate Hooker: It's irrelevant what the family thinks about how all this shakes out. I doubt their opinion is going to matter much if this nurse is dragged before whatever state board licenses her. They don't really have anything to lose here, other than their grandma, and that's a done deal.

And it probably doesn't matter what the "policy" of the center is, either. If the center goes to bat for this nurse against whatever state entity might want to discipline her, I'll be really surprised. I'm guessing if they feel they have to, they'll throw her under the bus and feel no regret whatsoever.

Maybe it won't come to that. Hopefully, it won't.

And apparently it isn't a non-story. It's been all over the place as a story for several days now.

I'm just saying, if I was a nurse and I had to choose between A) Being the nurse who got fired for performing CPR on an old lady even though the policy says not to and B) Being the nurse who everybody thinks is a horrible person for not doing anything and prompting a 911 operator to beg me to grab someone off the street to do it, I'd choose A.


The family's feelings are relevant because they're the only ones with standing to sue.  It's the feelings of everyone else that are irrelevant.

Nursing boards' standards don't apply to nurses when they are not nursing; nurses in this thread have confirmed that.  I can't imagine why a facility that doesn't offer nursing services would have a nursing job.

She's not a celebrity nurse, ffs.  I'd rather have a bunch of strangers hate me than have my kids ask when we're going to eat and have a bathroom again.

This nurse's job prospects will be hurt only with employers who want employees to ignore  the employers' rules.
 
2013-03-06 07:15:53 PM  

Smelly Pirate Hooker: andychrist420: Smelly Pirate Hooker: At the risk of sounding like an asshole, the nurse (or whatever she is) could have just administered CPR, just not quite as robustly as she might have for a younger, healthier person, the old lady would have died anyway, and we wouldn't be talking about this now.

Doing something that really isn't good enough is not the same as doing nothing. Seems to me if you call yourself a nurse, you do something. You don't just call 911 and then tell the operator that the "rules" command you to sit there and do nothing whatsoever while a person dies right in front of you. She (the nurse) obviously isn't too smart, or this would have occurred to her. Better to try (albeit not very hard) and fail to save the life of an old lady than to be singled out, worldwide, as someone who just sits back and watches somebody die. It's on a public record now. I wouldn't want to be her looking for a job as a nurse anytime soon. Nor would I want to be her patient.

Or you could RTFA.  The policy of this independent living center (not medical facility) was medical help was not provided other than calling 911.  She, and her family knew this going in, and were fine with it.  This is a non-story, except for the internet moralists/white knights

I did read it.

It's irrelevant what the family thinks about how all this shakes out. I doubt their opinion is going to matter much if this nurse is dragged before whatever state board licenses her. They don't really have anything to lose here, other than their grandma, and that's a done deal.

And it probably doesn't matter what the "policy" of the center is, either. If the center goes to bat for this nurse against whatever state entity might want to discipline her, I'll be really surprised. I'm guessing if they feel they have to, they'll throw her under the bus and feel no regret whatsoever.

Maybe it won't come to that. Hopefully, it won't.

And apparently it isn't a non-story. It's been all over the place as a story fo ...


It's only a story because the media is making it one.  And the caller, whether a nurse or not, was not employed as a nurse at the facility, as the facility provides no medical care.  This was know and accepted by all parties involved.  I'm not trying to be a dick, there's pleanty of examples of that upthread, but no crime was committed.  The old lady is at peace, the family respected her wishes, and the facility now has a vacancy.  Win-win-win.
 
2013-03-06 07:29:05 PM  
You can have a heartbeat and not be breathing. You can't have a non beating heart and be breathing. No cpr on a beating heart.
 
2013-03-06 07:51:38 PM  

andychrist420: It's only a story because the media is making it one. And the caller, whether a nurse or not, was not employed as a nurse at the facility, as the facility provides no medical care. This was know and accepted by all parties involved. I'm not trying to be a dick, there's pleanty of examples of that upthread, but no crime was committed. The old lady is at peace, the family respected her wishes, and the facility now has a vacancy. Win-win-win.


Wow, now we've elevated it to "Win!" status.  LMFAO!
 
2013-03-06 07:54:01 PM  
What an awesome thread!  I learned a lot.  As soon as I saw nurses arguing, my (mostly controllable) nurse fetish set me all aquiver, but the more I read, the more I realized that most of said arguing was being done by male nurses, and that kind of made me sad and somewhat ashamed.  I have a very quick csb to relate:

Early 90's:  I had rudimentary (at best) training in CPR and just happened to be the first aid "go to" guy at a soft drink factory, where I worked nights.  One morning, about 9 or so, after I'd been home for a while and had a few drinks, somebody furiously pounded on my door, startling the shiat out of me.  I opened the door, and it was an old guy (like 70) hollering something about calling an ambulance.  I didn't understand him, and said I hadn't called for one, and he said, "No, I need you to call for one!  My buddy's down!"  I looked out the door, and sure enough, there was a guy laying in the middle of the street.  I lived in a mobile home park, so there was no traffic, and it was about 2 degrees outside; snow piled up 4'.  Michigan in January.  So I dial 911, tell the ambulance where to come, grab my little CPR kit, and run out to save the day.  I took one look at the guy, and I'm just a layman, but I knew right then and there, that that guy was dead.  When the paramedics arrived, they stripped off his clothes and worked him for 40 minutes to no avail.  Even if they were to revive him, he would have probably died right away again from frostbite.  Point is, that guy was dead, and there was nothing ANYONE was going to do to save him.

/just one picture of an angry nurse in lingerie would have been nice in this thread
 
2013-03-06 08:37:40 PM  
This is not about this instance of denial of care. Even if the family wanted it, the protocol was broken and dysfunction was exposed. They are legally obligated to provide care -- it's not about this grandma, it's abut the next one who needs care and is denied it because a nurse violated her and the facility's legal duty to provide state mandated care as stipulated by their license to operate as a healthcare facility.
 
2013-03-06 08:51:34 PM  

Melvin Lovecraft: What an awesome thread!  I learned a lot.  As soon as I saw nurses arguing, my (mostly controllable) nurse fetish set me all aquiver, but the more I read, the more I realized that most of said arguing was being done by male nurses, and that kind of made me sad and somewhat ashamed.  I have a very quick csb to relate:

Early 90's:  I had rudimentary (at best) training in CPR and just happened to be the first aid "go to" guy at a soft drink factory, where I worked nights.  One morning, about 9 or so, after I'd been home for a while and had a few drinks, somebody furiously pounded on my door, startling the shiat out of me.  I opened the door, and it was an old guy (like 70) hollering something about calling an ambulance.  I didn't understand him, and said I hadn't called for one, and he said, "No, I need you to call for one!  My buddy's down!"  I looked out the door, and sure enough, there was a guy laying in the middle of the street.  I lived in a mobile home park, so there was no traffic, and it was about 2 degrees outside; snow piled up 4'.  Michigan in January.  So I dial 911, tell the ambulance where to come, grab my little CPR kit, and run out to save the day.  I took one look at the guy, and I'm just a layman, but I knew right then and there, that that guy was dead.  When the paramedics arrived, they stripped off his clothes and worked him for 40 minutes to no avail.  Even if they were to revive him, he would have probably died right away again from frostbite.  Point is, that guy was dead, and there was nothing ANYONE was going to do to save him.

/just one picture of an angry nurse in lingerie would have been nice in this thread


highlatencylife.files.wordpress.com
 
2013-03-06 08:55:28 PM  

lohphat: This is not about this instance of denial of care. Even if the family wanted it, the protocol was broken and dysfunction was exposed. They are legally obligated to provide care -- it's not about this grandma, it's abut the next one who needs care and is denied it because a nurse violated her and the facility's legal duty to provide state mandated care as stipulated by their license to operate as a healthcare facility.


No, no and no again.  They were NOT legally obligated to provide care and were, in fact, prevented from providing lifesaving measures by their insurance.  This was NOT a healthcare facility...it was NOT a nursing home.  This was a retirement community where residents live on their own, in their own apartments, independently.

We have been through this...read the thread.
 
2013-03-06 09:17:57 PM  

SarcasticFark: They were NOT legally obligated to provide care and were, in fact, prevented from providing lifesaving measures by their insurance.


Wrong again. Facility insurance does NOT trump the state's licencing laws that the nurse and facility are REQUIRED to provide care UNLESS there's a physician present or a DNR on file.

Their insurance polity does NOT negate state law.
 
2013-03-06 09:20:47 PM  

The more you eat the more you fart: hardinparamedic:


I respect what you said, and I too, hope for more...constructive...dialog with you from now on.

For the record, to earn an MSN, it takes the normal 128 credit hours of classes, PLUS 500 hours of hands-on training...then an additional 18 hours of physiology/pathophysiology and 21 hours of chemistry and additional biology courses, and 18 hours of Nurse Educator classes.

To earn Trauma Nurse status/licenses, the path goes like this:

BSN ->TNCC (trauma nursing core course) while working in an ER ->CEN (certified emergency nurse) certification -> work for at LEAST two years in an emergency medicine setting -> earn your MSN.

This adds up to more than 10 full years of education, 90% of being hand-on, and even a brand-new trauma nurse will have more than 2,000 hours of actual hands-on experience.

The debate at hand...whether this nurse acted ethically or morally, is NOT what I was arguing, NOR was I stating what *I* would do in that situation.  Personally speaking, I'd say "fark you" to the facility director and do whatever I thought was RIGHT....fark everyone else.

A LOT of my job consists of knowing the rules and knowing when to play "by the book" and knowing when to say "fark the rules....this needs to be done to save this person."

In addition to an area of specialization, MSN nurses are also allowed to suture, perform certain minor surgical procedures, prescribe most medications, prescribe courses of treatment, make a diagnosis, etc.

I am sure you are a very good paramedic.  The education aspect I was only arguing because I think a lot of people underestimate the skill that someone who is a nurse possesses.  As an MSN trauma nurse, otherwise known as an ENP in my state, I hold many certifications (including psych)....as do all of the other ENP's where I work, however, I am the only MALE enp that works in my hospital.

Do I PERSONALLY have a problem with what this woman did?  Yes.  Professionally?  Not from what I've read thusfar.   ...


Oh, I know how much is involved in becoming a trauma nurse. I work with several. Our team composition is Medic-RN(Advanced Credential)-RRT. Never meant to insinuate it wasn't difficult.

TNCC is a great class, too. It's similar to PHTLS and ITLS, but focuses on beyond golden hour care. What I'd really like to get is ATLS, but it's cost prohibitive, the closest one is 1800 bucks. Still, I have the textbook in my personal library, and it's an awesome read.

That said, Tennessee considers RN and EMT-P to be equivilant levels of care in terms of provider level when providing direct patient care. You're considered to be equals, not a lower level like RN to LPN is. The only thing an EMT-P cannot do is charge on a ward or unit, but they can work in the same scope and role as a nurse - with a few limitations like no chemotherapy, and special training requires for invasive procedures like central line access and ventilators/critical care equipment monitoring.

One thing I'm glad I can't do, and don't want any part of, is Transport ECMO as the primary care tech. ECMO and Bypass scare the living crap out of me.

At our team, we work as equals. We discuss care plans, and we have a three to go, one to say no policy when it comes to high risk procedures and transports.

I know it's a lot different outside of our specialty care and flight teams when it comes to RNs and Paramedics. Our Paramedics are expected to know and be able to step into the Nurse Role, and the Nurses are expected to step into the RRT role, and vice versa. Even when I was an EMT-IV, we were expected to train and know at that level, and it was hell on earth to step off a 911 rural truck and into what I could only describe as a daily feeling of feeling like an idiot.

However, there is an increased educational role and burden to do this, as like I said before, our education focuses on specialization versus generalization of roles.

Personally, I'd LOVE to see Paramedic education become the same standard as nurses have nationwide. If you haven't read it, the National Standards for Paramedics for 2012 are an exceptional white paper for the direction of our profession in that manner.

Paramedic Practitioners and advanced level practice are coming, thanks to the ACA. And I welcome it.

As for scenes, I'd be happy if you rolled up to help me, offer advice and direction, and be an extra set of hands. Once I knew you were who you said you were, I'd be happy to delegate care tasks and split the load, so to speak, on a critical patient. What i meant by that statement, and again apologizing for the rudeness, is my state is very specific about who and what I can take orders from. As a bystander, off duty, you place yourself at legal and civil liability risks. 1200-12-01 of TCA specifies the specific steps I have to take to get orders from a Physician On scene, and still does not recognize a NP or APN to give those orders. The actual steps are time and labor intensive, and basically require the medical provider on scene to either ride in with the patient and sign the actual care chart and orders he gives, or step aside and allow the EMS care team to render care.

If you're ever in Memphis, please let me know. I'd love to get together and have a drink and swap war stories.
 
2013-03-06 09:24:21 PM  

SarcasticFark: No, no and no again.  They were NOT legally obligated to provide care and were, in fact, prevented from providing lifesaving measures by their insurance.  This was NOT a healthcare facility...it was NOT a nursing home.  This was a retirement community where residents live on their own, in their own apartments, independently.

We have been through this...read the thread.


Depending on the State, that's not true. My position, despite being far too emotionally involved last night, comes from the fact that Tennessee requires medically trained staff who are able to perform CPR be available at assisted living facilities, even if it's just a CNA working as Residential Aide. Assisted Living facilities also have to be licensed by the State to operate.
 
2013-03-06 09:31:34 PM  

lohphat: This is not about this instance of denial of care. Even if the family wanted it, the protocol was broken and dysfunction was exposed. They are legally obligated to provide care -- it's not about this grandma, it's abut the next one who needs care and is denied it because a nurse violated her and the facility's legal duty to provide state mandated care as stipulated by their license to operate as a healthcare facility.


Except this place is not a healthcare facility and is needs no license.  It's an apartment complex that offers non-medical services such as cooking, cleaning, shuttle buses to shopping, community activities, and so on.
 
2013-03-06 09:35:51 PM  

hardinparamedic: SarcasticFark: No, no and no again.  They were NOT legally obligated to provide care and were, in fact, prevented from providing lifesaving measures by their insurance.  This was NOT a healthcare facility...it was NOT a nursing home.  This was a retirement community where residents live on their own, in their own apartments, independently.

We have been through this...read the thread.

Depending on the State, that's not true. My position, despite being far too emotionally involved last night, comes from the fact that Tennessee requires medically trained staff who are able to perform CPR be available at assisted living facilities, even if it's just a CNA working as Residential Aide. Assisted Living facilities also have to be licensed by the State to operate.


We have 49 States too many for Fark.
 
2013-03-06 09:38:12 PM  

BarkingUnicorn: We have 49 States too many for Fark.


Actually, I'd support a unified, Federal standard for all healthcare workers, Physicians down, and a national standard for healthcare facilities OTHER than the CMS rules. (CMS is a headache, period, and doesn't reflect the realities some situations deal with.) It would solve A LOT of problems in the Nation with reciprocity.

The fact someone trained in Louisiana cannot go to New York and work in their respective level is silly. Using Canada as an example, someone trained in Manitoba can go to Ontario and work. I personally like the way the EU countries do it.
 
2013-03-06 09:47:35 PM  

hardinparamedic: BarkingUnicorn: We have 49 States too many for Fark.

Actually, I'd support a unified, Federal standard for all healthcare workers, Physicians down, and a national standard for healthcare facilities OTHER than the CMS rules. (CMS is a headache, period, and doesn't reflect the realities some situations deal with.) It would solve A LOT of problems in the Nation with reciprocity.

The fact someone trained in Louisiana cannot go to New York and work in their respective level is silly. Using Canada as an example, someone trained in Manitoba can go to Ontario and work. I personally like the way the EU countries do it.


Another step towards fascism, many would say.  Interestingly, they're the same people who made Howard Johnson's and McDonald's so successful; they value consistency and having their expectations met everywhere they go.
 
2013-03-06 10:03:07 PM  

BarkingUnicorn: hardinparamedic: BarkingUnicorn: We have 49 States too many for Fark.

Actually, I'd support a unified, Federal standard for all healthcare workers, Physicians down, and a national standard for healthcare facilities OTHER than the CMS rules. (CMS is a headache, period, and doesn't reflect the realities some situations deal with.) It would solve A LOT of problems in the Nation with reciprocity.

The fact someone trained in Louisiana cannot go to New York and work in their respective level is silly. Using Canada as an example, someone trained in Manitoba can go to Ontario and work. I personally like the way the EU countries do it.

Another step towards fascism, many would say.  Interestingly, they're the same people who made Howard Johnson's and McDonald's so successful; they value consistency and having their expectations met everywhere they go.


Which is ironic because nursing already has pseudo-national licensure in the form of nursing compacts between the states, and national standardization would actually increase the freedom of work and professional scope that many healthcare professions have.
 
2013-03-06 10:56:10 PM  

hardinparamedic: BarkingUnicorn: hardinparamedic: BarkingUnicorn: We have 49 States too many for Fark.

Actually, I'd support a unified, Federal standard for all healthcare workers, Physicians down, and a national standard for healthcare facilities OTHER than the CMS rules. (CMS is a headache, period, and doesn't reflect the realities some situations deal with.) It would solve A LOT of problems in the Nation with reciprocity.

The fact someone trained in Louisiana cannot go to New York and work in their respective level is silly. Using Canada as an example, someone trained in Manitoba can go to Ontario and work. I personally like the way the EU countries do it.

Another step towards fascism, many would say.  Interestingly, they're the same people who made Howard Johnson's and McDonald's so successful; they value consistency and having their expectations met everywhere they go.

Which is ironic because nursing already has pseudo-national licensure in the form of nursing compacts between the states, and national standardization would actually increase the freedom of work and professional scope that many healthcare professions have.


Don't forget the Uniform Commercial Code, which is enacted by States independently but is crafted by a non-governmental body.
 
2013-03-07 02:29:01 AM  

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


Probably because the law requires it for an ALF to have a certain number of staff with one.  That's a guess, but it would make sense.  I imagine there's the same requirement for kindergartens.

Hell, I work in an office and the law requires the business to have a certain percentage of staff with First Aid certification.  We have literally never had a Serious Harm incident ever, in the history of the business.  Not one heart attack, not one CPR requirement.  No broken bones, no squirting arteries.  Ever.  But every two years off we go to our recertification courses, praying we never actually ever need to use the 'skills' we're taught because the law.
 
2013-03-07 02:48:50 AM  

if_i_really_have_to: Hell, I work in an office and the law requires the business to have a certain percentage of staff with First Aid certification.  We have literally never had a Serious Harm incident ever, in the history of the business.  Not one heart attack, not one CPR requirement.  No broken bones, no squirting arteries.  Ever.  But every two years off we go to our recertification courses, praying we never actually ever need to use the 'skills' we're taught because the law.


To be fair, though, you have a lot of legal protection for using those skills if you are a "layperson", i.e. someone with first aid/CPR training who is not required by their job or virtue of their licensure to use those skills.  Good Samaritan Laws apply there as well, unless you're a member of an in-house medical rescue team, like a Plant Emergency Operations team. Even if that is the event, your employer is required to maintain medical malpractice coverage on you.

Survival to discharge with good neurological function for an adult victim of sudden cardiac arrest, who receives immediate bystander CPR and AED use, and who receives early advanced care ranges from 30 to 60% depending on what city you live in. Since 2005 and the 2010 guidelines and the advent of advanced post-cardiac arrest therapies and early advanced care emphasis. The numbers that have been touted in this thread about CPR only working "3%" of the time come from statistics which incorporate all-cause factors for cardiac arrest. They lump unwitnessed arrests with witnessed arrests, arrests where bystander CPR is performed with arrests where no one touches the body for five to ten minutes, and arrests from sudden cardiac arrest causes with those from irreversible traumatic injuries like aortic sheer.
 
2013-03-07 07:30:08 AM  

log_jammin: cretinbob: No log_jammin. She doesn't have a legal duty to act, nurse or not.

you said a nurse can only practice under a physician license and the only reason I can see you making that point is if you were trying to say she couldn't legally preform CPR since she wasn't under a physicians license at the time. is that what you were trying to say? if not please explain why you brought that up.


Because she only had a LEGAL responsibility to act if she if she were a nurse and working in such a capacity. If she wasn't then she doesn't.

Anyway, I had to make the same call last night. I'll tell you, it's never an easy one, even when there is no possibility of successful resuscitation due to major trauma and blood loss. But one has to look at the bigger picture of public safety. Do I risk the lives of my crew and the people on the street as we tear down the interstate at 100mph with someone who is dead and is going to stay dead because no amount of surgery can repair them?
Sadly many other EMTs are of the mindset that, yeah you do just that because "protocols" and the inability to think critically. I've seen medics let patients slip through their fingers on scene because they wasted time doing shiat there instead of in the back of the ambulance on the way to the hospital. Would it have changed the outcome? Maybe, maybe not.
And nurses, don't get me started on those assholes. I left nursing because there are too many stupid ones who think they have all the answers but lack even 1 mg of compassion.

ANd I see that Securitywyrm  gets it. I've seen a lot of people call themseleves nurses because they think it elevates them in some way, even though they have zero training. CNAs are notorious for it.

But again, the point that everyone is missing here is that the family is OK and they believe that the patient is OK. It doesn't matter two farks what the rest of you think.
 
2013-03-07 07:58:54 AM  

audioguy16: As a paramedic, I encounter this predicament once in a while. The problem with this situation is that as a nurse, she has a duty to act .  If the person does not have a DNR, resuscitative efforts are given. As medical professionals,we are always trained to err on the side of the patient. That duty to act  supersedes the facility she works for. She opened herself for that liability.  I won't be surprised if she loses her license.


What is the difference between a "Medic" and a "Paramedic"? One is a licensed and regulated title, and the other is a position that can be assigned to anyone with a first aid kit.
What then, is the difference between "Nurse" and "Registered nurse/Licensed Nurse Practitioner"? Same thing. This individual was called 'nurse' but she is not a medical practitioner. Thus there was no legal obligation.

The facility has NO TRAINED MEDICAL STAFF. This was not a 'nursing home.' This was an 'independent living facility.' It's basically an apartment complex where they have meals provided and there's someone available to help you around your apartment. That's it.
 
2013-03-07 08:02:24 AM  

lohphat: This is not about this instance of denial of care. Even if the family wanted it, the protocol was broken and dysfunction was exposed. They are legally obligated to provide care -- it's not about this grandma, it's abut the next one who needs care and is denied it because a nurse violated her and the facility's legal duty to provide state mandated care as stipulated by their license to operate as a healthcare facility.


Please read article. This was an independent living facility, not a nursing home. An independent living facility is not a healthcare facility. It's an apartment complex that has people available to help you around your apartment and provides meals. That's it.
 
2013-03-07 08:07:44 AM  

Securitywyrm: What is the difference between a "Medic" and a "Paramedic"? One is a licensed and regulated title, and the other is a position that can be assigned to anyone with a first aid kit.


Erm, not really.

Paramedic is an official, legal term, 'Medic is slang derived from the military, and can also refer to a physician depending on what area of the world you're in. Most paramedics will call themselves a 'Medic.

However, both are considered "protected' titles corresponding to holding a license which grants that title in your state. You cannot claim to be a Paramedic without actually having a Paramedic card - i.e. an EMT-Basic who says he's a Paramedic can actually face a charge of practicing outside of his license, and misrepresentation. Impersonation of a Paramedic is, at least in Tennessee, a Felony.

Nurse is the same way. The only people who can call themselves "Nurses" are licensed nursing personel, LVN/LPNs and Registered Nurses, and Advanced Practice Nurses. One of the first things you learn in a CNA class is not to call yourself a nurse, you're a nurse aide.

 One of the reasons you're taught to verify the licensure of a person claiming to be a nurse or a medic on scene, in the field, with their wallet cards is because many people will falsely claim to be one in order to help, or because they want to be involved. I've had everything from nursing students, to some guy who had actually lost his nursing license for violation of the prescribed acts tell me they were a nrurse.
 
2013-03-07 08:31:26 AM  
end of story

Now you can go back to beating off to global warming threads
 
2013-03-07 08:33:12 AM  

hardinparamedic: Securitywyrm: What is the difference between a "Medic" and a "Paramedic"? One is a licensed and regulated title, and the other is a position that can be assigned to anyone with a first aid kit.

Erm, not really.

Paramedic is an official, legal term, 'Medic is slang derived from the military, and can also refer to a physician depending on what area of the world you're in. Most paramedics will call themselves a 'Medic.

However, both are considered "protected' titles corresponding to holding a license which grants that title in your state. You cannot claim to be a Paramedic without actually having a Paramedic card - i.e. an EMT-Basic who says he's a Paramedic can actually face a charge of practicing outside of his license, and misrepresentation. Impersonation of a Paramedic is, at least in Tennessee, a Felony.

Nurse is the same way. The only people who can call themselves "Nurses" are licensed nursing personel, LVN/LPNs and Registered Nurses, and Advanced Practice Nurses. One of the first things you learn in a CNA class is not to call yourself a nurse, you're a nurse aide.

 One of the reasons you're taught to verify the licensure of a person claiming to be a nurse or a medic on scene, in the field, with their wallet cards is because many people will falsely claim to be one in order to help, or because they want to be involved. I've had everything from nursing students, to some guy who had actually lost his nursing license for violation of the prescribed acts tell me they were a nrurse.


So far the criminal probe has found no evidence of wrongdoing. That's not 'we haven't decided to charge' but rather 'there is no evidence they did anything wrong.'

Here's a problem. The 911 operator says that "The facility can't be sued we take responsibility." However... will the dispatcher take responsibility for the job of the person on the phone for breaking facility policy?
You're a licensed paramedic, but let's say that you take a job waiting tables at a restaurant, and there's a wreck across the street. As you say, you're legally obligated to provide assistance. An hour later when you get back, you're fired from the job because you walked off to do your own thing.
Under what you're arguing, anyone who is a licensed nurse or paramedic can't hold a job doing anything else because they'll be legally obligated to play superhero and rush to the scene where they can provide help, regardless of what they're supposed to be doing on the clock.
 
2013-03-07 08:46:38 AM  

Securitywyrm: So far the criminal probe has found no evidence of wrongdoing. That's not 'we haven't decided to charge' but rather 'there is no evidence they did anything wrong.'


Because the either the California Board of Nursing or the DA's office would have to prove that she tried to act in the capacity of a nurse after representing herself as such. It's far harder to get someone on misrepresentation without an act behind it.

Securitywyrm: You're a licensed paramedic, but let's say that you take a job waiting tables at a restaurant, and there's a wreck across the street. As you say, you're legally obligated to provide assistance. An hour later when you get back, you're fired from the job because you walked off to do your own thing.


Depends on the State as to whether you could be compelled to do so or not. Until 2009, in Alabama - for example, EMS personnel had a duty to act regardless if they were on duty of off duty if they were certified or licensed in that state as such, by the State Law. If you failed to do so, you could be reported to the state board for negligence and failure to act and lose your license. Infamously, they went after a Tennessee paramedic who was not even licensed in that state after she drove by a wreck and called 911 rather than stop to render aid. Tennessee board refused to pursue it. However, Alabama also had state laws in place which did not allow an employer to fire a person for doing so if they were not employed as an EMT.

Some states, as well, have specific protections written in for healthcare workers who choose to act while off duty to render aid to prevent termination or litigation.

Securitywyrm: Under what you're arguing, anyone who is a licensed nurse or paramedic can't hold a job doing anything else because they'll be legally obligated to play superhero and rush to the scene where they can provide help, regardless of what they're supposed to be doing on the clock.


Actually, you might want to read the comments I've posted. They all include the phrase "If she was a licensed nurse and employed to provide care in ANY capacity".  Also see the example for Alabama.

If you are not employed or acting in the capacity of a volunteer, that's not what I'm saying at all. However, you have an ethical and moral duty to act based on your profession's oath and ethical guidelines.
 
2013-03-07 09:18:26 AM  

SarcasticFark: Melvin Lovecraft: What an awesome thread!  I learned a lot.  As soon as I saw nurses arguing, my (mostly controllable) nurse fetish set me all aquiver, but the more I read, the more I realized that most of said arguing was being done by male nurses, and that kind of made me sad and somewhat ashamed.  I have a very quick csb to relate:

Early 90's:  I had rudimentary (at best) training in CPR and just happened to be the first aid "go to" guy at a soft drink factory, where I worked nights.  One morning, about 9 or so, after I'd been home for a while and had a few drinks, somebody furiously pounded on my door, startling the shiat out of me.  I opened the door, and it was an old guy (like 70) hollering something about calling an ambulance.  I didn't understand him, and said I hadn't called for one, and he said, "No, I need you to call for one!  My buddy's down!"  I looked out the door, and sure enough, there was a guy laying in the middle of the street.  I lived in a mobile home park, so there was no traffic, and it was about 2 degrees outside; snow piled up 4'.  Michigan in January.  So I dial 911, tell the ambulance where to come, grab my little CPR kit, and run out to save the day.  I took one look at the guy, and I'm just a layman, but I knew right then and there, that that guy was dead.  When the paramedics arrived, they stripped off his clothes and worked him for 40 minutes to no avail.  Even if they were to revive him, he would have probably died right away again from frostbite.  Point is, that guy was dead, and there was nothing ANYONE was going to do to save him.

/just one picture of an angry nurse in lingerie would have been nice in this thread

[highlatencylife.files.wordpress.com image 200x306]


Why does a nurse need a feather duster?
 
2013-03-07 09:49:26 AM  

TabASlotB: .

/just one picture of an angry nurse in lingerie would have been nice in this thread

[highlatencylife.files.wordpress.com image 200x306]

Why does a nurse need a feather duster?


Because apparently we're just glorified maid/waitresses.  I want to see Brony/Hardin in that outfit.

/on second thought...
 
2013-03-07 09:51:57 AM  

hardinparamedic: If you are not employed or acting in the capacity of a volunteer, that's not what I'm saying at all. However, you have an ethical and moral duty to act based on your profession's oath and ethical guidelines.


Ah okay, so long as it's just ethics and morals we're talking about, I can see your point.
However, ethics and morals don't pay the bills. If you want to direct moral and ethical outrage at the company for their policy of not providing medical care, okay. However with all the people unemployed in this country, and the number of people acting as parasites to the system, I'll never fault someone for doing what it takes (within the law) to keep their job.
 
2013-03-07 10:03:03 AM  

lyanna96: I want to see Brony/Hardin in that outfit.


2.bp.blogspot.com
 
2013-03-07 10:45:38 AM  

Securitywyrm: lohphat: This is not about this instance of denial of care. Even if the family wanted it, the protocol was broken and dysfunction was exposed. They are legally obligated to provide care -- it's not about this grandma, it's abut the next one who needs care and is denied it because a nurse violated her and the facility's legal duty to provide state mandated care as stipulated by their license to operate as a healthcare facility.

Please read article. This was an independent living facility, not a nursing home. An independent living facility is not a healthcare facility. It's an apartment complex that has people available to help you around your apartment and provides meals. That's it.


A Licensed nurse was present. She was obligated to provide care under the terms of her license to be a nurse.

Not being in a healthcare facility does not exempt you from state licensing laws.
 
2013-03-07 10:59:18 AM  

lohphat: A Licensed nurse was present. She was obligated to provide care under the terms of her license to be a nurse.


Unfortunately, according to the wording of California State law, he's correct. California does not license assisted living facilities as other states do, and allow them to operate without medically trained or employed staff present.

While it's a pretty dick move, the information coming out is that the woman was not employed by the facility for the purpose of providing medical care, and the person at the patient's side was not a trained attendant.

Even though we can argue the nurse had a moral and ethical obligation to respond, thanks to the way the state law is worded she will get off without even a letter of reprimand from the board.

I suspect, given the outcry and the industry wording on the matter, that this loophole might soon be closed.
 
2013-03-07 07:55:01 PM  

hardinparamedic: lohphat: A Licensed nurse was present. She was obligated to provide care under the terms of her license to be a nurse.

Unfortunately, according to the wording of California State law, he's correct. California does not license assisted living facilities as other states do, and allow them to operate without medically trained or employed staff present.

While it's a pretty dick move, the information coming out is that the woman was not employed by the facility for the purpose of providing medical care, and the person at the patient's side was not a trained attendant.

Even though we can argue the nurse had a moral and ethical obligation to respond, thanks to the way the state law is worded she will get off without even a letter of reprimand from the board.

I suspect, given the outcry and the industry wording on the matter, that this loophole might soon be closed.


I'm moving to Denmark.

Thanks for the clarification but what concerns me more is my original point: a nurse elected to not give care without an MD or DNR. Who speaks for the next patient who wants to be revived in that scenario?
 
2013-03-07 09:42:47 PM  
The more you eat the more you fart:

I have a master's +30 in my field, and am licensed by my state as a "Trauma Nurse, MSN, Level 2-A" which means I out-rank you in skill, knowledge, and practical application by an order of magnitude.

I just turned 36


There's a typo in here somewhere...
 
2013-03-07 09:56:02 PM  

Pontious Pilates: 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?


The situation changed during the call.
At the time the call began, it was a simple collapse and unresponsiveness, cause unknown.  For this, you call the ambulance, no doubt.  As stated above, you do NOT do CPR on a person that is unconscious but is breathing and has a pulse.

Halfway through the call, the patient went into total respiratory arrest.

And THAT'S where things went straight to shiat...
 
2013-03-07 11:27:56 PM  

Ishidan: As stated above, you do NOT do CPR on a person that is unconscious but is breathing and has a pulse.


As of the 2010 guidelines, this is not correct. Laypeople are no longer taught to look for a pulse, as research has shown a >50% false detection rate in studies. In addition, rescue breathing is not performed if there are signs of poor circulation or gasping respirations, they are taught to go directly to CPR.

Coincidentally, CPR - including compressions - are provided to neonates, infants and pediatrics who have a pulse below 60 all the time as part of the Pediatric/Infant BLS and PALS ALS protocols. They've actually shown, in research, that CPR will not stop an adult heart if performed, but it will be painful as hell and run the risk of injuring the liver, pancreas, diaphragm or stomach from the xiphoid process.

Ishidan: Halfway through the call, the patient went into total respiratory arrest.


Incorrect. The Priority Dispatch system that the dispatcher uses identified what the caller told them as ineffective breathing and questionable life status, which pulls the ProQA system into the Pre-arrival instruction mode and instructs the dispatcher to provide CPR instruction.

Had the caller told the dispatcher simply that the facility had documentation on the patient's wishes to not be resuscitated, and that she did not want CPR, it would have ended the debacle right there. That's why having the paperwork is so important. That facility policy is useless to the EMS crew responding, and to the hospital which recieves that patient, and there is a chance of getting a vegetable back in that event.

 circ.ahajournals.org
 
2013-03-08 04:48:50 PM  

Ishidan: The more you eat the more you fart:

I have a master's +30 in my field, and am licensed by my state as a "Trauma Nurse, MSN, Level 2-A" which means I out-rank you in skill, knowledge, and practical application by an order of magnitude.

I just turned 36

There's a typo in here somewhere...


I've been suspicious of tmyetmyf throughout this entire thread. His/her posts have been characterized by a lot of yelling, a lot of abuse, a few (very) unusual anecdotes . . . but not a lot of actual, cited information.

I'm guessing the "just turned 36" was a forgetful moment of honesty.
 
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