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Calif. woman dies after nurse refuses to perform CPR

Napoleon said:
CBS is reporting otherwise and I'm more inclined to err on the side of reason and compassion.



Right, says the daughter who dumped her mother in a death house. Abandoning the elderly is a sick practice in this country.
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No links? Just how long was this old woman supposed to live? 92? 103? Do you have any idea what her medical condition was? Many people die younger than 86. Not everyone that dies was "abandoned" or "mistreated". What makes you even think that she was even "sick"? I have had friends suffer strokes, contract cancer and have all sorts of "sudden onset" conditions but know that they were (and many are) still loved and cared for. It is 100% guaranteed that everyone born will die, regardless of the statndard of care afforded them. You jump to conclusions based on your assertions, yet do not provide us evidence to back them up. I have no dog in this hunt, I simply supply information available to me - I suggest that you do the same.
 
ttwtt78640 said:
No links?
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I provided the link in post #106.

ttwtt78640 said:
Just how long was this old woman supposed to live? 92? 103? Do you have any idea what her medical condition was? Many people die younger than 86. Not everyone that dies was "abandoned" or "mistreated". What makes you even think that she was even "sick"? I have had friends suffer strokes, contract cancer and have all sorts of "sudden onset" conditions but know that they were (and many are) still loved and cared for. It is 100% guaranteed that everyone born will die, regardless of the statndard of care afforded them. You jump to conclusions based on your assertions, yet do not provide us evidence to back them up. I have no dog in this hunt, I simply supply information available to me - I suggest that you do the same.
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Just because every human will inevitably die doesn't mean you should simply stand there watching them die without attempting to save them. That isn't medicine. That isn't nursing. The facts are that CPR is called for in this situation and it was not administered. We don't know if CPR would have saved the woman but we do know that a licensed medical professional is ethically obligated to provide assistance in such situations and that pathetic excuse of a nurse didn't even try. Here's hoping that your local medical professionals don't hold your view should you ever have a heart attack.
 
Napoleon said:
The facts are that CPR is called for in this situation and it was not administered.
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You don't perform CPR on someone who's still breathing.

Did you notice how the 911 operator never had anyone check the woman's pulse? Chest compressions on a heart that's still beating = bad.
 
Jerry said:
You don't perform CPR on someone who's still breathing. Did you notice how the 911 operator never had anyone check the woman's pulse? Chest compressions on a heart that's still beating = bad.
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I'm going to go with the American Heart Association on this one. BTW - The nurse should have checked her pulse. What exactly is the function of this nurse anyway?
 
This can all seem very abstract to a healthy middle-aged person with no history of heart problems. But as people age, and increasingly cope with multiple diseases and frailty, the issue grows more urgent and more complex. The blunt question: Should a frail, elderly person receive CPR?

In his 33 years as an emergency room doctor — mostly in hospitals in Maryland and now at Christian Hospital in St. Louis — Dr. David Davis estimates he has resuscitated 600 people. CPR, he likes to point out, was developed during the Korean War to help wounded soldiers — otherwise healthy young men — stay alive until they reached field hospitals. Doing chest compressions on fragile old people disturbs him.


“It is violent,” Dr. Davis told me in an interview. “If you don’t do it hard enough, you can’t move any blood.” But if you do thrust hard enough, “you’re going to break the ribs and maybe the sternum.”

More on CPR for the Elderly - NYTimes.com
 
Napoleon said:
I provided the link in post #106.

Just because every human will inevitably die doesn't mean you should simply stand there watching them die without attempting to save them. That isn't medicine. That isn't nursing. The facts are that CPR is called for in this situation and it was not administered. We don't know if CPR would have saved the woman but we do know that a licensed medical professional is ethically obligated to provide assistance in such situations and that pathetic excuse of a nurse didn't even try. Here's hoping that your local medical professionals don't hold your view should you ever have a heart attack.
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Pathetic excuse for a nurse? What facts do you have? What you've read on line? The facility itself gave an interview during which they said every person living there had agreed to a DNR. That's first off. Second, giving proper CPR to someone 87 years old is a pretty sure way to kill them. 80-100 proper chest compressions per minute would break all of her ribs at minimum. Proper chest compressions compress the chest from 1-1/2" to 2". On a healthy young person they're going to be injured. Punctured lungs, lacerated organs, punctured heart muscle. To an 87-year-old. Yes!!! Just give CPR!!! Good God.
 
And there are "good Samaritan laws" that do not protect medical personnel. We now live in an age of litigation, but even when I was a little kid, my parents, both of them medical professionals, were loathe to stop and render aid because of the liability.

What lawyers hath wrought, LOL.
 
MaggieD said:
Pathetic excuse for a nurse? What facts do you have? What you've read on line?
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Once again, the American Heart Association. Besides, if the nurse isn't permitted to perform any medical duties then why is she there in the first place?

MaggieD said:
The facility itself gave an interview during which they said every person living there had agreed to a DNR.
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Says the for-profit death house trying to save face.

MaggieD said:
That's first off. Second, giving proper CPR to someone 87 years old is a pretty sure way to kill them. 80-100 proper chest compressions per minute would break all of her ribs at minimum. Proper chest compressions compress the chest from 1-1/2" to 2". On a healthy young person they're going to be injured. Punctured lungs, lacerated organs, punctured heart muscle.
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I'd rather have a lacerated organ than be dead. The likelihood that it would have saved her life is low (maybe 18% according to this study) but standing around doing nothing but whine about how stressed you are is NEVER an acceptable or ethical practice for a licensed nurse in the course of a medical emergency. It doesn't matter whether the patient would have eventually died. What matters is that a licensed nurse is ethically required to provide medical assistance barring a DNR order (and according to CBS there wasn't one.)
 
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Napoleon said:
Once again, the American Heart Association.

Says the for-profit death house trying to save face.

I'd rather have a lacerated organ than be dead.
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Are you 87 years old? This isn't about you.
 
Napoleon said:
I provided the link in post #106.



Just because every human will inevitably die doesn't mean you should simply stand there watching them die without attempting to save them. That isn't medicine. That isn't nursing. The facts are that CPR is called for in this situation and it was not administered. We don't know if CPR would have saved the woman but we do know that a licensed medical professional is ethically obligated to provide assistance in such situations and that pathetic excuse of a nurse didn't even try. Here's hoping that your local medical professionals don't hold your view should you ever have a heart attack.
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From your CBS link:

That depends upon two things: first is, what's the agreement that this woman and her family had with this home, and...it was a residential facility, not a nursing home, assisted living. Very different if it was that. So if their agreement they say specifically, 'We do not provide emergency medical care. We will get somebody for you,' then that could shield them from some problems.
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Napoleon said:
Indeed, this is about medical ethics and the nurse clearly has none.
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The nurse works at a facility that is clearly no-CPR and the residents live there by choice. I see it as a sort of soft-DNR, though sad.
 
Napoleon said:
Indeed, this is about medical ethics and the nurse clearly has none.
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Until it is shown that the residents did not sign DNR's, your opinion is worthless. Medical ethics quite clearly call for DNRs to be honored.
 
ttwtt78640 said:
From your CBS link:
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It doesn't matter. The nurse is bound my medical ethics. From the Code of Ethics for Nurses and published by the American Nursing Society:

"The nurse should provide interventions to relieve pain and other symptoms in the dying patient even when those interventions entail risks of hastening death. However, nurses may not act with the sole intent of ending the patient's life even though such action may be motivated by compassion, respect for patient autonomy and quality of life considerations."

That nurse did ZERO to ease that woman's suffering. Her license should be suspended at best. She doesn't need it to be a fly on the wall anyway.

MaggieD said:
Until it is shown that the residents did not sign DNR's, your opinion is worthless. Medical ethics quite clearly call for DNRs to be honored.
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I've already posted a link from CBS clearly stating that she did not have a DNR order on file.
 
Napoleon said:
It doesn't matter. The nurse is bound my medical ethics. From the Code of Ethics for Nurses and published by the American Nursing Society:

"The nurse should provide interventions to relieve pain and other symptoms in the dying patient even when those interventions entail risks of hastening death. However, nurses may not act with the sole intent of ending the patient's life even though such action may be motivated by compassion, respect for patient autonomy and quality of life considerations."

That nurse did ZERO to ease that woman's suffering. Her license should be suspended at best. She doesn't need it to be a fly on the wall anyway.
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That's baloney. A nurse is not bound to disregard a DNR. In fact, she is bound to honor it.
 
Welcome to the United States of Litigation.

First the news once again blew the original story. The person who refused to do CPR was not a nurse.
"The staffer was identified today as a resident services director, not a nurse "Refusal to Give CPR to Elderly Woman Probed by Police - ABC News

"In the event of a health emergency at this independent living community, our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives. That is the protocol we followed," Jeffrey Toomer said in a statement issued to ABC News.

Seems the known policy was followed.
 
MaggieD said:
That's baloney. A nurse is not bound to disregard a DNR. In fact, she is bound to honor it.
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Once again, as reported by CBS, there was no DNR order and if you don't like the Code of Ethics for Nurses then you'll have to take it up with the American Nurses Association.
 
Napoleon said:
Indeed, this is about medical ethics and the nurse clearly has none.
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No.

No. She was constrained by legal obligations. A terrible situation, to be sure, which is why this has made the news (plus audio's "Not at this time"). Maggie noted the facility's DNR policy, and the patient's daughter has affirmed this in what she has said following her mother's death.
 
Napoleon said:
Once again, as reported by CBS, there was no DNR order and if you don't like the Code of Ethics for Nurses then you'll have to take it up with the American Nurses Association.
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Hello! The facility has a no-CPR policy that all residents are aware of and still chose, even pay, to live there. The nurse was bound by contract not so different than DNR, entered into with informed consent by residents.

Have you been listening to replays of radio news from today? This no-CPR deal is old news now.
 
nota bene said:
No. No. She was constrained by legal obligations. A terrible situation, to be sure, which is why this has made the news (plus audio's "Not at this time"). Maggie noted the facility's DNR policy, and the patient's daughter has affirmed this in what she has said following her mother's death.
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She was not constrained by legal obligations. As reported, there was no DNR order on file for this woman and California has a Good Samaritan law. Also the fact that no one has ever been successfully sued for administering CPR.
 
Napoleon said:
I completely agree and, because this woman did not sign a DNR order, I have to assume that she would have wanted to be saved. Places like this are where uncaring children ship their parents to die. No elderly person in their right mind would choose to live there. Nursing homes are often viewed as death traps and this is one reason why.
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I completely disagree with your characterization of nursing homes (and by implication, assisted living centers, etc). In some cases, children have no choice. If your parent is demented, incontinent, bed-ridden, etc it can be impossible to care for them at home. In addition, depending on the circumstances, these places can provide the patient with a level of socializing they could not get anywhere else.
 
Napoleon said:
I'm going to go with the American Heart Association on this one. BTW - The nurse should have checked her pulse. What exactly is the function of this nurse anyway?
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You apparently don't know what the AHA's current recommendations for CPR are. You don't check the pulse any more before starting CPR. You check breathing and responsiveness:

Part 5: Adult Basic Life Support
 
Napoleon said:
True, but I've never met an elderly person who would rather be in a place like that than at home. Since you're in the administrative field of healthcare; Is it more expensive to put someone in a (non) nursing home than to hire a home nurse? I'm also wondering, whats the point in having a nursing staff if they're only allowed to do what anyone off the street could do?
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Depending on the circumstances, medicare will pay for a nursing home, but not enough to pay for round the clock in the home.
 
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