What gives?

layoutshooter

Veteran Expediter
Retired Expediter
What gives here? Did this woman have a "DNR" order? Is this something we can expect more of in the future? Is this the "norm" these days? Sure hope there is more on this to come out. Do the residents of this place understand what they face? Lot's of questions and few answers in the article. It is disturbing.



[h=1]Elderly Woman Dies After Nurse Refuses to Give Her CPR[/h]
A 911 dispatcher pleaded with a nurse at a Bakersfield, Calif., senior living facility to save the life of an elderly woman by giving her CPR, but the nurse said policy did not allow her to, according to a newly released audiotape of the call.

"Is there anybody there that's willing to help this lady and not let her die?" the dispatcher asked in a recording of the 911 call released by the Bakersfield Fire Department.


"Not at this time," the nurse said.


The incident unfolded on Tuesday when 87-year-old Lorraine Bayless collapsed at Glenwood Gardens, a senior living facility in Bakersfield.


In the seven-minute, 16-second recording, the nurse told the dispatcher it was against the facility's policy for employees to perform CPR on residents.


With every passing second, Bayless' chances of survival were diminishing. The dispatcher's tone turned desperate.


"Anybody there can do CPR. Give them the phone please. I understand if your facility is not willing to do that. Give the phone to that passerby," the dispatcher said. "This woman is not breathing enough. She is going to die if we don't get this started."


After several minutes, an ambulance arrived and took Bayless to Mercy Southwest Hospital, where she died.


Glenwood Gardens released a statement confirming its policy prohibiting employees from performing CPR.


"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," the statement said.


Despite protocol being followed, the nursing home said it would launch an internal investigation into the matter.









Elderly Woman Dies After Nurse Refuses to Give Her CPR - Yahoo! News
 

davekc

Senior Moderator
Staff member
Fleet Owner
I don't know if it is Obamacare, but certainly the fear of being sued plays in to it.
 

layoutshooter

Veteran Expediter
Retired Expediter
I agree and so would I. Unless this woman had a "DNR" order on record there would be no question as to what is the right thing to do.

I did once withhold CPR on a patient. He was obviously dead. Eye open and full of dirt, no blinking. Pupils, fixed. No pulse. No breathing. Ear to ear cut across the neck, deep, no bleeding. I saw no point. Moved on to the other patient who was alive and concentrated resources on her.

There are reasons to withhold CPR. A "policy" is not one of them.
 

Tennesseahawk

Veteran Expediter
It's a sign of the times. People will do crap, and not care about the consequences. Consciences are getting to be hard to come by.

Oh... and I love the part...

"We are doing an internal investigation, because public opinion of our policy found them to be soulless."
 
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layoutshooter

Veteran Expediter
Retired Expediter
There is no excuse for cowards. If that was the case. There are those who do right, and those who do wrong. There is no excuse.
 

Humble2drive

Expert Expediter
What gives here? Did this woman have a "DNR" order? Is this something we can expect more of in the future? Is this the "norm" these days? Sure hope there is more on this to come out. Do the residents of this place understand what they face? Lot's of questions and few answers in the article. It is disturbing.

It is hard to tell "what gives" here due to the lack of information.

If the woman had a DNR order then the nurse most likely would have stated that.

In the absence of a DNR, a physician has the responsibility to determine the "Intent of care". In the case of an elderly patient who is suffering great discomfort which will inevitable result in death, it can be deemed that prolonging the dying experience without benefit is futile and not in the patient's best interest.
This could be one reason for the policy that the nurse is referring to.

As DaveKC states, liability is always a part of these decisions as well. :(

This may turn out to be very "disturbing" or it may be that the patient was relieved from further suffering. More info needed.
 

layoutshooter

Veteran Expediter
Retired Expediter
Not always.

Most of the time it is. There are a few circumstances where it is not good, but the norm is to act and provide CPR. A work place "policy" should never dictate what is given. Only the patient should.

Again. No mention was made of a possible "DNR" order on record. Barring that it should have been provided. Company policy is not a "DNR" order and holds no moral requirement to follow it.
 

Humble2drive

Expert Expediter
Most of the time it is. There are a few circumstances where it is not good, but the norm is to act and provide CPR. A work place "policy" should never dictate what is given. Only the patient should.

Again. No mention was made of a possible "DNR" order on record. Barring that it should have been provided. Company policy is not a "DNR" order and holds no moral requirement to follow it.

Yes. Absolutely CPR is the right decision in almost every case.

Yes. I agree that no DNR order was mentioned and probably doesn't exist. Most people who end up in a situation where they need one do not have it due to lack of education, lack of money to pay for one, procrastination, etc.

My point was that given the patient's age and the fact that she was in a senior facility. Her physician may have shifted her intent of care away from "life prolonging care" to "comfort and care" if resuscitation could prolong a painful yet inevitable dying process. That would be a standing order vs a "workplace policy".

What the nurse referred to as a "policy" at the spur of the moment during a 911 call is being called a "practice" by the facility management and is under internal investigation. If they do in fact refuse CPR to ALL patients yet call 911 and allow CPR in their facility by EMTs then this smells of legal liability issues.
If you do see any follow up stories on this it would be interesting to see. Too often, the initial headline grabbing story hits page one and the follow up story gets buried somewhere.
By the way, what is a moral responsibility?
 

Turtle

Administrator
Staff member
Retired Expediter
The statement released by the facility pretty much says it all...

"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."
 

layoutshooter

Veteran Expediter
Retired Expediter
The statement released by the facility pretty much says it all...

"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."

Unless I was aware of a "DNR" on record for this particular person I would have ignored the "practice" or "policy" and performed CPR.

CPR, as you know, is a stopgap measure to try to prevent brain death long enough to allow emergency services to arrive. It seldom "revives" anyone. It buys the person time.


In the real life it is going to take emergency services AT LEAST 10 minutes to arrive on the scene and a couple of minutes to start operations. That is a death sentence. Brain death, without intervention, occurs at about 10 minutes. In many areas, rural and urban alike, 10 minutes is a generous estimate. 20-40 is more the norm. In Detroit they may never arrive.

I would wonder, if that is a written policy at the home, are the residents made aware of it and do they understand the meaning of it. It is possible that this woman had a "DNR" order in place? Sure, in which case the proper course was followed. Would "CPR" have saved this woman's life? Not likely. It seldom does in general and it is less likely to work in the elderly. That does not relieve one of the moral obligation to act, if in a position and training level to act, no matter what the policy of the work place.
 

EnglishLady

Veteran Expediter
Yes. Absolutely CPR is the right decision in almost every case.

Yes. I agree that no DNR order was mentioned and probably doesn't exist. Most people who end up in a situation where they need one do not have it due to lack of education, lack of money to pay for one, procrastination, etc.

My point was that given the patient's age and the fact that she was in a senior facility. Her physician may have shifted her intent of care away from "life prolonging care" to "comfort and care" if resuscitation could prolong a painful yet inevitable dying process. That would be a standing order vs a "workplace policy".

What the nurse referred to as a "policy" at the spur of the moment during a 911 call is being called a "practice" by the facility management and is under internal investigation. If they do in fact refuse CPR to ALL patients yet call 911 and allow CPR in their facility by EMTs then this smells of legal liability issues.
If you do see any follow up stories on this it would be interesting to see. Too often, the initial headline grabbing story hits page one and the follow up story gets buried somewhere.
By the way, what is a moral responsibility?

This a actually a question for my education :) .....

The lady was in an Independent Living Community not a Nursing Home or Hospice .... in the UK Independent Living Community means the resident lives in their own apartment that have emergency alarms in every room, just in case the resident needs help due to a fall or whatever.

If a residents health is an issue, needing regular medical care, then they would need a Nursing Home &/or a Hospice if terminally ill.

Are USA Independent Living Communities different?
 

layoutshooter

Veteran Expediter
Retired Expediter
This a actually a question for my education :) .....

The lady was in an Independent Living Community not a Nursing Home or Hospice .... in the UK Independent Living Community means the resident lives in their own apartment that have emergency alarms in every room, just in case the resident needs help due to a fall or whatever.

If a residents health is an issue, needing regular medical care, then they would need a Nursing Home &/or a Hospice if terminally ill.

Are USA Independent Living Communities different?


It is more or less the same here. People can choose the level of independence wanted based on individual needs. Some places are privately funded and some operate, all or in part, on government subsidies.
 

EnglishLady

Veteran Expediter
It is more or less the same here. People can choose the level of independence wanted based on individual needs. Some places are privately funded and some operate, all or in part, on government subsidies.

Thank you for that :)

So my next question would be to Humble2drive .......

Quote Humble2drive
"My point was that given the patient's age and the fact that she was in a senior facility. Her physician may have shifted her intent of care away from "life prolonging care" to "comfort and care" if resuscitation could prolong a painful yet inevitable dying process. "

Obviously we do not know all the facts, but would this lady be in an ILC if she was that ill?
 

layoutshooter

Veteran Expediter
Retired Expediter
Many people have "Living wills" or "DNR" orders on record. Those documents spell out the needs and wants of the individual in the event of an emergency. Those orders should be reviewed and changed as the individuals life changes.

Company "policy" is NOT a valid reason to withhold treatment. Same goes for "government policy". Health care and end of life issues are individual issues and should ONLY be dealt with by the individual and their health care provider.
 

layoutshooter

Veteran Expediter
Retired Expediter
Yes. Absolutely CPR is the right decision in almost every case.

Yes. I agree that no DNR order was mentioned and probably doesn't exist. Most people who end up in a situation where they need one do not have it due to lack of education, lack of money to pay for one, procrastination, etc.

My point was that given the patient's age and the fact that she was in a senior facility. Her physician may have shifted her intent of care away from "life prolonging care" to "comfort and care" if resuscitation could prolong a painful yet inevitable dying process. That would be a standing order vs a "workplace policy".

What the nurse referred to as a "policy" at the spur of the moment during a 911 call is being called a "practice" by the facility management and is under internal investigation. If they do in fact refuse CPR to ALL patients yet call 911 and allow CPR in their facility by EMTs then this smells of legal liability issues.
If you do see any follow up stories on this it would be interesting to see. Too often, the initial headline grabbing story hits page one and the follow up story gets buried somewhere.
By the way, what is a moral responsibility?


If you don't know what a moral responsibility is I can't teach you. That is taught to the young, to prepare them for adult life.

There is NO cost to a DNR order or living wills. The patient's doctor is not there to "shift" the care, only to insure that the patients personal wishes are adhered too. NO doctor, home or government has the right or authority to decide life and death issues.

I listened to the 911 call, the nurse's tone of voice in itself was disturbing. Even the 911 op was bothered by it. It did seem, and I understand it was only one phone conversation, that she did not care about this woman in any way, shape or form.
 

LDB

Veteran Expediter
Retired Expediter
"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," the statement said.

The following is our medical emergency policy:

In the event of a health emergency we will take the trouble of dialing 911 and then we'll do absolutely nothing except sit and watch and wait. Don't expect us to do anything to attempt to save the life of your loved one. That is not part of our storage service for your loved one. We store them for you, we do not treat them for you.
 
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