The Toybox

people for the conservation of limited amounts of indignation


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not what i really needed to find out today
children of dune - leto 1
seperis
I don't think any company should be able to create a policy that literally prohibits its employees--that would be staff, including trained medical staff at a senior living facility--from trying to save someone's life and perform CPR. When I say "I don't think" what I mean is, are you fucking serious?

Below cut for triggering material, including links to information about the death of a patient in an independent nursing facility, links to audio and partial transcripts of the 911 call.



Actually, yeah, that can happen. For seven fucking minutes.

I heard some of the 911 call--did I mention the entire thing is seven minutes?--on the radio, which, if you're curious, is exactly as chilling as the article makes it sound. It's not that I don't get a company would try to pull something like this, because companies are run by people and people suck when they can put everything in the abstract; what I don't get is that, in general, a person doesn't suck, and this is about as concrete as it gets.

ETA: as I hit post when I went to get other links by accident.

Nursing Home CPR Case: Glenwood Gardens Defends Nurse Who Refused To Help Ailing Patient

Retirement Home's 'No CPR Policy' Makes No Legal Sense

Listen: Nurse Refuses To Give CPR To Dying Woman - link at the bottom to the an mp3 of the 911 call

Dramatic 911 tape reveals dispatcher’s fight to save patient; nurse refuses to help - this has a partial transcript of parts of the conversation between the nurse and 911

Ethics required medical staff to do CPR, even if policy didn't, bioethicist writes

Posted at Dreamwidth: http://seperis.dreamwidth.org/967940.html. | You can reply here or there. | comment count unavailable comments

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I work in an independent living facility and we're all certified in cpr and I work in the kitchen.

Honestly, until now, I had assumed that the attraction of independent living facilities was, y'know, being able to keep personal autonomy in your life and living arrangements while also being within close proximity to medical care in the event you need it. I mean, why on earth else would anyone want to live there? I mean, if someone wants to have an audience die because no one will do CPR, dude, there are much cheaper places to live.

*sends sympathy and support* I'm going to guess a lot of independent living facilities and their employees who aren't actively engaged in evil are going to be getting some flack as this unfolds.

We don't have any medical staff at our building - there is at the nursing home, but our 'policy' is to call an ambulance if there's a problem. We all know cpr, but I've never done it on a living person before. (And the way my luck is going, that'll probably change.)

I don't really like talking about this, but 6 years ago, we had a woman fall in our front lobby. One of my coworkers and I went up there and talked to her, she said she was fine, so we helped her up. Turns out she'd had a stroke (she died later) and we shouldn't have helped her up. Now I'm paranoid about helping a person get up after a fall.

*LOTS OF HUGS* I'll be honest, I'd feel the same in your situation, but I really, really hope you don't blame yourself for that.

It didn't help that we had a caregiver for another resident and she made a couple comments about us killing her. But I try not to dwell on it. It wasn't intentional, so I just remind myself when I get bogged down on the details.

Define 'shouldn't have helped her up'? Because really, there's no reason not to help her up, beyond being aware of any injuries she sustained during, and being careful of moving the head/neck/spine as little as possible, if you can help it. Having a stroke doesn't inherently mean they shouldn't be moved, so I'm not sure why you say that.

That's what the paramedics said when they came.

If it was a true stroke, it could be either from a blood clot (which prevents some or all blood going to the brain), or from a bleed (which means blood is leaking into the brain). Paramedics are incapable of determining which type it is, and can only identify stroke-like symptoms and transport to a proper facility for definitive care. They can't identify the presence of a clot or bleed, or when it occurred beyond the incident that likely caused it (usually identified by when the slurred speach/facial droop/arm drift begins), and they certainly can't tell if you moved a blood clot further along, made it more occlusive, or caused a subdural bleed (somehow, by helping someone up.. yeahno).

Don't take it personal. If you have, then I'm truly sorry, because it wasn't right for them to put that guilt on you at all.

But in case you'd like some advice from an internet stranger, if you've got someone who fell and you didn't witness it and don't know the extent of injuries, you generally want to protect the head/neck/spine (by immobilizing them, generally) as best you can, don't let them move their head or neck or back much at all if you can help it. The only exception here is if there's an airway compromise, because airway is more important than this (better alive and paralyzed from nerve damage than dead but with an injured nervous system).

I suspect they weren't happy that you helped her up because you don't know to do that, but blame her death on you because of it? That's crazy and they couldn't back that up if challenged.

Thank you for telling me that. It's been almost 6 years now since it happened and I still think of her. I loved that woman to pieces and it made me skittish for a long time after that.


Thank you very much for explaining that.

As someone who took a CPR class, like, I don't know, maybe ten years ago. how do you live with yourself? This isn't POLICY???????????????????

You know, I wonder that, too.

WHAT? How is any human being unwilling to perform CPR (especially when being guided), nevertheless how does a NURSE not do it? I mean, it is not a grey area here. They knew it was life or death, and the person on the phone refused to help or ask anyone else to help. It is one thing to live in the independent part of the facility and not expect nursing care. It is quite another to live there and thus not be treated with the common care a stranger might show. If she'd somehow cut her femoral artery, would they have just stood around and watched her bleed out on the floor until the ambulance arrived? Oh, probably. And then charged her to clean up. What the fuck?

Yeah, I'm really shaky on the legality of specifically prohibiting emergency are. Hell, legality be damned; I'm shaky on how that doesn't fall under sociopathic behavior.

I can't wrap my mind around this. I have my job because I can make pretty pictures on my computer, and they brought people in to certify me in CPR just in case.

*nods* It's--something, yeah.

I've seen this a lot, and the only thing I can think is that the patient had a DNR. The family, from what I've heard, isn't pressing any charges and the nurse isn't in trouble.

Although it's difficult, if a person has a Do Not Resuscitate, than the nurse literally could not go against that wish.

But since the audio didn't mention that, I don't know why else she wouldn't.

So far, the articles are stating she did NOT have a DNR.

exactly my thinking. maybe the nurse thought she had one, even if she didn't? if you resuscitate a person who has one, and you're their caregiver (so, not a passerby), they can sue the shit out of you, and rightfully so, since they chose to die and you ignored their wishes. not just policy, but a moral obligation. if that idea is involved somehow, at least it helps explain how something like this could happen.

I wonder if the so called policy, was put in place after an incident which did not have a good outcome.

The policy may have been with the very real threat of dismissal, if broken. What if the nurse was a single mother? What level of nursing does she have?

I'm not defending the action or inaction, as a retired RN there is no way I could ever stand there and do nothing, but I have a sense we don't know all the facts. The very fact the family are not pursuing this, speaks volumes to me.

This is what I'm wondering, too. Especially with the poor outcomes for geriatric CPR, and this country's sue-happy behavior, I could easily see the nurse having been threatened with dismissal or lawsuit if she had done something outside policy. (Especially if, as with a lot of these places, "nurse" is just a title with no training behind it. I'm a former EMT who fixes computers these days, and I've been in some of these independent living facilities where I was hands-down the most qualified medical personnel in the building.)

I don't know that I could have done nothing, in her position, but I can't know what was going on in her head.

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