US Facility defends nurse who refused to perform CPR

The one important sentence in the article is buried. The daughter of the woman who died says:

"KGET-TV says Bayless' daughter told the station she is a nurse and was "satisfied with Glenwood's handling of the situation." It said she had no "do not resuscitate" order on file."

Do not resuscitate means no cpr. The patient's final wish was followed.

Eta no, I'm wrong, it says no no dnr order. Sorry. :oops:
 
They may well have fired her if she had performed CPR, since it's against their policy.

Also, the resident had a DNR directiveon file. Although, as the story is reported, it appears the staff didn't make their decision based on the DNR, but on their policy, which is to not perform CPR on their independent living residents (who don't pay as much as their assisted living and skilled nursing residents, who would receive CPR).

Shame on the nurse and the retirement facility if the decision was based on the policy rather than the DNR directive.
 
ledboots said:
The one important sentence in the article is buried. The daughter of the woman who died says:

"KGET-TV says Bayless' daughter told the station she is a nurse and was "satisfied with Glenwood's handling of the situation." It said she had no "do not resuscitate" order on file."

Do not resuscitate means no cpr. The patient's final wish was followed.
Click to expand...


There wasn't any "do not resuscitate" order on file.

"It said she had no "do not resuscitate" order on file."
 
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mlp said:
They may well have fired her if she had performed CPR, since it's against their policy.

Also, the resident had a DNR directiveon file. Although, as the story is reported, it appears the staff didn't make their decision based on the DNR, but on their policy, which is to not perform CPR on their independent living residents (who don't pay as much as their assisted living and skilled nursing residents, who would receive CPR).

Shame on the nurse and the retirement facility if the decision was based on the policy rather than the DNR directive.
Click to expand...

Yea, it was the facilities policy, which is why I said to remind me to never go to a nursing home. The daughter may have known about the policy, but I'm guessing the mother didn't....
 
This is why I think some rules are made to be broken. And why I hated formal workplaces when I was working full time- at times I was forced to do unethical or stupid things (not like this, but other things) because it was the "company's policy" and you are not allowed to make your own decisions. But I think the nurse was spineless. Sometimes you have to break rules to do the right thing.
 
beancounter said:
Yea, it was the facilities policy, which is why I said to remind me to never go to a nursing home. The daughter may have known about the policy, but I'm guessing the mother didn't....
Click to expand...

I think I didn't make myself clear. There were two separate things at play here.

1. The mother had signed a do not resuscitate directive (DNR). That's basically a directive to not take any steps to resecitate if the heart stops beating and/or the individual stops breathing, and is not unusual for elderly or terminally ill people who don't want to prolong the process of dying.

2. The facility has a a policy to not perform CPR on independent living residents, but instead to call 911. The reason for that is because the facility isn't offering nursing services to the independent living residents, who aren't paying for those services.

If a nurse refuses to do CPR based on 2., then I say shame on her and shame on the facility.

If the nurse refused to do CPR based on 1., then she was doing exactly as the woman in question wanted, and she should be commended for standing up to the 911 operator, who would have been out of line.

In any event, even if the nurse refused based on 2. (not knowing, at that moment, about the DNR), the outcome was as the woman wanted and had directed pursuant to the DNR.

Hospitals (and many retirement facilities) put some kind of code on the door and/or chart so that staff can immediately tell if the patient/resident has a DNR directive on record.
 
beancounter said:
Another thought. Why bother having nurses on staff if you're not going to provide vital medical services...like CPR.
Any technican can give a shot, hand out pills, or attach an IV.
Click to expand...
No. Not an IV, they can't. Or shouldn't. It is very easy to kill someone by mistake.

The nurse was on duty caring for the patients in the skilled nursing facilities section. Believe me, nurses know exactly who hss a DNR and who doesn't. It is on the chart, the door, the computer, the patient likely has a yellow dnr wristband on, etc.

A DNR is not something the daughter can just make up. A doctor's order is needed.

Edit: Oh i'm sorry whoops I read that wrong, that's what I get for doing 2 things at once! She had no dnr order.

I would have done cpr no matter what the institution's policy is. Because of the risk of lawsuits, my hospital has a policy that if someone who isn't a patient codes, we are supposed to call 911 and not intervene, even for a fellow staff member.
I participated in one code when a maintenance worker had a heart attack, and once I gave a patient visitor epinephrine without a doctor order. They were both fine, luckily. No one said anything to me except "Don't do it again." :rolleyes:
 
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I have no children and no siblings, so a nursing home would be my only option if I couldn't live on my own. Luckily I will probably die before then.
 
beancounter said:
Another thought. Why bother having nurses on staff if you're not going to provide vital medical services...like CPR.
Any technican can give a shot, hand out pills, or attach an IV.
Click to expand...

This facility is typical of a larger scale retirement facility which provides three levels of care, in three distint areas. The independent living residents typically live in apartment or townhomes. They don't get medical services as part of their package - they're basically a bunch of healthy seniors living in senior housing. That's where the woman in question was living.

The assisted living residents typically also live in apartments or suites, sometimes just a room. They get some assistance as far as checking whether they're taking their meds, eating, etc., and help taking their meds, if necessary.

The skilled nursing facility is for those who need around the clock supervision/care. They're more typical of what most people think of as a nursing home.

There may be different packages available as far as housekeeping, laundry, meals, etc. that the residents of the independent living and/or assisted living areas can avail themselves of, but the foregoing is a general summary of the medical side of these facilities. It's typical of residents to move from independent living to assisted living to skilled nursing as their physical and/or mental condition deteriorates. (Many/most of the skilled nursing facilities have locked Alzheimer's units.)
 
ledboots said:
A DNR is not something the daughter can just make up. A doctor's order is needed.
Click to expand...

Maybe in Florida a doctor's order is needed, but in the states with which I'm familiar, it's a decision made by an individual while s/he is of sound mind, which is then set out on a legal document, signed by the individual in question.
 
I don't understand the problem. It says people are informed that part of the facility does not do CPR before they sign up and move in. The daughter is satisfied with their actions. I don't see how the mother could have been ignorant of the fact that she would not be getting CPR. Seems like the newspaper is just making up a story where none exists.

My Dad would have this if he were to end up in a nursing home. He and my step-mom both have instructions not to put them on life support should they end up in a coma or something else renders them unable to live with being hooked up to a machine and not likely to regain consciousness. I told him it was a good thing he made these provisions because if there were no instructions I for one would be incapable of making the decision to let him die. I know no one lives forever but I would find it impossible to be the one to tell the hospital to take him off life support. So it's not outside the realm of reality that an 87 year old woman in a nursing home would be fine with not receiving CPR if she should end up collapsing.
 
mlp said:
beancounter said:
Yea, it was the facilities policy, which is why I said to remind me to never go to a nursing home. The daughter may have known about the policy, but I'm guessing the mother didn't....
Click to expand...

I think I didn't make myself clear. There were two separate things at play here.

1. The mother had signed a do not resuscitate directive (DNR). That's basically a directive to not take any steps to resecitate if the heart stops beating and/or the individual stops breathing, and is not unusual for elderly or terminally ill people who don't want to prolong the process of dying.

2. The facility has a a policy to not perform CPR on independent living residents, but instead to call 911. The reason for that is because the facility isn't offering nursing services to the independent living residents, who aren't paying for those services.

If a nurse refuses to do CPR based on 2., then I say shame on her and shame on the facility.

If the nurse refused to do CPR based on 1., then she was doing exactly as the woman in question wanted, and she should be commended for standing up to the 911 operator, who would have been out of line.

In any event, even if the nurse refused based on 2. (not knowing, at that moment, about the DNR), the outcome was as the woman wanted and had directed pursuant to the DNR.

Hospitals (and many retirement facilities) put some kind of code on the door and/or chart so that staff can immediately tell if the patient/resident has a DNR directive on record.
Click to expand...

I went back and checked. the article states that she did not have a "do not resusitate order.", but besides that...

And yes, I understand that the facility had covered its *** legally.

But that's not my point....:bang:
 
Pickle Juice said:
I don't understand the problem. It says people are informed that part of the facility does not do CPR before they sign up and move in. The daughter is satisfied with their actions. I don't see how the mother could have been ignorant of the fact that she would not be getting CPR. Seems like the newspaper is just making up a story where none exists.

My Dad would have this if he were to end up in a nursing home. He and my step-mom both have instructions not to put them on life support should they end up in a coma or something else renders them unable to live with being hooked up to a machine and not likely to regain consciousness. I told him it was a good thing he made these provisions because if there were no instructions I for one would be incapable of making the decision to let him die. I know no one lives forever but I would find it impossible to be the one to tell the hospital to take him off life support. So it's not outside the realm of reality that an 87 year old woman in a nursing home would be fine with not receiving CPR if she should end up collapsing.
Click to expand...

A do not resuitate policy, when not signed by the person who is impacted by that policy, opens the door for abuse.
I can just see all of the people drooling at the opportunity to get their inheritance sooner than later.
 
I still don't understand. If the facility has a no CPR policy, and residents are informed of this and must consent before they move in, why is a DNR order necessary? Are people trying to make it look like the woman was tricked into choosing this facility and deliberately not informed she would be getting no CPR should she collapse?
 
beancounter said:
A do not resuitate policy, when not signed by the person who is impacted by that policy, opens the door for abuse.
I can just see all of the people drooling at the opportunity to get their inheritance sooner than later.
Click to expand...
Oh we posted at the same time.

I just don't see that the article has presented any evidence that the woman who died was ignorant of the no CPR thing.
 
I think that many people might not focus on the fact that it's the facility's policy to not provide CPR to independent living residents, but in this case, the woman in question had clearly thought about her wishes and expressed them in the DNR directive.

Really, every0ne, once they reach adulthood, should have a living will which directs what measures should/should not be taken if they end up in a persistant vegetative state, coma, etc. And at some age in the future, I will definitely have a DNR directive in place.

I make a decision about DNR every time I take one of my kids in for a procedure which entails them going under anesthesia. I almost always check on the "do what is necessary to try to save the life" box, but in cases of ones who were having surgery for cancer, I have checked the DNR box - I figure if they don't have the strength to make it through surgery, I would probably just be prolonging their ordeal.
 
beancounter said:
I went back and checked. the article states that she did not have a "do not resusitate order.",
Click to expand...

Ah, O.K. - I misread that.

Then I agree with you - anyone who was present and had the knowledge to perform CPR had the moral, if not legal, obligation to do so.
 

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