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Subscribe to RSSPolice in Bakersfield, Calif., say that no criminal charges will be filed in the death of an 87-year-old woman who was denied CPR by a nurse at her retirement home on the grounds that it violated company policy. Police say no laws were broken, and the woman's family said their loved one did not want any life-prolonging intervention.
Criminal charges will not be filed against anyone involved in the case of an elderly California woman who collapsed at a retirement home and later died after a nurse refused a 911 dispatcher’s pleas to perform CPR, police in Bakersfield, Calif., said Wednesday.
Lorraine Bayless fell unconscious and was barely breathing at the Glenwood Gardens independent living facility on Feb. 26, prompting staff to call for help. In a dramatic 911 call released earlier this week, an unidentified nurse cites a company policy that prohibited her from performing the potentially life-saving technique, and the 87-year-old woman was pronounced dead at a hospital.
Police launched an investigation on Monday to see if elder abuse laws had been broken, but the department said on Wednesday that it had concluded its probe and will not be filing charges.
“The investigation revealed that no criminal statutes had been violated,” the Bakersfield Police Department said in a statement Wednesday night.
While Bayless’ daughter reportedly said she was satisfied with her mother’s case, the death raised questions about the retirement home’s policy and whether the nurse had an ethical obligation to help.
Related stories:
Policy questioned after nurse refuses to do CPR
Opinion: Ethics required medical staff to do CPR, even if policy didn't
Leave a Comment:
of course she had an ethical obligation to help....she is a trained medical professional who had the ability to save a life. pathetic. what kind of company policy is that, Obamacare?....let them die?...only in Cali...Godless tax happy communists.
Good luck with your declining wealth, power and current brain drain Cali. You guys are well on your way to leper colony...lol.
I need more detail. Perhaps I am missing something but that is a life you can save so screw company policy. That is somebody's mother....if the daughter was satisfied with her mothers case then this story isn't complete. No child would be satisfied with that outcome unless mom was suffering greatly....which I can't seem to find this info so will assume medical professionals in Cali companies just let peeps die due to "Company Policy"...pathetic.
The lady had a DNR. Guess that wouldnt stop u from interfering into her life though, would it? Just like a republican, jump to conclusions, with complete disregard for facts. Godless tax happy communist? hate much?
One of these days she will be the one layed out flat, and then mabey someone will help her and mabey someone won't. and while she is laying there she will be thinking I hope someone is going to help me.
I am a nursing student and was a caregiver at one time of my mother. We had a "Do Not Resuscitate" order on file with her primary care physician. Apparently, this facility has DNR's in place for all its clients, otherwise the nurse would have been in trouble. My question is why do people continually want to subject patients to further pain and discomfort? Why not let them pass peacefully? What is to be gained by performing CPR on this lady who is at the facility probably for comfort care only? The daughter was happy with the care her mother received and that is the way it should be. Do any of you posting on this page have a living-will in place just in case you all drop dead?
I will say it again! I would be happy to enter a facility that has those rules. It is my life, not yours and the way I live it or choose to allow my death to happen is none of your business! I would rather live my life out without heroics, which some might think, is a form of assisted suicide, but I would call it a natural way to die. Why must society/government decide instead of the individual/family how my life is to be lived?! The only one benefit extending my life would be, to the ones that are profiting from me, keeping me alive. Quality of life not quantity, is how I see it, I would have to question, am I enriching my life or anyone elses by prolonging the inevitable?
You know Troy, a-hole, that wouldn't be from Obama care, and "let them die" was said at a Republican Town Hall. you are a waste of perfectly good oxygen.
I was angry like you, until I saw about a dnr order. But I never even thought about bringing the repubs or politics into the conversation. Look in the mirror and repeat " I am somebody"
But then if we drop dead, the living will wouldn't apply now would it?
The woman had a Do Not Resuscitate order on her - which means if she stops breathing, let her go. Usually, that means they have some other disease like Altzheimer's. It has nothing to do with Obamacare or "godless tax happy communists" - I assume that you mean that liberals are the "godless tax happy communists" because that's what others have called them - but that can't be further from the truth. Many liberals are religious, being Jews, Christians, Buddhists, etc. Many liberals don't like being taxed, some of them are in the 1%, but they pay their taxes because they understand that it takes tax revenue to run the government, and it can't only be dealt with by cutting services. (In fact, that actually comes close to religion, because the majority of services the GOP want to cut are to the poor, who the Bible and other religions tell you that you are supposed to help.) Liberals are not communists - not even close. You just keep drinking that Tea Party koolaid.
This case has nothing to do with politics or Obamacare, so let's not get carried away here. Troy is right. The deceased woman had a DNR (Do Not Resuscitate) Advanced Medical Directive. So the point made about the ethical behavior of the nurse/director in refusing to comply with emergency rescue protocal is moot.
Mr. Eric Seal - if the person had a DNR why was the nurse calling 911 ? And why are they employing medical staf if all they do is help with meals and make beds ? Any home attendant can do that and a lot cheaper. Is it maybe just a trick so the relatives will thing that their elderly are safe and shovel a lot of money for a big lie?
Eugene: They had to call 9-1-1 because they have to get the patient to a medical facility - if she's alive when they get there, it's God's will that she live. If she's dead, they pronounce her dead. If someone dies during the night and they find them the next morning, and they are already stiff, they still have to call 9-1-1.
Her nursing license may face a different fate. Licenses for ANY medical practitioner (Nurses, doctors, physicians assistants, Nurse practitioners, etc) are obtained after swearing an oath to use your training to save lives NO MATTER WHAT. She will lose her license at the least, and face charges at best.
Neale: Not if the patient had a DNR, which this one did.
Since you did not bother to read the article, the woman had on her file DNR do not resuscitate, it means if she is dying she does not want anything done to prevent it or to keep her alive. The nurse was following the request of the dying woman, the nurse will not loose her license over this, she could have lost her license if she had tried to keep the woman alive.
nurses do not swear to a oath
@eugene, comment 1.10, She did not call, another resident called, and she wound up talking on that residents phone.
Neale Osborn: Wrong. Nurses don't swear oaths and have no obligation to save anyone, if the facility has a DNR policy or the patient is DNR. She won't lose her license, nor should she.
Troy1101: It's no accident that your far right-wing politics and your ignorance of health laws go hand in hand.
I just love how so many are ignoring the fact that:
1) The lady had a DNR... which means that she wants no lifesaving action taken when it's her time to go...
2) The report states that she was "barely breathing".... and you NEVER perform CPR on someone who is breathing and has a heart beat. CPR can stop a heart that was beating on its own and it can cause a respiratory arrest..
Very simply, and clearly, the
individual involved here that knew nothing about what they were
talking about, and that was practicing out side of their
scope-of-practice, was the dispatcher. Beyond the fact that the nurse
has a license, (which implies a higher level of education, but also
the ever present qualifier that one has to know what one can, and can
not do,) the dispatcher is nothing more than a glorified phone
operator.
What really puzzles me about this event
is that it would seem that even most ignorant of medical protocol out
there has to realize that the dispatcher was on the phone, while the
nurse was present at the scene. So even if they had an equal position
in licensure the dispatcher would have to defer to the eyewitnesses
assessment of the nurse at the scene. As a nurse I would told the
dispatcher that; I was not starting CPR, send the ambulance, and mind
your own business!
The problem is that the uninformed out
there see it as being like Hollywood, nurses don't go around saving
peoples lives all the time, and that is not what I'm trained to do. (
In fact watching most nurses perform CPR is one of the silliest thing
I have ever seen....in most cases the patient is clearly dead...yet
they are afraid that if they stop some one is going to call the
press.) All nurses do is care for, and heal people.....24 hours a
day, 7 days a week, 365 days a year....not all this other glamor
stuff.
I have pretty much read all of comments
on this story. I have my own personal reasons; As a nurse I'm tired
of nurses getting the blame for events that we have no control over,(
such as 87 year old's that are A+Ox3, who chose with a clear mind and
with the full knowledge and support of their family, to live in a
facility where they know beforehand that CPR will not be
administered, but instead 911 will be called, and that is what
happens, and still somehow, and for some reason, the nurse was
suppose to throw them on the floor and start pounding on their
chest.) while seldom getting any credit for the million and one
things that we do do. Add to that the total ignorance that prevails
in society today as what passes as news these days being nothing more
than shameless sensationalism. Which I guess is alright till innocent
people get crucified in the process. But I digress.
After all these comments, some
questions that caused me to find and listen to the whole 911 tape
arose. The tape runs 7 minutes, and a few seconds The call starts
with a resident, (on their cell phone,) the phone is passed around to
different people during the course of the call and ends with the
EMT's entering the room, so not an unreasonable amount of time for
the EMS to respond, and I would say more-than-likely the amount of
time that the average emergency patient is on the ground before EMS
arrives. Hardly warrens the dispatchers yelling, pleading and the
pronouncement that “ They are going to let her die.”
But the question that comes to my mind
from listening to the 911 call is what is the indication for CPR? The
dispatcher's reasoning is that the woman is breathing too slow, but
even after the nurse identifies herself as a nurse, the dispatcher
does not ask for vital signs, or even if the woman has a detectable
pulse.(the lack of a pulse would clearly indicate CPR,) Meanwhile the
nurse states that the woman's respiratory rate is 3 to 5 and she has
“ a weak and thready pulse.” So the woman is unresponsive, in
respiratory depression, and bradycardic; This to me sounds like an
indication for intubation, ALS, (Advanced life support,) and
transport. Why would one start CPR if there was a pulse? Why in all
her rantings did the dispatcher not ask for some vital signs? If she
was going to tell the nurse what to do how about seeing that her head
was up, and that she place O2 on her? As it happened in a dinning
area my first thought would have been choking, but while the
dispatcher tells someone to do a chin-lift there is no mention of why
or looking for evidence of food in the airway The dispatcher does ask
if there is an AED in the facility which there is not so CPR in the
event of an arrest is pointless. Seems to me, after listening to the
call, that the only intervention that the dispatcher appears to be
aware of is CPR, which is not a cure all. The woman may have been
over-sedated, or having a drug reaction. A casual study of possible
causes of bradycardia in a standard medical text list 11. One
commentator suggest that his interpretation of the 911 tape is that
the woman had gone into agonal respirations, which is certainly
possible, in which case CPR would only be a show.
Lots of people that have no idea what goes on with the elderly. I would be willing to bet that hundreds of people died that same day with no one performing DNR on them in care facilities throughout the country. The only difference is we listened to a 911 tape that was released for some reason. Oh yeah, media hype followed by public hysteria.
What makes you think you can make the medical decisions for people? People choose to have a DNR because they would rather go out with dignity instead of a prolonged, painful, miserable death. Do you know what CPR does to an 87 year old? Broken ribs, punctured organs etc. Then if you are lucky and survive that, the a high probability of dying from pneumonia since you can hardly breath due to the broken ribs.
I hope you learn more about it before you have to deal with the issue for yourself our a loved one.
Longshank,
You can be my nurse any day. Any day! I'd choose you over any of the bleeding hearts that think we should do anything to save someone who is ready to die. My grandmother was 89 when she died. Her last few years werent life, they were sustained get that check.
At any point, if somene did CPR on her it would have killed her even if she was doing well at the time. I've taken the CPR training, and one of the things they tell you is correct CPR can and will break bones. My grandmother would not have survived CPR if it were given to her as a demonstration.
This whole story is to get the bleeding hearts riled up over nothing. The family was satisfied with her care. Why does this story go on? Is some lawyer funding this hoping to make a buck?
She went natureally. Her family is satisfied. So some pissed 911 worker didn't get their medal? 911 was a technicallity. I'd gladly end my days in such a home. I'd fight against any home that did any differently.
Sorry, but a 80 plus. Unless my life gets dramatically different, let me die in dignity.
Wow, GrimReefer, you actually READ that novel Longshank wrote? Really?
Wow. Before opening your mouth, learn the facts you hate filled right wing nut.
WHAT'S THE POINT in hiring a retirement home to care for an elderly family member, if all you are going to do is choke and do NOTHING when the key moment dictates that you, the geriatric nurse, DO SOMETHING ????
...and yet... you've done Nothing for the sweet, helpless elderly person in your care.
Quit your yob, and find a completely new career, nursey. Do not send your resume to me. Do not resuscitate your Nursing career; it is DOA.
Rest In Peace, Lorraine Bayless.
Neale Osborn.....and DancingSpiderman....I believe the original story said that the "nurse's" at this place don't have actual medical training. They are cargivers. I don't think she has a license to lose.
At any rate I would guess that at some point if she helped care for this woman very long she was aware of her wishes and that coupled with the policy of the company would dictate what was right or wrong for her to do. I am sure that it was hard for her to just allow the woman to die in her arms but knew it was her will. Who are we or the law to tell us how we are to die or live? If I say let me die then no law or no person should stop that from happening if I am not totaly incapable of making a choice. My first wife was very ill for many years and she reminded me often that I was not to save her . She just wanted it over. I ultimately was put in the position to stop her meds and allow her to pass .This was the most difficult choice I have ever made and pains me today 5 years later. I watched as my wife ( in a coma) of 37 years slowly left me. 12 hours of agony for me but she was pain free. Finally she was at peace.
In my opinion this nurse did the most nobel jesture any caregive can. She allowed this woman to go on her terms.
That is not actually correct Lisa, the resus guidelines are that CPR should be started if someone "is not breathing normally" and the pulse check has been removed because even we ICU specialists are unable to quickly and accurately detect the presence or absence of a pulse in such a situation. Patients will frequently breath slightly during an arrest, we call this agonal respirations and we perform CPR even if it is occurring. Similarly we regularly perform CPR on ptients in ICU with a beating heart, in fact when we successfully restore a heartbeat by defibrillation we ALWAYS continue CPR for around a minute after it is restored because the heart is often stunned when it restarts and needs some physical help to improve its pumping otherwise you run the risk of it stopping again. CPR on a beating heart does not make it stop it helps augment its pumping.
Excuse me, but IF the woman had a DNR on file, WHY were the Paramedics called BY THE NURSE.
It does not fit the logic of an on-file DNR procedure.
There is no legal obligation to come to the come to the aid of a person in distress with very few exceptions. Think about the ramifications if there were.
Myownthougt- The nurse did NOT call 911, another patient did.
My mother has a DNR, we were instructed to NOT call 911, but to call the police to report a fatality, the police then send out the ME to pronounce the person dead. By calling the police you avoid the possibility of improper disposal of a body.
The word policy refers to guidelines to make decisions. How can anyone be so freakin' stupid and heartless. What someone should do is the right thing. In the military, there are times when a subordinate can disobey an order. A policy is not a rule.
Because there is a policy in EVERY hospital that someone with a DNR (Do Not Resuscitate) order (also called a living will) is not to be given CPR or put on machines to bring them back when they go into cardiac arrest. Had it been choking, she could have done the Heimlich manuver, but it was a cardiac arrest. Usually, the patient has another disease like Altzheimer's or something like that.
All humanity and decency went out the window for fear of a lawsuit, eh? And not just in this case.
The report is that it was a stroke, CPR would have made no diffrence, an experienced nurse would have assessed that and there is no reason to talk to the dispatcher on the phone about it.
John, sorry, but YOU nor some dispatcher gets to decide WHAT is the right thing to have done in this case.
(in fact, by releasing the 9-11 call, the police MAY have violated the old lady's Hipa rights to have her medical records/treatment kept private.)
Saints PRESERVE me from some ignorant do-gooder like you being anywhere around if I PERSONALLY ever collapse.
This is why dumb people aren't in health care or for anything important , we don't know the total details and stupid media just feeding you half answers to the question. DNR is there for a reason , if your a family member would you like to see your mother suffer in pain being hooked on a machine that's keeping her alive? If you think it's better that's she alive then YOUR SELFISH!!!
If there was a DNR in place, why in the world would the facility call 911???
It is called self preservation. If the nurse had provided CPR and the woman still died you can bet a lawsuit would follow ruinning the nurses career and costing the company lots of money. it would be great if we could return to the days of old where you helped someone in dire need and not be sued. But alas, we have to many lawyers and not enough legal work for them to do.
John, the facility did not call the 911 center, a bystander did. We really don't know what the right thing to do in this case was because we are not involved. Having few facts to go on here's what we can reasonably say:
1. The employee is a nurse, but is not employed by the facility as a nurse. Therefore she had no legal duty to act as a nurse under those circumstances (decision by the state board of nursing).
2. The employee, as we all do, had an ethical duty to act in this case. What we don't know is what the right ethical choice was in this situation. We know that fundamentally we are obligated to do what is in the best interest of the person in peril (principle of Beneficience). We are also obligated, when faced with an individual who has lost decision-making ability, to act as that individual would act if the individual were able to do so (principle of Autonomy). Even if you have been given Medical Power of Attorney for someone, you are expected to make the same decision that person would have made, not your own decision.
3. The family had no disagreement with the actions of the employee. Now, we can interpret that decision as self-serving or as an indication of justification. I've read some comments over that last several days where posters jumped to the conclusion that the resident was rich and that the family didn't care bacause they were getting Granny's stash. There's no factual basis upon which to make that conclusion. What is more likely is that the resident was 87 years old and that the family was comfortable with her death from these natural circumstances.
4. What we health professionals accept better than many others is that death will come to all of us. It doesn't have to come to us with a rush of frantic, useless activity that will not change the outcome.
Only stupid people (who are not involved) believe they know enough to make an intelligent comment about the "rightness" or "wrongness" of anyone's actions in this case.
I don't think it was as much the company policy as it was the sheer arrogance of that Nurse. She didn't seem to even feel bad about the woman's imminent death - one of which she alone could have prevented. Apparently this woman did not have a DNR - it's one thing if she was in a comma or incapacitated to the point that life was really not worth living anymore - but this woman was seemingly enjoying her life.
The daughter - don't get me started - was probably pleased that the family no longer had to care for their 87 year old mother.
If I had my mother/father in that facility - I would be taking them out immediately. In fact I am taking note of this company so I don't make the mistake of using them in the future.
As an ICU specialist I have seen a few times the results of CPR in 88 year olds, I have only seen it a few times because the success rate of CPR in this age group is incredibly low and almost none ever make it to us in ICU. I have attended many more codes where CPR was being given to 88 year olds in a hospital ward. Let me describe what happens if you perform good quality CPR and defibrillation to an 88 year old; First almost every rib in their ribcage will break, many in multiple places, some of these ribs will penetrate lungs and some can even penetrate the heart. Either way in the incredibly unlikely even the patient survives the arrest they end up in ICU on a ventilator with their shattered ribcage being repeatedly inflated resulting in absolutely insufferable pain. There fragile skin is often severely burnt by repeated deifibrillation attempts.
As someone who almost certainly has done this a lot more then any of the other people commenting here I say one thing without any doubt, performing CPR on an 88 year old is incredibly cruel and humiliating whose best possible result is weeks in agony in ICU and almost total certainty that of the very few patients who survive to ICU less then 0.1% will ever leave ICU or go home. Performing CPR on an 88 year old is grossly unethical and cruel.
Excuse me, but IF the woman had a DNR on file, WHY were the Paramedics called BY THE NURSE.
It does not fit the logic of an on-file DNR procedure.
Why didn't the nurse just inform the dispatcher that the patient had a DNR order? Wouldn't that haven't ended the argument?
I frequently called EMS for my nursing home patients who had DNR orders. All care is provided in that case for the patient except CPR and intubation. That would have included transport to hospital. There is many care tasks to attempt up to the point of CPR.
This incident illustrates the importance of communicating the patient care instructions (such as DNR status) to EMS when calling for assistance.
Mrs. Bayless specifically picked the home she did because she would have her wishes followed when it was her time she wanted to be allowed to die with dignity with NO measures to extend her life. No one was stupid nor heartless John6268. How you die is as important as how you live and we should all be allowed to make that decision and Mrs. Bayless did.
AussieRob: thanks for the details. IT is informative to see such things through the eyes of one whose been there. Agree with Myownthoughts and Maggie: I heard the Nurse on the radio replay of the 911 call. She may not have known about the DNR. Her story was she called 911 to get help because company policy prohibited her from rendering assistance. So I was wondering why they pay a nurse to be on staff. A min wage teenager can dial 911. And they can probably run faster to the scene of the fall to tell the dispatcher if it was a man or woman.
AussieRob:
What do you know about this that all of the ignorant "experts" on this board have spouted off about without knowing most of the details..................Oh, I guess you encounter these things often compared to those others.......
Seriously, thank you for your time in providing some "real" background on what is ethical and what happens with such elderly patients.
It seems like a lot of you folks dont have relatives who are nearing death.
I have a grandpa who lost his wife about 4 years ago, and he's ready ANY DAY NOW to go meet his maker in heaven.
If this happened to my grandpa, he'd want everyone to stand back...and let him pass.
Who are you to judge when someones ready to go on to heaven?
Thank you, joemike and Aussie. the ones screaming about this aren't thinking it through and putting themselves in the nurse's or the patient's position. I have done CPR on elderly patients as well many times, and it ends exactly as Aussie said. All of you yelling about mean nurses and rescuing this woman from death haven't a clue what you are insisting should have been done to her. It would be to make yourself feel better since it wouldn't have helped her have any kind of quality of life.
I Read You - You seriously wonder why they have paid nurses on staff?
I take it you've never been to a nursing home or assisted living facility before...otherwise you'd be embarrassed by asking that question.
this is modern america today too many LEVITES they just as soon pass you by on the other side. no conscience no regard for their fellow man. medical persons should do what they can not just sit wringing their hands. if she was possibly having a srtoke didn't anyone in all of those people have an aspirin??? if you try and fail its much better than not trying at all. ex emt 1. you bigots and gender gapers one day it will be your turn. then what sh#%%^t load of excuses will you have then? or is america becoming like ch#%^$&na the little 9 year old girl was hit by a car and for fear of the government no helped her and she died in the streets. God bless the few good samaritans left in this country.
Only when it is known to be an illegal act. The subordinate's sense of morality does not give reason to violate an order.
So if the nursing home has a policy of honouring the patients' wishes that includes directions not to intervene, does the medical ethics outweigh the patients wishes or does the ethics of following company policy trump medical ethics?
This nurse had no way of knowing if there was a DNR on the lady, she should have her nursing license revolked and she should be sued along with the company for neglect. Heartless piece of dung that she is and the company she workd for. Everyone who has loved ones there should move them to a place where human life still has vallue. I believe that in every nursing home and assisted living ficility the residents, if they have a signed DNR on file, should be required to wear a bracelet that tells anyone this information.
Wow I see the S***storm is still
brewing a week later on this one!
Joemike 404; Thanks for a well written
breakdown on the theoretical basis of the legal/Ethical/Moral
issues involved here. These
issues in healthcare have grown to be unimaginably complex.
AussieRob; Thanks for the practical
stroll through what heroic measures, and the ICU look like. All I
could add to your comments is
that if, and when, these patients make it back to long-term care
they are never the same. A wet
newspaper laying on the floor has about the same quality of life.
Jessica 1170252; Thanks for your
defense of nurses that work in long-term care. We earn every cent
that we make, and there is no way
we could be replaced by a minimum wage teenager hanging
out next to the phone.
Those of you that still don't get it,
apparently no amount of logic or first-hand experience will change
your minds...You'll just have to
wait till you get there.
DNR does not equal do not treat. As someone above said, there are many treatments besides CPR that can be given.
"DNR does not equal do not treat. As someone above said, there are many treatments besides CPR that can be given."
Also, I believe a bystander called 911 and passed the phone to the Nurse.
I want the so called nurses name released to the public so she can receive the public attention she deserves. I would never want anyone I know or a member of my family to fall under her care ever!
Her actions give the nursing profession a very bad name.
Shame on her and her employer.
She followed the policy in place because the patient had a "Do Not Resuscitate" order on file there. I don't know why it hasn't been in this story or others, but a person on another site that is local said that the order was in place, and that was why she wouldn't do it. I don't know why the nurse didn't tell the 9-1-1 operator that there was a DNR on the patient.
You don't know anything about the situation other than the old woman died. The old woman was breathing at the time of the demand to do CPR. The dispatcher was either ill trained or simply did not know the dangers of brittle bones and CPR, let alone what good doing CPR on someone would do if they have a heartbeat and are breathing on their own. This entire ordeal was blown out of proportion, and the article above is meant to close this story so the media doesn't have to go on and explain how hey were wrong in even reporting it.
debnran, thee Nurse would have broken the privacy laws had she discussed the patient with the dispatcher. Privacy laws are pretty clear on who can talk to who about what.
The dispatcher should be fired for releasing the tape!
This came from other articles, and from people who were local to the story. There was a DNR on file because that facility only takes people with DNRs. In the other articles, the family stated that there was a DNR on file with the facility and with her doctor. The daughter AND the woman herself knew it and was ok with it. The family talked about it because of the uproar of the tape having been released. I do know what a DNR order is, also called a living will. It means that if she has a cardiac incident, and stops breathing, that they cannot do CPR on her without violating her directive. THAT is the policy that the place has - do not violate the DNR order.
That is right CoCo, by releasing the location, age of pt., gender, occupation of family member, and reason for the call, it was a clear violation of HIPPA policy. So who dropped the ball in the first place, the dispatcher, the facility, the EMT's??
Do you know what a DNR is? Obviously not or you would not make a stupid comment like you did. The nurse could lose her lic. and could be sued if she had of preformed CPR.
As a nurse I could care less if you
thank me for the job I do, because I'm going to do it, whether you
thank me, or not. I love nursing. I have a profound respect for the
struggles that the nurses that came before me had to endure to gain
any autonomy, and respect. I am a strong believer in the concept that
nursing is as the theorist Rosemarie Rizzo Parse describes it; A
human science, distinct from medical science, or any other
discipline. To be a nurse is the most rewarding, and the most god
awful job that one could ever have. Because it really does not matter
at all to anyone, or so it seems, the 11 hours, 59 minutes and 50
seconds that you gave all that you had, and did everything right.
It's the 10 seconds that you @!$%#ed everything up, and almost killed,
or injured that patient that haunts you, and reminds you that what
you do is indeed a calling.
All that being said nurses will always
,” Fly under the radar,” As a nurse I know that the coolness that
the uninitiated felt from that 911 tape was a nurse that was staying
calm, and biting her tongue, because that's what nurses have to do.
Because that is all she could do.
Is she a good nurse or a bad nurse? How
the hell should I know? There are certainly bad nurses out there. If
you think they are rough on the patients you should see what they do
to other nurses. But the information to make that call is not
available to me, or you. In time other nurses will be assigned to
investigate, and they will get to the bottom of it. That is one of
the qualities of a profession, they self-regulate. At that nursing
does at least as good of a job of disciplining their own as medical
doctors do, and I would say they are miles ahead of the lawyers and
clergy.
So what is the answer? There is none,
all this is part of the job. Being crucified in the court of public
opinion by individuals that do not have a clue as to what they are
talking about.
But we will get up tomorrow, or
tonight, and do it all again. In the meantime all of you out there
that are planning at some point in your life getting sick, injured,
or dying, you should thank somebody that we do it. But don't thank
me, cause I'm going to be a nurse anyway.
the nurse did exactly right.. eveyr resident there has a DNR.. those big red letters on the records say DNR
First of all, dispatchers have absolutely no medical training whatsoever, unless they have it from a different job. They are dispatchers, and that is what they are supposed to do: DISPATCH! Not argue, not contradict a trained medical professional, not question why that professional is or isn't doing whatever, and certainly not to debate a facility's policies in the middle of a crisis. They are trained to dispatch. Most of them do have a manual to coach a friend/family member with, but they're very basic and not meant to override any medical professional.
Secondly, there are many good reasons for what is now called a DNR....what we used to call a No Code. At the age of 87, it's rare that a patient survives a massive physiological event such as this. If they should survive, their quality of life is going to decrease dramatically, and most of them know that.
When you're 20, you're bulletproof. At 30, you're probably still thinking you are bulletproof but you might consider ducking a round just in case. By 40, you're still far from old but find yourself slowing down just a bit. At 50, you begin to realize you just might not be bulletproof after all, and you start to think about what is important to you, and how you really do feel about things. Then you are sixty, and you drag yourself out of bed, look around, and think, "Crap, how did this happen?" That's about the point where most people start thinking about whether they want to be turned into some doc's lab rat when....not if, but when....the inevitable happens. I made that decision before I was old enough to sign the papers legally, and have made my preferences known to every medical professional I meet under professional circumstances.
I ended up in the hospital six years ago, and was pretty much unconscious for the first three days. They asked my youngest, who was then 17, what my resuscitation preference weres, and she told them. Several times. They apparently hemmed and hawed around, to the point that she finally told them, "Look...I love her, and I don't want to lose her....BUT!....we have had this conversation a hundred times and I know that is what she wants. Now, if she cardiac arrests and you feel like you have to resuscitate her you do what you need to, but call me immediately so I can get as far away as possible because I don't even want to think about how mad she will be. My choice would be to get at LEAST a state away, and two would be better."
What can I say? She's a nurse's kid, and she knows what she's talking about. With a family history that indicates that it's entirely possible that I will take ten steps from the bed some morning soon and have "a sudden and fatal cardiac event" (which I've known virtually my entire life), I have never entertained the possibility of becoming someone's science experiment. I've seen...and treated....literally hundreds of elderly people in the ER, and I would conservatively guess that a minimum of 97% of them feel the same way.
As for what the nurses in those facilities do.....I can tell you now that A) they work their butts off keeping your loved one that you go visit once a month (if that!) happy and making sure that they have the opportunity to enjoy the highest level of quality of life possible for what time they have left. It's not a job for sissies.
you are misinformed at best, a DNR order was in place, which meant ANY attempt at CPR would be a VIOLATION OF LAW! this patient and her family knew the policy and placed this order specifically to keep some interfering do-gooder from performing CPR ( which has an extremely high FAILURE rate in people of advanced age) and works less than 30 per cent of the time in healthy people! you watch to much tv if you are unaware of this!!
personally I think the 911 operator, or the person responsible for releasing the recording of that call, should be fired and brought up on criminal charges!!
Let's get a couple of the stupid things out of the way.
1. Discussing the patient's condition with a 911 dispatcher is NOT a violation of HIPAA (would you all PLEASE learn the correct acronym). Sharing information necessary to the care of a patient doesn't violate this law.
2. Calls to a 911 center are a PUBLIC record. Releasing that information is also not a HIPAA violation and if fact I could force (under the right circumstances) a 911 center to release a tape under the Freedom of Information Act.
3. A DNR is an expression of the patient's wishes and is NOT a legally binding document. If I resuscitate a person with a DNR, I could be sued for negligence or malpractice, but it would not be a criminal violation. Of course that would depend on whether or not a local jurisdiction or state passed a law specifically making it a crime to do so. While that might be possible, I know of no jurisdiction that has done so. In order to be sued, I would have to have known that the DNR was in place and even then it would depend on the circumstances.
Excuse me, but IF the woman had a DNR on file, WHY were the Paramedics called BY THE NURSE.
It does not fit the logic of an on-file DNR procedure.
Just as an FYI: There is a difference between a DNR request (signed by the patient or family which indicates the patient's wishes) and a DNR ORDER which is a physician's written order that must be followed by the nurse in a facility.
This patient had a DNR ORDER. It can get complicated about whether to hurry and call EMS at this point but since someone did, the patient still needed to be transported to the ER as she still had a weak pulse and respiratory status. There are still many things that can be done that does not include traditional CPR measures.
The nurse's only fault that I can see from the article is that she did not communicate the patient's DNR status to the dispatcher. It is appropriate to communicate that information to the dispatcher so that she can communicate that to EMS responders.
To confuse matters even more for the uninformed public, State law varies on whether the physician's DNR Order transfers once a patient arrives at the hospital. Frustrating, to be sure.
YOU obviously have great concern for the name of nurses but you are ignorant of what a nurses' function is. OBVIOUSLY this woman died as SHE planned. It is people like you who would make an elderly woman suffer in vain because of your misplaced concern. IT IS NONE OF YOUR BUSINESS.
Hopefully there will not be someone like you countermanding decisions a person has made for their last moments.
Well, myown, that nurse didn't call. Someone else did.
She was not a nurse. That's what the 911 dispatcher called her. There is no law that says you have to perform CPR if you are not trained to do so. The women was still breathing. You can't perform CPR on someone who is still breathing. There is no way of telling if CPR would have helped. It's amazing that Bakersfield PD had the free time to "investigate" this "crime".
SHE said she was a nurse. But what I found out - that isn't in this story or previous ones - was that the patient had a DNR (Do not Resuscitate) order. The nurse should have told the dispatcher that the patient had a DNR - it made a mountain out of a molehill. I don't know if the entire facility had DNRs on all the patients, but that particular one had one, and it was put in place by the patient and the daughter who is also a nurse.
I really doubt that out of control dispatcher would have even listened to the nurse if she had told the dispatcher the woman had a DNR on file. If the dispatcher was so stupid as to try to get the nurse to do CPR on a person breathing likely they could not comprehend DNR.
BTW other stations reported the DNR.
Well, Eric Seal. It is obvious you don't know all the facts either. The fact is that I am a Republican has nothing to do with this subject. I work with the elderly and never jump to conclusions about their wishes.
We ask what their wishes are and then follow them. The real problem sometimes is that the family is not on the same page at the end even if the patient has indicated their wishes in the medical treatment section of their living will. So what put you on a little tangent this time. It has nothing to do with being a Democrat or a Republican. Do you try to insert your bias in every unrelated subject? It is just in this case you are acting like a jack ass.
Wrong section Jane, but I agree. However, Eric was responding to Troy who was the one to make it political talking about it being a part of Obamacare and calling liberals "godless tax happy communists". Just as there are Atheist democrats, there are atheist republicans too. Conversely, there are democrats who are very religious. Some republicans believe everyone should pay their fair share of taxes, so do the democrats - we aren't tax happy because we think that corporations should pay more taxes than individuals, and shouldn't be getting refunds - we understand that WE have to pay taxes to make the government work, so should they. As for the communist part - obviously he doesn't understand WHAT communism actually is.
Jonathan, the employee is a nurse but was not employed by the facility as a nurse. She is employed as an activities director.
Exactly what about "Do not Resuscitate" do they not understand?
I find it interesting that everyone is focusing on the DNR.
If one was in place, why did they call the ambulance?
It also sounds like she was still breathing when they called.
Sounds like everyone needs to get the facts before spouting venemous postings...
NBCSnooze wouldn't want to miss an opportunity to present a biased report by includig relevant facts/details.
There is absolutely nothing in this article that states the lady had a DNR in place. The article only states that the COMPANY policy was to not preform CPR. Other articles say she had a DNR, something the reporter for this article probably intentionally left out to get a rise out of people.
I dont know why this article doesnt mention it, but the lady had a DNR. Thats why the daughter was ok with how they handled it. Guess Lisa didnt feel it was important to add this info.
"It was our beloved mother and grandmother's wish to die naturally and without any kind of life prolonging intervention," the family said. "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."
NBC removed the link I tried to provide from abc article, sorry.
The only story I've seen running that she had a DNR was about SeniorMarketing.com defending the caretaker response posted about 13-14 hours ago WALB an ABC Baltimore affiliate,Yahoo! Finance news and few other news outlets. Yesterday ABC was reporting there was no DNR just like NBC and everybody else.
That's a quote from the abcnews.go.com>health posted 10 hours ago.
Thanks some lame, If you read between the lines, its pretty clear. The family knew the terms of the home and said it was her wish.
Bayless' family said it was her desire to forgo resuscitation efforts and that she died of natural causes, which her family said was her "greatest wish."
From mercurynews.com
It didn't have to be on file at the home. They only had to know about it. It would be on file with her doctor and the hospital that she would be taken to - the only thing the home would do is have it written in her charts somewhere.
Although most people who don't want to be kept on machines don't have a formal DNR signed by their doctors, it is equally true that if she did have such an order it would likely be filed with her doctor's office and NOT with this institution. She was not in a nursing home, but in effectively an apartment building for seniors who at most needed a little extra help. If you were living in an ordinary apartment building, you would not provide the manager with a copy of your medical paperwork, and she had been assured that the staff of this building would not do CPR on residents.
it would do you no good if you wanted to live. the conservatives and big money have got that one sewed up if you don't have big money and oil they don't care whether you live or not. this is our new conservative romneyite world.if you dont believe it look what this guy did to planned parenthood in texas.
This woman knew full well when she moved into this facility that they did not offer any kind of medical services, and in fact, the woman's family has said that this is why she chose this facility, because she knew she did not want any interventions to keep her alive. She was fully informed, this was her desire, and the only unfortunate part is that it wasn't effectively communicated to the 911 dispatcher. The woman might have been a nurse in the past, but she was employed as a program coordinator and not a nurse (and it's not clear if she is even currently licensed or currently CPR certified). Save your outrage, folks.
When the daughter said she was ok with leting her mother die, it became my opinion that the lady had a DNR on file. Which of course make all this talk stupid. But if she did not the nurse should be in trouble.
I would like to know how the media got a hold of this 911 tape? Then they talked about it ad nauseum when they couldn't even get their facts straight. Who released this tape to them???? In the space of about 3 minutes they stated she was in a nursing home, then it was assisted living, then independent living. They really should stop reported half baked stories and it went on for days.
I would slap the 911 operator for wanting to start CPR when the woman was still breathing. Duh.
California
911 calls fall under the California Public Records Act, which makes all records available to the public through request. CPRA limits disclosure of personal information by protecting the right to privacy over the public’s interest.
That's how - this was in California. A simple Google search found this information. For other states if you are interested go here:
Over the days, more complete details of this case have been in released on other news sites, but very few additional relevant facts on this one, for some reason. The 911 call was initiated by another resident, not any employee (including the nurse) of the facility. Once initiated, there is no way to break off a 911call until the dispatcher is satisfied.
The one good thing that will come of this hoopla is that "blanket DNR" policies, as this independent living facility used for all its residents, is being re-examined from a legal and ethics viewpoint by several agencies. Ms Bayless herself evidently did not have a DNR order, but was treated as such because she had agreed to the facility's DNR policy when she moved in. According to her family, this was her wish. I'm not necessarily anti blanket-DNR policy, but it sure has muddied the waters in this case, hasn't it? Certainly the same thing could happen if a group of residents took a trip to the local Target store and a resident collapsed there. What I've learned from this: an actual DNR policy and a med-alert DNR bracelet is a better bet.
My healing wishes go to all the "victims" of this story, the nurse, the dispatcher, and Ms Bayliss's family for all they've endured via the public scrutiny.
I could not have said it better than you did CaliforniaNurse. As a nurse myself I agree...it was to muddied up in this case which I bet will lead to changes in policies overall.
As has been said numerous times and simply ignored, CPR on someone of that age requires special care to perform. The workers in many of these assisted living places are not required to train in the procedure. MOST care facilities of this type have the same procedures and policies.
You can do more harm than goood if you start pumping the chest of an elderly person with brittle bones. The dispatcher had no business telling the caller to perform CPR. She also had no business trying to get an untrained person to do it as she "talked them through". Any action would have likely killed the old woman right on the spot. She was alive and breathing at the time. Best chance for her survival was to wait for someone who had plenty of experience in CPR on elderly patients.
Anyway, I would have been surprised if the Nurse had been found liable in any way. I am surprised, however, that the dispatcher was not disciplined by her employer. Why has the media made such a big deal out of this and continued to give the information about the dangers of geriatric CPR?
all i can say is - i hope my daughter or sons don't treat ME like this - she was "ok" with the treatment her mother got - letting her die ? wow - dont think a DNR was meant to let you die , when you can easily be saved !!!
It's quite possible that the woman had some other terminal disease - Altzheimer's, cancer, or something else. The woman, and her family had the DNR order on the woman. DNR means Do Not Resuscitate - which means if you stop breathing, don't start it back up mechanically. If she starts back on her own, fine. Usually a DNR is on someone with another terminal disease.
Tom...that is exactly what a DNR is.... if there is an incident which causes cardiac arrest or respiratory arrest....let me go....that is the purest difinition of a DNR
Yes, that is what a DNR is. Research it. What makes you think she could have been "easily saved"? The likelihood of her surviving a DNR is very low. Unscathed is almost unheard of. Serious injuries is the minimum to expect. A horrific, slow painful death is not at all uncommon.
A DNR means that if you have an incident such as this person had, that you put yourself in the hands of God, not man. A pretty good choice I think.
Tom--you know, I HOPE you do not ever collapse, at age 87, and have some over enthusiastic, ill trained person jump on your stomach, SLAM you in the chest with their fist (which will break the ribs of most elderly persons, but is indicated in CPR to jolt the heart), and then shove repeatedly on those broken ribs, pushing the splinters into the lungs, liver, and possibly heart.
Does NO one believe GOD has some say in when someone's time has come?
"Easily saved"? Have you ever done CPR on an 87yo small framed female? Outcome is not too good for the pt.
Okay, Tom, I believe in everyone's right to make individual choices, so I will hope on your behalf that if you ever have a massive stroke you will be resuscitated and your kids will choose to keep you "alive" on a respirator and tube-feeding. It wouldn't be my choice, but de gustibus non disputandum est...
people dont care abouth their families nowdays. they are not taught respect. they are not taught loyalty.mom and dad changed their diapers fed and clothed the children sent them to school.worked hard all of their lives to take care of their families. and what do they get in return put in a licensed home of neglect because they dont want the burden of caring for their elderly loved ones.the people in these homes have no freedoms cramped rooms thieves. they cannot even go outside because the homes are tooooooo lazy to build fences so they can go outside.they're fed SLOP. i worked in a nursing home and watched the head kitchen cook feed old rotten hamburger meat to these elderly people and make them sick.(the cook knew this meat was old and didnt care). these places are nothing more than government excuses for licensed neglect.
Actually, in the five years before he died my father lived in one of these "horrible" places. He had his own one bedroom apartment with maid service, a kitchen, and down the hall was a very nice and clean dining room where staff members came to your table with menus and took orders like they do in a restaurant. And the food was excellent.
Like the place where this lady died, it was designed for independant living, and individual medical care was not part of the program. And when he chose to live there we were all aware of the DNR specification in the contract he signed.
So don't generalize.
Yes I interviewed at a facility that was part of this group. Did not take the job, but I got to walk through the place. High end Bed and Breakfast is what comes to mind.
The story should have mentioned the DNR in the first place. But then again, raising public rants against healthcare facilities must take precedence over reporting the whole story.
Some channels did investigate enough to get the truth about the DNR. NBC did not.
I don't think the DNR was even looked at. I know it wasn't mentioned in the tape I heard - had the nurse mentioned it, the dispatcher should have stopped asking. (Unless she was one of those people who believe that people shouldn't be allowed to decide when they die.)
debnran--don't COUNT on the dispatcher stopping asking just because of something' silly
like a ENR.
A man who worked with my dad had early onset Alzheimers, and lived for 25 YEARS, most of it totally oblivious to the world around him, and curled into a fetal position.
Because he never made a DNR (who KNEW you needed to in the 70's, and at age 40?) and was, at age 65 not CAPABLE of deciding, when he had a HEART attack, the hospital did CPR AND open heart surgery to 'save his life'.
Years later, I faced a similar situation, with my father having Alzheimers (only he was in his late 80's,) and I placed an order in not only his nursing home files, but the HOSPITAL, the ER of the hospital, his doctors' offices (he had more than ONE) and anyone else that I thought might possibly be around should he collapse.
And if not for the fact that his Dr. was a family friend who had KNOWN my father so long that he had HEARD repeatedly, my dad repeatedly express NO extraordinary means, legally, that probably would not have been good enough--since as an Alzheimer's patient, he was not 'cognizant' enough to be able to make that kind of decision!
Scary!
And lest any of you think his "LIFE" was worth living, I visited 2-3 times a week, driving 1 1/2 hours from my home, and spent 10 minutes in his room (he had NO IDEA who I was by then) and then spent 45 minutes in the car bawling my eyes out and praying to GOD to let him go.
Mercifully, after 'only' 4 years, God listened.
Swlisman; Heat to boiling, shove a stick in and stir....As long as some innocent somewhere get threated with dismemberment....It's all good fun.
Momaid: I've seen family members that vist every day for years..and never come to any thing that even has any resemblance to acceptance. Most just give up
Wow... I work in healthcare, and not one facility I've worked for or been in would have a policy to not do CPR... It IS an ethical issue... since this woman did not have a DNR, I would GLADLY lose my job saving her life! IF she were to have a DNR, then I could see this scenario acceptable. The story doesn't state what else the nurse really did do though.. I hope the nurse would of at least made her passing more comfortable...
But as Troy1101 stated above, "Only in Cali..."
Why would you do CPR on someone who was still breathing?
she did have a DNR
The woman did have a DNR in place, as that fact has already been reported by more responsible news outlets. MSN purposely and continuously leaves that important fact out.
Well, you may work in healthcare, but have you ever done CPR on someone that age? I bet not or you wouldn't think that was going to save her life. This wouldn't have been a story at all if someone hadn't called 911. It would have been a lady who knew she lived in a facility that would allow her to die naturally when it was her time. Perhaps if the nurse/activities director hadn't been distracted by someone yelling at her and anyone else around to do CPR she might have been more able to help the lady more in a compassionate and reasonable way.
No Greg, you would apparently lose your job and still have her die, the difference being you would force her to die with all the ribs in her body smashed into twigs and in the ~0.1% chance that she initially was successfully resuscitated she would then be ventilated in ICU having those shattered ribs endlessly inflated causing insufferable pain. Don't for a second think you would be helping an 88 year old if you were to try and "save" them with CPR, what you are suggesting is cruel and deeply unethical.
Excuse me. Okay the lady had a DNR order. Then the first call should have been to the daughter to ask her what to do. Do you really want some ignorant twit like that attendant deciding whether this is the big one from which you should not return? The old lady was found in distress and that attendant stood there and watched her die.
As has been clearly demonstrated on the many discussion threads regarding this story, understanding and interpreting these matters is not clear cut and easy. There may have been no crime committed, but the ethical and moral debate will go on.
Was the attendant qualified to determine what happened? Had she fallen slammed her head on the floor and was having a seizure? Did she have a heart attack? No one ever said what happened only that she was struggling for breath. Yes I have read more than one account, but they were all lacking in important details.
Maybe the staff called the daughter who told them to call an ambulance to get her mother to a hospital? The story doesn't tell both sides of the story. The story is made to demonize adult care and the Nurse in particular.
Well, Joe, that is exactly why the Ambulance was called.....because it wasn't the duty of the attendant (or nurse or whatever) to diagnose the situation.....she did, however, know that this person did not want to be rescusitated. The lady was not pronounced dead until after arrival at the the hospital......do we even know what the paramedics did on the way to the hospital? Did they do CPR? Was she still breathing? Did she have a pulse? If so, then CPR was not warranted. We don't have all of that information....only that the 911 operator wanted the person to do CPR, possibly on a still breathing, still heart beating person.
Joe,
A person has a DNR so that the family doesn't have to be called whenever anything goes wrong. That's the reason to have one-so that those decisions are made ahead of time, not in the heat of a crisis. I'm not sure why you feel you need to call the lady an "ignorant twit", but nurses and doctors watch patients with DNR instructions die every day throughout the country.
If anyone is a twit, it would be the dispatcher for attempting to instruct someone to perform CPR on a person who was breathing.
No, the first call should not have been to the daughter to determine the daughter's wishes. It's not ABOUT the daughter's wishes, and except in rare occasions where a family member has power of attorney or guardianship, they don't get a vote.
Too bloody right! and in this case the daughter has no problems with that. For those of you who say that this woman should have been kept alive under all circumstances, wait until it happens to you or to someone you love.
Been there, done that.
Some people really need to get an education before they post comments.
1) You DO NOT perform CPR if a DNR is in place.
2) You do not perform CPR on someone who is still breathing.
3) If they are still breathing, then they still have a heartbeat. Again you DO NOT perform CPR.
4) And no, CPR is not going to save someone with 100% certainty, especially a geriatric.
And yes the dispatcher needs training. She did not understand the situation and how to respond. Any dispatcher that has dealt with a long term care facility should know all about DNR's.
thank you wdt! Maybe some of the nurse haters will get the drift!
amen, CoCo
OK, a DNR was in place. WHY did the nurse call 911 for the Paramedics?
Would someone read the story, please? The nurse didn't call. Someone else did.
This should be the advertisement for this retirement home!!
" Do you have a parent you absolutely despise? Can't wait to get your hands on your inheritance? Bring them to Glenwood Gardens! We guarantee you the absolute shortest wait legally possible."
The nurse is also a poor excuse for a human being. I hope someone treats one of her family members the same way. She is just taking up space on this planet, she is useless.
She (the nurse or nurse assistant) is a caring person who knew what the patient really wanted, rather than listening to the uninvolved 911 operator trying to make a name for herself.
Vast numbers of people of all ages, not just the elderly, have Advance Directives stating exactly what they want if catastrophe happens, and expect those requests to be honored.
And if this woman has terminal cancer and she signs a DNR. The nurse is not to give her CPR....Period. If she does she could be in court next week for dong it too.
Seems to me people who can't read the article and get the facts before posting nasty comments would be more useful than those who just post whatever pops into the heads, too. Please now read the article.
I was director of nurses for greater than 10 years and believe me "sometimes dead is better" 911 dispatchers should learn that most nurses working in this type of facility are quite competant of making decisions and usually don't make them on their own.A little trust in this should have been shown If the family gave the green light for CPR while knowing that this was a DNR facility then they would have been in the wrong and the nurse would have been wrong and everyone involved would have been wrong, except the dispatcher
But the nurse who called 911 was incapable of explaining why she could not do CPR. So she wasn't bright enough to explain it to the operator.
The nurse had no reason to explain to the Dispacher why she was not starting CPR, The woman still had a pulse and this the nurse stated.
Janika, Did it occur to you that HIPPA laws prevent her from discussing that information. The way this whole issue was broadcast is exactly why. Not only would she have disclosed private medical information to the dispatcher, it would have gone to every idiot watching TV.
HIPAA!!!!!
Wrong! Communicating the patient's DNR Order status to the dispatcher is proper and necessary so that the dispatcher can pass that information on to EMS responders who are en route. It would not be a violation of HIPAA to share that info.
This story is the first time I've ever heard that discussing a DNR status with a 911 dispatcher is a HIPAA violation. I don't know if it's true or not, but in the numerous times I've called 911, (my acute care facility does not provide emergency or ICU level care) I answer every question the dispatcher asks and I don't think code status has ever come up. We discuss patient details, like code status with the firefighter/EMTs when they arrive.
Yea like in her haste to get someone to start CPR if the dispatcher had asked for vital signs I would have gave them to her...It's called a baseline. Once the dispatcher came to the conclusion that the nurse was not going to start CPR, there is no reason to brow-beat her about it....Move on to something that is useful, history, code-status, current condition, vital signs...I would have given her all this over the phone....It's called report, and you can give that information to anyone that has a legal right to know
How could you charge her when she is only following her orders and the facility also informs the clients that there is a DNR policy ? Personally I carry a DNR card on me, signed and notorized, so anyone will know how I want handled for anyway.. I believe the 911 operators should be trained to know these little things, then they would not get all excited and try to take over a situation via the phone.
I can't figure out why any criminal charges against the nurse were even being considered. The last I heard, California Bureau of Registered Nurses (BRN) was investigating for possible licensure action re: the nurse. Hopefully, the BRN is satisfied that no disciplinary action is warranted. She may or may not be a wonderful nurse, but I think most of us can sympthize that this was an incredibly murky situation.
she was having a stroke the nurse was too dumb to give her an aspirin howcome?
outside of the hospital only a justice of the peace, coroner, or medical examiner can pronounce someone dead.
Texastornado55................why are you trolling here ? You must be trolling because your comments make no sense. Would you really torture your elderly "brittle" family members through CPR, etc ? People's bodies wear out son. It was her season to leave the earth and enjoy a beautiful afterlife.....she knew it and her daughter knew it. If anyone tries to bring me back when I'm 87 they'll be met with a punch in the face.
Also, you give aspirin when someone is having a heart attack, not a stroke. And you don't try to cram it down her throat if she's unconscious.
Txtwist ... quit watching television.
If someone has a DNR, then why bother calling 911?
The hospital has to be the one to pronounce her dead....the nursing home can't do that.
true. In our facility, a DNR just means that when it's their time to die, we do not resuscitate, but call the family and let them know that their family member has passed, or is about to. The report said it was an assisted living facility, which usually means higher functioning residents, and my first thought was that someone just collapsed and was not given the right to be rescued. It was appalling to hear that at first, and especially the daughter's response, however, most of media reports do not tell the entire story, so there you have it.
I'm a nurse and I pronouce people dead all the time, I fill out the paperwork and the MD signs it.The 911 call was made by a by-stander who passed the phone around till the nurse ended up with it.
The primary care physician can come and sign a death certificate. They don't have to go to the hospital.
Because not every episode of unconsciousness, particularly in an 87 y/o, is life threatening.
Exactly, and nobody bothered to determine if this one would have been if somebody had rendered aid, which didn't necessarily have to be CPR.
Who said no one rendered aid? Aid doesn't always involve CPR, and the nurse may have been rendering aid while the operator was yelling at her.
Longshank ... thank you. Whenever we had a resident die during shift, the coroner always asked me for the time I called it. Granted he's officiating the paperwork with his signature.
for those morbidly curious, there is less paperwork for a death than for a hospitalization. go figure.
The paperwork for a death is very short.
In skilled nursing care facilities, where trained people willing to administer CPP always are on duty, the staff knows pretty clearly who has DNR orders and who does not. But DNR is not written in lipstick on foreheads. Neither do most people wear "med alert" bracelets with DNR engraved on the bracelet. It's in the charts and in the records the medically trained staff make entried upon all the time.
The staff at my mother in law's skilled care facility know her and that she has a DNR order. I am confident they will act appropriately. When we recently brought in hospice care to help her there was complete understanding on their part as to what mom wants.
We would be quite upset if somebody made a 911 call and some "passerby" willing to do CPR got involved and Mom wound up on a respirator in the nearby hospital. It s not as simple as bringing over the DNR and asking the attending physicial to turn off the respirator. Hospitals have procedure too, and theirs may be you need a court order once mom was put on life support --with or without reason.
I actually know two cardiac surgeons who have it tattooed on their sternum.
Retired RN..........wow...what a great idea, having DNR tatooed on the sternum...my husband died 10 months ago and I have since filled out a living will stating absolutely NO life saving measures should be taken to save my life, if somthing life threatening should happen to me I am ready to join my husband and I am not afraid to die, especially since I've read over 400 near death experiences which I believe in, I am so ready to "go home"!
I always thought that one had to have a life threatening condition or disease though, to have a DNR order, how were these cardiac surgeons allowed the DNR ? I would like to get a DNR bracelet myself and will be researching this, the worse thing I can imagine is being brought back from the brink of death in my particular circumstance.
This whole freaking story was blown out of all proportion and was half-baked to begin with.
NO: You do NOT perform CPR on someone who has a DNR.
Anyone who has the gall to criticize this nurse does not know what the f*ck they are talking about.
All the posters that think this is so bad have better read the fine print real good before they go into a facility, or put a loved one in a facility. This is the way it is, and happens all the time. Just so happens the news media and a reporter that did not do all the research on the story got a hold of it. If you are a DNR, then you do nothing except comfort care. If you are a full code, then everything is done. Simple as that. And as "scully" said, sometimes dead is better.
Ummm, since when do you perform CPR on a person that is breathing on their own (as has been reported that this lady was)? I've been certified in CPR for decades and they have ALWAYS told us not to perform CPR on someone who is breathing on their own. Did I miss something during my last certification (I passed with flying colors)?
Performing CPR on a person breathing does nothing. The purpose of CPR is not to start the heart, but rather to keep blood moving so tissue death doesn't set in. If she was breathing at the time (which was what was reported), CPR would be useless.
BTW for the commenters (and MSN), the lady was NOT a nurse. That has been made clear in the days that followed the event, but some folks just give comments without actually knowing much about the story.
If this doesn't serve as a warning, nothing will. Economic collapse is only months away now, and Obama and the sleeze of politicians on the Potomac must find someone to "throw under the bus." That will be the elderly, because like this lady, her remaining life didn't warrant that much effort from the nurses. That nurse personifies the nation and society, as does the old lady and the elderly. Obama and his Jesse James kind must have victims, and the elderly are this time "it."
You know, Hal, some people are on drugs....and there's another whole group who aren't but really should be.
Take a deep breath. Nothing about this issue has a single thing to do with Obama, Jesse Jones, or any posse and in fact, better access to health care will improve longevity.
You are an IDIOT if you believe anything you wrote
Hal, you and people like you are what is wrong with the republican party!
Even if the lady had a DNR order, that does not preclude calling for an ambulance, which the "nurse" (if she even was an actual nurse) did......it was not her duty to diagnose - only to call for help (thus the ambulance). Maybe the lady broke a hip (it can happen spontaneously), had a stroke, just fainted from low blood pressure, or any number of things that could have happened causing her to fall to the floor. Then the daughter would be notified afterward. As it turns out, she did have a DNR, as stated by her family in another article. All you judgmental "do-gooders" need to realize that the vast majority of people in this country would rather NOT be kept alive on machines to suffer every day until finally being allowed to die. I know, because I am a nurse (RN) for 40 years, and most everyone always says "I hope I can just die in my sleep' or "I hope I just drop over dead".....the ones that want "everything done" don't realize what that entails or the futility of it. Of course, there are many times that a person made need some heroic efforts to get them over a crisis, where they may need a ventilator for a few days, or possibly even a few weeks,. I've worked in Critical Care Units for years, and have seen people survive and go on to productive lives.....but when efforts are futile, which most nurses and physicians know and understand, then it is time to let go. Machines can keep dead brains with beating hearts going on and on.....but a dead brain does not come back. I've stood with many families over the years and said prayers with them as their loved one gives their last breath, and helped them through their sorrow....so don't dare say I am heartless when I encourage them to let go and allow their loved one to go to the next life when there is no hope. Everyone should have an Advance Directive stating exactly what they want done in these circumstances (whether for or against heroic measures) so that their family knows what to do without feeling guilty. When you sign an advanced directive, you are doing it as much for them as for you.
the nurse did not call, another patient did.
There is no case where anyone should risk their life giving CPR to anyone. You don't ever know what you might get when you give CPR to a patient. And if there was a signed DNR paper the nurse could be sued for doing it. When I get to that point in my life and I sign those paper I don't want anyone to give me CPR and bring me back at all.......why is there anything that might say she has to do CPR.
Jumbob,
Unless you know something I don't, the lady claimed to be a nurse on the 911 call. The lady wasn't working as a nurse at the facility, but that doesn't mean that she isn't a nurse. She could still be a nurse but working in a different capacity. I see no reason why during the call, the lady would make up a story that she is a nurse. There is no purpose in doing so and I see no reason why she would have lied.
bereaucratic red tape sorry excuses why people dont want to help each other they might be sued and this is as good an excuse as any for doing nothing ............
The woman had a DNR. The nurse followed all the rules. Her daughter was happy with the way it was handled. Let people die in peace that want it that way.