Old lady dies in nursing home because Nurse refuses CPR, cites company policy.

[8mpg]

I thought do no harm meant something.

I guess letting a woman suffocate three feet away is allowed in the fine print though.

You must be medical knowledge ignorant. Going above and beyond your knowledge and scope of practice (which can be limited by the facility which it is clearly here) can land you in jail or loss of your nursing license. You only do what you know and are trained to do. Most nursing home / assisted living nurses are not trained or have the knowledge

[Forever_frost]

No, a nursing home nurse probably wouldnt know. There are different levels of nursing with different certifications. Many nurses do no take and have an ACLS certification are not trained to run a code without physician supervision. Many nurses (especially LVN's) do not know proper ACLS algorithms and would not know not to shock asystole.



And how exactly would the nurse know? When you have 100's of seniors in an assisted living (and that is only part of the facility), you dont know who is what code status, what diseases they have, etc. Could this have been an asthma attack? You going to do CPR on a kid with asthma?

May have a point, if it was a kid with asthma. Instead, you had a nurse telling a dispatcher she wasn't going to touch the woman because it was against company policy and she felt 'stressed'.

[yellowstang]

Fuck, if I make it to 87, don't try CPR on me either, whether or not I need it.

[jluv]

That's why you don't put your old parents in a nursing home without a physician or at least a midlevel on site at all times.

[sc281]

No, a nursing home nurse probably wouldnt know. There are different levels of nursing with different certifications. Many nurses do no take and have an ACLS certification are not trained to run a code without physician supervision. Many nurses (especially LVN's) do not know proper ACLS algorithms and would not know not to shock asystole.



And how exactly would the nurse know? When you have 100's of seniors in an assisted living (and that is only part of the facility), you dont know who is what code status, what diseases they have, etc. Could this have been an asthma attack? You going to do CPR on a kid with asthma?

I don't see where a kid with asthma is in this, but if that's what I was told to do, then yea. What's the point of doing CPR classes if you won't use it cause you might catch something... Now if it's sores all over the place, obviously not, but chances are I wouldn't know if it was asthma.


But in a facility like this, I'm sure they'd have the little air bag and gas mask to not have to go mouth to mouth, right? Or the oxygen, I mean come on, old people everywhere. The only thing they carry around more often than hard candy is oxygen tanks.

You must be medical knowledge ignorant. Going above and beyond your knowledge and scope of practice (which can be limited by the facility which it is clearly here) can land you in jail or loss of your nursing license. You only do what you know and are trained to do. Most nursing home / assisted living nurses are not trained or have the knowledge

Yea, I don't know much about medicine, but I do know that in this case, doing something and being wrong would have been no less lethal than doing nothing.

I'll gladly stay ignorant if the cost of knowledge is losing the willingness to try.

I'm not trying to rail against you, although that's what it seems like. I'm just having a hard time accepting this.

[8mpg]

May have a point, if it was a kid with asthma. Instead, you had a nurse telling a dispatcher she wasn't going to touch the woman because it was against company policy and she felt 'stressed'.

Most people freak out and dont know what to do. Its a normal response to intense stress in these situations. I work as a nurse in a hospital and I cant tell you how many times a room of med/surg nurses stand there with a blank face because they freak out and hesitate.

This is why certain people are trained properly to handle these situations, ie EMS.

[8mpg]

I don't see where a kid with asthma is in this, but if that's what I was told to do, then yea. What's the point of doing CPR classes if you won't use it cause you might catch something... Now if it's sores all over the place, obviously not, but chances are I wouldn't know if it was asthma.


But in a facility like this, I'm sure they'd have the little air bag and gas mask to not have to go mouth to mouth, right? Or the oxygen, I mean come on, old people everywhere. The only thing they carry around more often than hard candy is oxygen tanks.





Yea, I don't know much about medicine, but I do know that in this case, doing something and being wrong would have been no less lethal than doing nothing.

I'll gladly stay ignorant if the cost of knowledge is losing the willingness to try.

I'm not trying to rail against you, although that's what it seems like. I'm just having a hard time accepting this.

Once you get in the situation, the heat of the moment, Id like to see how you perform. To assume there is proper equipment is crazy. There are times hospitals dont have what they need. I doubt the assisted living place has a properly stocked crash cart ready at a moments notice. I have done my fair share of rotations in nursing home and wouldnt ever expect them to do anything. It is very sad to say they are under staffed, ignorant, and neglect patients.

People will never understand medicine until they are in it. While the nurse could have tried to do something, she also could have lost her job. While I know you will say a persons life is worth her job, but I could beg to differ. If she is reported and loses her license, it is her career and her family she will jeopardize.

[slow06]

I don't see where a kid with asthma is in this, but if that's what I was told to do, then yea. What's the point of doing CPR classes if you won't use it cause you might catch something... Now if it's sores all over the place, obviously not, but chances are I wouldn't know if it was asthma.


But in a facility like this, I'm sure they'd have the little air bag and gas mask to not have to go mouth to mouth, right? Or the oxygen, I mean come on, old people everywhere. The only thing they carry around more often than hard candy is oxygen tanks.





Yea, I don't know much about medicine, but I do know that in this case, doing something and being wrong would have been no less lethal than doing nothing.

I'll gladly stay ignorant if the cost of knowledge is losing the willingness to try.

I'm not trying to rail against you, although that's what it seems like. I'm just having a hard time accepting this.

In a facility that basically says "Don't touch them and call 911" I doubt they have those things around.

Also I love this quote. Not sure I agree with you on the topic overall, but still a good sound byte.

[slow06]

Once you get in the situation, the heat of the moment, Id like to see how you perform. To assume there is proper equipment is crazy. There are times hospitals dont have what they need. I doubt the assisted living place has a properly stocked crash cart ready at a moments notice. I have done my fair share of rotations in nursing home and wouldnt ever expect them to do anything. It is very sad to say they are under staffed, ignorant, and neglect patients.

People will never understand medicine until they are in it. While the nurse could have tried to do something, she also could have lost her job. While I know you will say a persons life is worth her job, but I could beg to differ. If she is reported and loses her license, it is her career and her family she will jeopardize.

For something like a <10% chance of saving her. Even if you did, you are breaking several bones and possibly puncturing the lungs of an 87 year old.

Not sure where I stand here, but I'm leaning towards giving the "nurse" a break.

[yellowstang]

I see it like this. As already stated, sue happy Americans.

Different scenario, but same result. What would you do???

Car wreck, car rolled, driver stuck inside, upside down and is held in by his seat belt. Would you try and get them out if you thought the car would catch fire? What if they have a neck/back injury, and sue you because you made it worse and the car didn't catch fire?

When something like that actually happens, you can't tell how you'd react. Sure, we think "I woulda done so and so", but until you are actually faced with it, you can't be sure what you'd do.

[Forever_frost]

I've dealt with that scenario, well one close to it. A white small car was in a sandwich between two semis after the truck behind didn't see the group in front stopping. There was a fire but it's not really a thought. You get in there and try to break the door loose to get them out. If they're paralyzed later, well fine, they didn't burn to death.

Some people just are pre-programmed to move towards things going wrong and try to make it right and some people just lock up.

Edit: When I hear gunshots I still haven't figured out how to make my first response be to duck

[46Tbird]

Tim, I totally agree with everything you've said. The story reeks of sensationalism, but the honest truth is that old people die in these places all the time. Sadly, that's usually the reason their family sent them there in the first place. And, it would appear that is the case in this instance:

"Still, the woman’s daughter told the station that she was satisfied with how the facility handled the situation."

[CJ]

not sure if it's been covered, but from what I've heard she was choking on some bread, that was the reason for the call. Also, she did NOT have a DNR. After hearing the tape I'm pretty livid about the whole situation, the woman clearly didn't give a shit and was pretty careless about the whole conversation. I would sue the shit out of them personally.

[downshift_me]

But in a facility like this, I'm sure they'd have the little air bag and gas mask to not have to go mouth to mouth, right? Or the oxygen, I mean come on, old people everywhere. The only thing they carry around more often than hard candy is oxygen tanks.

Ambu bags are generally not in a nursing facility and if she was solo the ambu bag would NOT be a feasible option. Some people (myself) do carry around a mouthpiece to prevent actual "mouth-to-mouth." You also cannot just go haywire with oxygen either, because you will cause a vomit disaster with the likelihood of them aspirating into their lungs. Plus, not all masks have a oxygen port.

Compressions are the bare minimum you can do to help someone, but I am telling you right now if I did not perform as necessary or if there were an AED available and I didn't use it my boss would have my ass. Now, I will say things are ran quite a bit differently in a nursing facility and as stated their crash carts are not stocked very well. So, before you toss granny, gramps, mom, pop, etc into one you'd better make yourself clear on their policies and preparations in the event it happens.

[Probie]

Most people freak out and dont know what to do. Its a normal response to intense stress in these situations. I work as a nurse in a hospital and I cant tell you how many times a room of med/surg nurses stand there with a blank face because they freak out and hesitate.

This is why certain people are trained properly to handle these situations, ie EMS.

The other day in my EMT class we were doing a car crash simulation ( parent in worst condition, kids in the car were just bruised up and fine). The way it was set up is there were four ambulance crews, the next comes onto the scene when the one before them calls for support. I was in the fourth ambulance crew with two other people. We get the call to go outside and when we get there all the kids are loaded up onto stretchers and we are left with the parent. We start get the patient onto the backboard. Our instructor then calls out that the patient has stopped breathing but still has a pulse. The other two people just look at each other. I'm already opening the airway and grabbing a bvm while one starts doing compressions. My instructor immediately asks them why they are doing that. They can't answer and he explains that you don't do compressions on a patient with a decent heart rate (was 60bpm steady but weak). So we get the patient loaded up onto the striker and while waiting for the ambulance. While waiting ( I am still ventilating). The instructor says the patient has lost their heart beat. Once again my partners just look at each other. I put down the bvm and start compresions, then I tell them to get the aed ready and for the other one to ventilate. The person putting the aed on PUT THE PADS RIGHT ON TOP OF EACH OTHER BECAUSE THE PICTURES TOLD HIM TO. And the other one is trying to ventilate the patient while I am doing compressions at around 30 breaths per minute. Patient died, I got an A my partners failed. Long story short, some people just can't handle pressure. Some people just shouldn't be in EMS, same goes for the kid that puked during the birthing video.

/rant