Everyone is pretty worked up about this situation, and I wanted to see if there was interest in having a conversation about it. By now I'm sure you all have heard about the "nurse" in California who refused to perform CPR on a dying elderly lady. How do you feel about this?
I think I am okay with having a policy like this, as long as the patients and family clearly know when they move there, that they will receive no medical care of any kind from the staff (including a basic skill anyone can perform). I'm not sure if the facility can really legally refuse to help someone like that without having an official DNR on file. That's really my biggest question. Maybe Skip Kirkwood will have some insight on that.
I may, and already have, taken some flack for supporting the "nurse" based on what we know at this point. To me it sounds like there was a communication failure on the part of the dispatcher and the "nurse". One never hears the "nurse" say the the patient is a DNR. I also don't recall hearing the dispatcher ask if the patient has a DNR. That may have happened in some of the tape edited out, I would assume had the "nurse" said, "the patient has a DNR" that would have been the end of the debate about providing compressions. Apparently the patient did not have a DNR, in which case I'll be interested to see what kind of precedent this sets for not resuscitating someone based on forms other than an official DNR
How many times have you crushed an elderly patient's chest because the family refuses to let go, knowing the whole time the patient will almost certainly never recover normal ADLs. Is this policy by the facility really all that terrible?
1) I'm willing to bet the facility agreement states "this is independent living and we do not provide medical care." I'm willing to bet the contract does not state "our employees are prohibited from providing basic first aid even if they know how or can be directed to do so by 911." The former is OK, the latter is unconscionable--what if someone is bleeding severely (something that's quite survivable), are they supposed to just stand by stupidly?
2) OK, the case was someone not likely to survive, but they were in the "independent living" section. I can't find this facility's particular rules, but a lot of those "independent living" places only require that you be age 55 or older and able to pay the rent. There are quite a lot of people who are under 70 and in decent health in these places--are we to penalize them as well?
3) Presumably, the policy applies to non-residents as well. So when your visiting 8-y/o grandson chokes on something, the staff is there to stand by and watch while he dies.
The facility might be within its legal rights to fire someone for performing CPR on them. It might even be unable to be sued for withholding care. But I find it hard to see that there is a way this policy can be written and advertised that makes any moral or ethical sense.
This "nurse" watched someone die right in front of them, and didn't do a thing to help. But at least she'll keep her job--after all, she *was* only following orders.