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March 4th, 2013
06:21 PM ET
Dispatcher pleaded with nurse to do CPR
Brooke Baldwin's "Hot Topics Panel" discuss the death of an elderly woman after nurse refused to give her CPR.
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The news reporting on this has been irresponsible. I really feel for the nurse in this case, as she is being unjustly maligned. It is not reasonable to expect that CPR be done on elderly people. Not only is it not likely to have a good outcome,, but the physical effort required is only going to cause more suffering. What do anyone think happens when chest compressions are done on a body riddled with osteoporosis? The woman's rib cage would have collapsed. There are sometimes good reasons for following a policy that discourages CPR.
The reporters and members of the panel displayed their ignorance of the issues surrounding standard medical care. The coverage was emotional rather than factual and informed. This patient (or representative) had signed an agreement that CPR would not be performed. Calling 911but not initiating CPR is often standard nursing home procedure. CPR on an 87-year old patient would inflict damage, possibly pain, and likely be unsuccessful. This "report" was far below CNN's standards of good reporting. Brooke Baldwin should have done some research before she spoke.
I've spoken with 2 nurses at a hospital and a care facility about this incident – they were both horrified as I was by the nurse's reaction. They both feel, and I agree, that she wasn't really an RN. It seems abundantly clear that the facility was simply looking at another empty bed they could fill. I have never seen or heard such callousness in a medical professional. The 911 operator was appropriately appalled and horrified. I can only ask that nurse, what if it had been your mother, aunt, or grandmother? And personally I don't care if the facility has a policy – I have a policy too – and my policy trumps you pathetic bottom-line attitude and would instruct me to save this woman's life. It was horrifying to hear the indifference in that nurse's voice. Such ice in those veins as she stood there watching her die.
Notice how none of the talking heads in this segment actually work in medicine or healthcare. It's easy pass a judgement when you don't necessarily know the behind-the-scenes of things going on besides the soundbite. There are a whole host of other reasons why the nurse could have refused to administer CPR. For example, what if the patient had an up to date Do Not Resuscitate order and in spite of what protocol dictated, refused to administer CPR for that reason?
I understand that these are testy issues that have very visceral reactions from a lot of people irrespective of knowledge base. I'm not implying that the nurse was right to refuse to administer CPR, but I am saying that this case is not as immediately clear-cut as this 4-minute segment would lead a lay person to believe. This is absolutely shoddy reporting.
P.S. On TV, around 75% of people who receive CPR survive, whereas in real life, the number is about 8%.
Tola, with all due respect, if the woman patient had a DNR, the nurse would have known about it and mentioned it, or not even have called 911. What would have been the point? I do agree, there may have been other extenuating circumstances ... but ... we heard the 911 call didn't we? I will agree that the case may have other issues of which we are not aware, but the point is ... if I were the emergency operator and heard that same call, I would have been equally as incredulous and also persisted. Additionally, new CPR procedures have increased survival rates by 50% - however this is still a very low 12-15% survivors overall. According to this report the daughter of the patient was satisfied with the care given. I suppose we must accept that and hope our loved ones don't experience such a crisis.
One minute and thirty seconds into the 911 call , it is stated that the elderly woman is breathing. What part of performing CPR do you people don't understand. You do not perform CPR on anyone who is breathing. Period. In this ladies situation if anyone would have performed CPR without a doubt have killed her right there on the spot. She is in her eighties and if you do CPR on someone who is not breathing, no heart beat at that age your more than likely wasting your time but if you start do not stop until the paramedics have arrived.
I have worked in healthcare for years. No one has said if this elderly woman might have had many other medical conditions causing her to have chosen to be what is considered a DNR ( Do not resuscitate) . It is possible she has chosen on her living will to NOT have emergency procedures performed, which is well within her right! At her age , this would not be uncommon. It is unbelievable that this nurse would be crucified before the facts are understood. She could have been end stage cancer or dying from other ailments but still able to live on her own at this time. So tired of hearing this one sided reporting. Dignified care of the elderly is following THEIR "last stage of life " wishes whatever they may be .
I find Gordon's comment unfounded. Depending upon one's level of certification, compressions are to be initiated on anyone who is unresponsive...even with questionable or ineffective breathing. There is no empirical evidence that performing CPR when unnecessary increases mortality. Conversely, the chance of survival decreases significantly during each minute that passes without effective compressions. While soft tissue injury or even rib fractures may occur, such adverse effects pale in comparison to the potential benefit of successful resuscitation. Until a tax base will support emergency infrastructure that permits responder arrival within 4 minutes, community and bystander CPR and AED provision are an imperative step in giving cardiac arrest victims a chance at survival.
CNN is feeding and emotional flame here rather than an informative one. Need to do your research on nursing home, assisted care, and residential care for the elderly; also on Resident Rights. In some facilities CNA's (certified nursing assistants) are NOT even trained to do CPR as it would place them in a postiition to be required to administer CPR. Each facility has their policies on this. Seems as though this facility had one as well. The family and the resident would be made aware of this upon admission. As the family in this situaton seemilngly hasn't any problem with the care given, my guess is they were well aware of this practice. Having worked in long term care in a Social Services capacity, I can tell you just because they are elderly, doesn't mean you can violate their rights or wishes. This woman may have chosen this facilty BECAUSE they had such a policy.. Additionally, CNN keeps replaying that this same facility refused to help an elderly resident up after he fell and broke a bone. This is the protocol folks! If they fall, you keep them still until medical help arrives. WHY? Because you may injure them further, AND because many elderly are in such a compromised state that surgery to repair the break is out of the question! So why move them and risk further injury? Bad reporting CNN, just plain inflammatory.
My family and friends all know that should medical conditions limit my ability to fully recover...there is a permanent, legal document that says I do not want to be resusitated. I do not want to spend months or years in a nursing home knowing I will never be able to go home. And, if I am incapable of understanding or restating my wishes, my children who are my legal medical advocates, will speak for me. I am 77 years old.
Reporters who assume everyone would want resusitation should rethink their reports which have been VERY one sided; not my side.
I used to work for a LARGE office supply company. Their policy regarding medical emergencies was very clear. In the event that such an episode were to occur to someone within the store or on company owned property, we were not permitted to assist them in any way, other than to call 911, regardless of the immediacy of the situation or training that employees may have.to assist the person. I work in a restaurant and several weeks ago, a customer was in choking distress. I did not think twice about policies, rules or liability. I iinstinctively did what needed to be done and successfully performed the Heimlich Manuever. I would not hesitate at all to do it again if necessary!! I can understand and sympathize with the nurse who made that "call", being frustrated by "the system", what she has been trained and committed to do, and her conscience. I truly feel bad for her, to be put in the position of having to decide if policies or conscience is more important. Regardless, it will be something that she will always think about.
Great idea dispatcher, do CPR, there's a 3% chance it might save her. IF she doesn't died we can put her in ICU on life support, with all the tubes, IVs, breathing machines, etc. Hopefully she will not be in pain, broken ribs, tube down throat and inability to response and won't get too many bed sores. We can keep her there until her family is physical and financially exhausted and we have gotten all the money we can from medicare. IF she recovers, whatever condition that may be for a lady her age, we can put her in a nursing home to live out her life, excuse me I mean to prolong her death.
I have been a nurse for over 20 years and I have never heard of such foolishness. If there was a DNR in place that is the first thing a nurse mentions on the call. It is obvious that there was not one. If this patient was a infant many of you would be furious that CPR was not initiated. Who is any more fragile than them. If there was compassion or genuine concern heard from the nurse than we would not be seeing the same reaction. If in case this facility does have such policies in place to not administer healthcare when a a person is in need then they should not hire HEALTHCARE providers. Why have a physician on board ordering mess or labs or therapy? This is a sad day for us Nurses to witness. This has everything to do with money when all said and done. Family members should think twice before placing your loved one here unless your just a callous as the mentality of those running this FOR PROFIT facility.
Much has been said about this sad, sad situation. I have a couple of questions that I hope CNN can investigate and report back to their news audience.
1. This is an assisted living facility. Have all residents signed a DNR order (not a family member but the resident). When a new resident is coming in is it part of the package for them to sign. Do marketing materials clearly state this, their web site......on and on.....
2. If I visit my grandmother at one of these facilities and I have a heart attack or my child has a heart attack, does this mean they will not assist me or my child.....is this posted so all can see.
3. How many other facilities in American have a rule of this type! Just another way of throwing aside what should be one of our most treasured jewels our seniors.
Don't get me wrong, I know from personal experience how difficult it can be caring for seniors, they are not all loving angels (by a long shot). But lets not forget, they are why we are here and how our children see us treat our seniors today.......is how they will treat us in the future!
I look forward to hearing the results of your investigation.
I am a Registered Nurse with an advanced degree in gerontology and expertise in end-of -life decision making. I thought this was Saturday Night Live but no one was laughing. This was a poorly investigated report and the panel participants were incompetent to discuss the issues involved. The use of a comedian as a panel member was inexcusable. The reporter failed to establish the resuscitation policies at the facility, the specific wishes of the woman involved, or the health status of the woman. It was a major omission to not do any research into the effectiveness or probable consequences of giving CPR to someone 87 years old. Several others who have posted already mentioned the hazards of CPR in the elderly. The effectiveness of CPR in this age group has been seriously overestimated. CPR initiated by a solo rescuer outside a hospital has a much lower success rate. Concurrent health problems lower the success rate. CPR on healthy 87 year olds has an extremely low survival rate and high probability of major injury. You cannot mix the results for all age groups and situations to say that CPR is 50 % effective.
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