Elderly Woman Dies After Nurse Refuses To Give CPR

[haha]

And I wouldn't want someone deciding I would rather be dead than have broken ribs or that I would rather die than have a 9.4% chance of the CPR succeeding. (

I've had broken ribs 3 times in my life, never with pneumothorax. It is painful for a while, but from my standpoint no especially big deal. I would never let fear of broken ribs make me prefer being dead.

Ha

 

[donheff]

As a person who was "almost dead" and was considered in a state of "walking death" by my Internist of over 20 years (the quotes are what he said to my wife), I am wary of people's simplistic view of whether all people who are 87 should be left to die when they need CPR.

But were you 87 when you came back from the dead? I didn't see anyone suggesting that the average Joe should be treated as a DNR if he or she collapses on the street. But once people get into their mid to late 80s it is questionable that the default should be to take every possible action to prolong life.

 

[braumeister]

 

[Original Wally]

IMO, With both the 911 dispatcher and facility nurse doing their jobs. If either of them did things differently, they could lose their jobs. .

Had the employee NOT followed the institution protocol, she not only could possibly have been fired, but she may have been "black-balled" from the profession - having a reputation of NOT following prodecures. That would be a huge risk for any potential employer.

My own 2 cents - It looks like the protocol was followed as specified in the literature given to new residents. The 911 operator did what SHE thought to be morally right. The care home did what her employer required her to (not) do.

I think Mid-pack nailed it - each did "the right thing" and it turned out the way it turned out. The only "lesson" that I think society should glean from this incident is that PERHAPS there needs to be a stronger identification of the rules up front. Also, it is not unreasonable to assume that this particular institution will have a similar situation on a somewhat recurring basis. With that in mind, perhaps there could be better training of 911 operators to let them know that when this institution calls, CPR is not an option. Dispatch rescue and pray.

 

[easysurfer]

As a person who was "almost dead" and was considered in a state of "walking death" by my Internist of over 20 years (the quotes are what he said to my wife), I am wary of people's simplistic view of whether all people who are 87 should be left to die when they need CPR. I had terminal, end stage kidney failure and was fast approaching heart failure and had congestive heart failure. I felt absolutely horrible and felt like I was being poisoned. BTW, I know what it feels like to have Arsenic poisoning so I am not just making that up. I would not have wanted to be denied CPR just because I was a basket case. I very much wanted to live. I was pretty much cured of the kidney failure and heart failure and congestive heart failure overnight. I got a kidney and pancreas transplant in April, 1996. It literally saved my life. Before the transplant my BP was 250/125 and a day after it was almost back to normal. When the organs became available, I was second on the list but got the organs because the person who was first had the flu. The sickest person gets moved up the list the fastest. I was really, really sick. I was only on the list for four months. The usual wait is 4 years.

I am still pretty much a basket case of problems but I am not terminally ill anymore. If I get really sick because I am old and have no hope of getting better then I will get a DNR.

Deciding whether a person should have a DNR by default is crazy. Ignoring an old person having a CPR moment on the sidewalk because they are old is foolish. Resuscitate them and let them get a DNR for next time. If you let them die and they wanted to live then you've made an irreversible mistake.

Mike D.

Mike,

I enjoyed reading your post. Glad that you bounced back from being on death's door. You are living proof that decision for a DNR or not isn't always cut and dry.

In your situation when you were gravely ill, did you and your wife explicitly state to your doctors/hospital that you do not have a DNR order and asked them to comply with the request?

Easysurfer

 

[MikeD]

My Dr and my wife discussed whether I was going to blow my brains out. He thought I might and that she should be ready. She didn't know what to think. I would never do that.

I told every one I dealt with medically that I wanted to get better. They could tell by my attitude, too.

Mike D.

 

[rodi]

Mike's point is valid. If the person wants all medical steps taken - then all medical steps should be taken.
My brother had a terminal, inoperable cancer. He wanted all steps taken, even though the steps were extreme with no hope of a "cure"... He had 5 major surgeries in his last 2 weeks of life... all in attempts to slow the progression, reduce the symptoms. It was his choice... so they did it. (Even the doctors thought it was crazy but his tumor was unusual, it was a teaching hospital, so he was used to teach the residency candidates.)

On the other hand - my mother had a DNR, that needed to be honored... she chose to ex-tubate an inflated vent to make sure her wishes were followed.

Both were valid choices.

I still wonder who brought this to the media attention. It has to violate some privacy rules.

 

[Meadbh]

Throughout this thread I have been thinking....what if everyone was clear on what this lady wanted and just let her pass away with dignity? What would the headline have been?

ELDERLY WOMAN DIES PEACEFULLY AT LONG TERM CARE FACILITY AFTER STAFF FOLLOWED WISHES!

Not so newsworthy, is it?

 

[Katsmeow]

But were you 87 when you came back from the dead? I didn't see anyone suggesting that the average Joe should be treated as a DNR if he or she collapses on the street. But once people get into their mid to late 80s it is questionable that the default should be to take every possible action to prolong life.

Giving someone CPR who collapses is not the same thing as taking every possible action to prolong life. It is taking immediate action when you don't know what that persons wishes would be and if that person survives the CPR then a decision can be made on further actions depending on the situation.

 

[growing_older]

My grandmother lived her last decades of life in a wonderful, very well respected and very well run progressive nursing care home that allowed residents to move from independent to assisted to medically assisted care. Suffering from two cancers, she had some small strokes and was moved to more intensive levels where they discussed her DNR options and started talking to the family about preparing for the inevitable. She started losing her memory and had trouble recognizing visitors. At 87, quality of life was not so good and prognosis looked grim. Doctors gave her 3 to 6 months to live. Her power of attorney kicked in as she was no longer capable to manage her own affairs.

At which point my Aunt, her child who lived nearest her, started calling in cousins to help better understand her medical options. Some very challenging doctor confrontations later, medications were changed, her cognition improved, she moved out of the intensive care and a few months later was back to independent living for another 10 years. She had a full decade of life before the cancer finally killed her, most of which she was the main party organizer in her community.

DNR is great for people who want that. But sometimes things are not what they seem, even if well respected doctors tell you so. Even the best doctors and institutions are not infallible or omniscient.

 

[Buck2520]

Good thread on an issue we all need to think about. The thing in this case I don't understand is why the 911 operator was even trying to get someone to do CPR. My understanding of the case was that the woman still had a faint heartbeat and shallow breathing. I could be wrong, but this is what I read in the original news reports. CPR was not even called for in this case.

 

[growing_older]

I have wondered about the same thing. We used to learn mouth-to-mouth and for insufficient breathing I wonder if that would have been helpful. Certainly the concerns about "violent" CPR and causing injury are issues that I would expect never to arise if a bystander attempted mouth-to-mouth.