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Elderly Woman Dies After Nurse Refuses To Give CPR
Old 03-03-2013, 11:11 AM   #1
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Elderly Woman Dies After Nurse Refuses To Give CPR

"However, on Tuesday the woman who needed CPR was refused by the nurse. The nurse said it was against policy at the facility for staff to give CPR"

Elderly Woman Dies after Nurse Refuses to Administer CPR | Health Aim

I never new CPR or not was up to policy.
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Old 03-03-2013, 12:48 PM   #2
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Not speaking to hospital policy, but my understanding is that CPR is a violent process and has a small chance of restoring life (something like 1 in 5 alive after 30 days after CPR administered after surgery).

This letter is worth reading: Death After CPR | Roy on Rescue

Doctors seem programed to fight for life with any resources, but everyone still dies, it's just a question of how.
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Old 03-03-2013, 12:53 PM   #3
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I've read this too. But here's another look: I had an electrician doing some work on my heating system. He told me a story about his then 49 yo wife. They were in the Houston Airport, heading to France, when she suddenly experienced cardiac arrest. He started CPR and EMTs got to her so quickly, and resusitated her (with the paddles and drugs I would assume), and now 8 years later, she is well and working and sometimes taking care of grandkids.

Different circumstances for sure, and she was a free living young person, but very nice outcome.

Ha
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Old 03-03-2013, 01:03 PM   #4
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It must be incredibly stressful to work in a nursing home.
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Old 03-03-2013, 01:48 PM   #5
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I worked quite a few codes on elderly patients when I worked in a hospital. We had some that came around with basic CPR and a very few others with the paddles and drugs. Every one of them died within the following week or two. CPR can be pretty violent. The last few codes I worked in the hospital I had the feeling that we were doing the wrong thing and were actually disrespecting the obviously dead patient. I would now be very hesitant to perform CPR on any elderly person. I think it is very telling that the nurse daughter of the patient in the OP link said she was satisfied with the care her mother received.
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Old 03-03-2013, 01:51 PM   #6
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Glenwood Gardens looks to be one of those graduated care facilities, where one buys into independent living, with options to move to assisted living and nursing home care.

I understand that turnover is a factor in these business models. So do some of the snarkier Yelp commenters...

http://www.yelp.com/biz/glenwood-gardens-bakersfield
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You think your parents were a pain in the ass when you were a teenager? LOL, wait till they're in their 90s and crapping themselves. The solution, of course, is senior housing, but it's hard to find a reasonable facility that they like. This situation gets complicated when there are large amounts of money involved and you're concerned about getting embezzled by some greedy nursing home that keeps your parents around like living zombies, barely breathing.
Glenwood Gardens is different. A place with principles. They know that the old and infirm are just regular old folks that want to move on quickly to free up their assets for their children to spend on granite counters and iPads. They will expedite this process without prejudice. The facility is staffed by caring nurses that can "detach with love". I highly recommend Glendwood Gardens.
Hoo boy. And I thought some of the Amazon comments had snark...
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Old 03-03-2013, 01:56 PM   #7
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In this case, policy at the facility seems to be questionable (we won't start CPR no matter what).. But I would like to know whether this lady had a living will / care directive, and if so, what her expressed wishes were.
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Old 03-03-2013, 04:59 PM   #8
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I listened to the call on the news. The "victim" was 87 years old. If I was in a nursing home at 87 I would have a DNR on file. Heck, shouldn't DNR be the default policy in nursing homes?
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Old 03-03-2013, 05:58 PM   #9
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I think when someone is in a nursing home or independent living home, the mistake is to treat the place like a hospital. At a hospital, of there was no DNR on file, I don't think a hospital would refuse. This story was on the evening news, and the news said the place was not legally obligated to perform CPR. So, I guess the nurse there was doing what she was told
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Old 03-03-2013, 06:41 PM   #10
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My daughter is in her final year of nursing school at UCLA. She is in her 300hr rotation at a local LA-area hospital ICU this quarter. She recently was involved in a code blue of a very sick 80+ yr-old woman who had DNR on file. The woman's daughter was in the room and went into such hysterics that the hospital decided to ignore the DNR. My daughter performed chest compressions in an attempt to revive the woman, but was ultimately unsuccessful. The daughter was satisfied that the hospital did their best to help her mother. Te mother didn't complain despite having her DNR ignored.

On the other hand, my stepfather's cousin, in her mid-90's, had her DNR ignored when she went into cardiac arrest at an assisted living facility in southern California. She was furious when she became conscious and aware of what was done to her a few days later. She wanted to end her suffering and was ready to go. She lived another year or so after that, but was quite unhappy the entire time.

Knowing what to do at the (possible) end of life is not easy. I had had very clear instructions from my father about what to do if he was left alive and dependent on machines to keep him alive. A few years later he went into liver and kidney failure and was being kept alive in the ICU on a ventilator while I flew back from a business trip in the Philippines. While my brother and sister helped make the decision, I, as the person named in the durable power of attorney, had to make the final call. You can imagine what it feels like to tell the doctor to unplug the machines and then watch your father fade away and die over the next couple of days. It was a devastating thing for me, personally, to have to say. With or without instructions, end-of-life decisions are hard!
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Old 03-03-2013, 07:49 PM   #11
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Originally Posted by haha View Post
I've read this too. But here's another look: I had an electrician doing some work on my heating system. He told me a story about his then 49 yo wife. They were in the Houston Airport, heading to France, when she suddenly experienced cardiac arrest. He started CPR and EMTs got to her so quickly, and resusitated her (with the paddles and drugs I would assume), and now 8 years later, she is well and working and sometimes taking care of grandkids.

Different circumstances for sure, and she was a free living young person, but very nice outcome.

Ha
By contrast, the EMT who taught the CPR course that i took had administered CPR many times, but none of them lived.
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Old 03-03-2013, 09:06 PM   #12
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Originally Posted by donheff View Post
I listened to the call on the news. The "victim" was 87 years old. If I was in a nursing home at 87 I would have a DNR on file. Heck, shouldn't DNR be the default policy in nursing homes?
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Old 03-03-2013, 09:10 PM   #13
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Originally Posted by scrinch View Post
My daughter is in her final year of nursing school at UCLA. She is in her 300hr rotation at a local LA-area hospital ICU this quarter. She recently was involved in a code blue of a very sick 80+ yr-old woman who had DNR on file. The woman's daughter was in the room and went into such hysterics that the hospital decided to ignore the DNR. My daughter performed chest compressions in an attempt to revive the woman, but was ultimately unsuccessful. The daughter was satisfied that the hospital did their best to help her mother. Te mother didn't complain despite having her DNR ignored.

On the other hand, my stepfather's cousin, in her mid-90's, had her DNR ignored when she went into cardiac arrest at an assisted living facility in southern California. She was furious when she became conscious and aware of what was done to her a few days later. She wanted to end her suffering and was ready to go. She lived another year or so after that, but was quite unhappy the entire time.

Knowing what to do at the (possible) end of life is not easy. I had had very clear instructions from my father about what to do if he was left alive and dependent on machines to keep him alive. A few years later he went into liver and kidney failure and was being kept alive in the ICU on a ventilator while I flew back from a business trip in the Philippines. While my brother and sister helped make the decision, I, as the person named in the durable power of attorney, had to make the final call. You can imagine what it feels like to tell the doctor to unplug the machines and then watch your father fade away and die over the next couple of days. It was a devastating thing for me, personally, to have to say. With or without instructions, end-of-life decisions are hard!
You honored your father's wishes. You acted as he wanted. Never forget that, however tough it was. He entrusted you with a tough decision and you came through for him. Well done.
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Old 03-03-2013, 09:49 PM   #14
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By contrast, the EMT who taught the CPR course that i took had administered CPR many times, but none of them lived.
So is this EMT just very unlucky, or could there me a possibility that he is doing it wrong? I would have guessed that an EMT would be involved in numerous CPR attempts and at least some would have had to have been successful even if it was not a very effective treatment.
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Old 03-03-2013, 10:03 PM   #15
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If she had a DNR on file with the facility that would be one thing, but if she doesn't it seems as if the facility has a moral obligation to try to save her life by administering CPR. I'll bet the facility policy is based on liability issues. Seems stupid though.
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Old 03-03-2013, 10:12 PM   #16
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I would have guessed that an EMT would be involved in numerous CPR attempts and at least some would have had to have been successful even if it was not a very effective treatment.
Maybe not:

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You may have the impression from television shows or movies that CPR is a highly effective emergency treatment for anyone who has collapsed. It surprises many to learn that the dramatic CPR results they often see are a myth. Unfortunately, CPR is often ineffective, and only in certain circumstances is its success rate anything other than dismal.
CPR: Less Effective Than You Might Think - Medical Myths - Harvard Commentaries | Aetna InteliHealth
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Old 03-03-2013, 10:57 PM   #17
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Just recently went through end of life decisions with my mother, and applaud the lady upholding the policy of the nursing home if the dying person had a DNR. I am thankful my mother had a DNR in place and we upheld her wish when she started to fail, and called in hospice instead of sending her to the hospital to prolong her misery.

We as a society need to re-evaluate our ideas of death. We should embrace it and allow our loved ones to pass with dignity, instead of prolonging life no matter what. Truly, at some point, life is no longer worth living. I personally witnessed that point.

Mom, rest in peace. I'm proud of our family for following your wishes!
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Old 03-04-2013, 06:30 AM   #18
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You can't fault the 911 dispatcher or the nurse, they both did their jobs to the best of their ability.

I happen to have CNN on, Soledad O'Brien just reported the elderly woman had a DNR on file at the home.

End of life is always a sad event for survivors, no way around it.

Not sure why this particular story was even reported nationally. I am sure people expire in senior living homes daily.

I wouldn't want to be resuscitated at 87, YMMV.

Quote:
The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse's actions in a statement, saying she did indeed follow policy.

"In the event of a health emergency at this independent living community our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives," Toomer said in a written statement. "That is the protocol we followed."

Toomer offered condolences to the woman's family and said a "thorough internal review" of the incident would be conducted.

He told KGET-TV that residents of the home's independent living community are informed of the policy and agree to it when they move in. He said the policy does not apply at the adjacent assisted living and skilled nursing facilities.
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Old 03-04-2013, 07:39 AM   #19
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You can't fault the 911 dispatcher or the nurse, they both did their jobs to the best of their ability.

I happen to have CNN on, Soledad O'Brien just reported the elderly woman had a DNR on file at the home.....
If she had a DNR, then I'm not sure why the story is newsworthy (or why the nurse didn't tell the dispatcher the patient had a DNR).
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Old 03-04-2013, 07:42 AM   #20
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If she had a DNR, then I'm not sure why the story is newsworthy (or why the nurse didn't tell the dispatcher the patient had a DNR).
CBS just reported she did not, contrary to CNN. You would think CBS and CNN would have their facts straight before reporting anything, clearly at least one does not (and I'm naive). Who knows...
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