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Old 03-02-2013, 20:48   #26
podwich
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Very odd. While I agree the outcome for an 87-year-old is very likely poor, it is an extremely strange situation where a nurse is refusing to provide an attempt at CPR to a person who is not identified as DNR.

If they're not going to provide medical care, why have nurses within contact? I'm guessing the apparent policy has something to do with limiting liability, but it's just weird. Maybe the residents sign something regarding non-availability of CPR if they live there? I dunno.
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Old 03-02-2013, 20:49   #27
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God, Please give my son the wisdom to not let others care for me in my old age. Over and out.
And may he have the wisdom to allow nature to takes it course when you to take your last breath.
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Old 03-02-2013, 21:08   #28
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She was 87 years old. 87! There are no good outcomes for people that age that go into cardiac arrest. It is time to go. Her daughter was ok with it and you should be also.
Well said. At 87 letting nature take its course is appropriate. There are worse things than death.
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Old 03-02-2013, 21:11   #29
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If they're not going to provide medical care, why have nurses within contact?
Medication administration. Nurses handle the narcotics, and other meds.
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Old 03-02-2013, 21:12   #30
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I read the article. The woman was not in the more costly assisted living facility. She was in the adjacent independent living facility. The people who pay for medical services get medical services. The people who do not pay for medical services do not get medical services. If people get services without paying, no one will pay because there will be no reason to. In a competitive environment, companies giving services away for free will go under.
Is this an endorsement of their policies?
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Old 03-02-2013, 21:26   #31
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And may he have the wisdom to allow nature to takes it course when you to take your last breath.
Thank you.
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Old 03-02-2013, 21:36   #32
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I suspect it's that attitude right there that led to this in the first place. I suspect the company made the choice to require their staff to do nothing rather than risk a lawsuit if they did try and something went wrong. Of course, if the CPR doesn't work, even if done correctly, the person dies and now the family want a scapegoat. I can't say that I blame them.
I can most definitely blame them. If, out of purely monetary concerns around litigation, a medical professional ignores the ethical comitments of their profession, it's time to close the doors and find another line of work.

Nurses and doctors are there first, foremost and always to assist the sick and dying. The thought of a group of trained nurses sitting around and watching an elderly woman die while a 911 operator begs them to start CPR is morally repulsive.

I can almost understand the corporate powers-that-be writing a policy to protect the company's bottom line, but one would hope that in a situation as aggregious as this, the nurses involved would have had the moral courage to say "I'm not an accountant, I'm a medical professional first."
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Old 03-02-2013, 21:45   #33
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She was 87 years old. 87! There are no good outcomes for people that age that go into cardiac arrest. It is time to go. Her daughter was ok with it and you should be also.
If her condition was so hopeless, a "Do Not Resuscitate" order was called for. None was in place.

The lady's daughter is entitled to her private opinion, but it is clear that her Mother, the deceased, did not feel it was simply "time to go". Do her feelings and desire to live a little longer mean nothing because she was 87?

I'll be interested in seeing if/how the daughter's opinion changes when the first ambulance chasers start telling her that she likely has a case for a lucrative lawsuit.
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Old 03-02-2013, 21:45   #34
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Color me callous, but it is our legal system that got us to a place where we are now.

The nurse did not do anything wrong. No one - no one can [SUCCESSFULLY] sue her, or her employer. They followed protocol specifically and exactly as dictated. Even as a nurse she has no duty to respond beyond calling 911...and the dispatcher on the phone does not (appear to ) have medical training at a higher level than the nurse.

Only the nurse's supervisor, a NP, PA or MD could realisitically direct the nurse to perform CPR. That is the way the system is set up. Chances are, grandma was where she was with everyone totally aware of the limitations in place.

Callous maybe, but I do not see any reason for a huballo. It it were my mom, she would not be there to begin with, UNLESS she wanted to die a fairly natural death. Running CPR on a 86-88yr old...who here has ever done it successfully?

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Old 03-02-2013, 21:59   #35
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If her condition was so hopeless, a "Do Not Resuscitate" order was called for. None was in place.

The lady's daughter is entitled to her private opinion, but it is clear that her Mother, the deceased, did not feel it was simply "time to go". Do her feelings and desire to live a little longer mean nothing because she was 87?

I'll be interested in seeing if/how the daughter's opinion changes when the first ambulance chasers start telling her that she likely has a case for a lucrative lawsuit.
You do not know the lady or her daughter. You have no clue as to whether she wanted to live or not. It is not uncommon for there to be no DNR. It does not mean she wanted to be revived. Her daughter is entitled to more than just an opinion.
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Old 03-02-2013, 22:10   #36
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You do not know the lady or her daughter. You have no clue as to whether she wanted to live or not. It is not uncommon for there to be no DNR. It does not mean she wanted to be revived. Her daughter is entitled to more than just an opinion.
The article clearly states that there was not a DNR in place. Absent a written DNR order, medical professionals must assume that the patient wants to live - that's why they have DNRs in the first place, so that patients whose condition and quality of life are such that resuscitation is not desired can make their wishes known.

Is it common for there to be no DNR? Yes, but then again it is common for people to want to live. What isn't common is for medical professionals to pretend that a DNR is in place and act accordingly when such is not the case.
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Old 03-02-2013, 22:22   #37
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I hope the family sues. If the deceased didn't have a DNR, I think they have a good shot at being compensated for total incompetence and indifference. Lazy and incompetent "assisted" care workers are fairly commonplace nowadays, I can usually count on at least one run a shift for- "code yellow, personal assistance", to pick an elderly person off the floor because the staff on site simply won't help.

My department has started documenting these runs and is currently challenging these "assisted" care facilities to do what families expect of them.
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Old 03-02-2013, 22:27   #38
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Bayless died Tuesday at Mercy Hospital Southwest. Toomer told 17 News that is the policy of Glenwood Gardens that staff does not attempt CPR. Toomer said residents are made aware of this policy when they move into the building.

Bayless did not live in a nursing facility. She lived in the independent living facility where there are no nurses on staff to provide assistance, according to Toomer. It's somewhat of an apartment complex for seniors.

We also spoke to Bayless' daughter. She said she is a nurse and she remains satisfied with the care her mother received at Glenwood Gardens.

Independent living with no requirement of medical care. Family is ok with what happened. Why are you guys all worked up about this.
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Old 03-02-2013, 22:28   #39
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The article clearly states that there was not a DNR in place. Absent a written DNR order, medical professionals must assume that the patient wants to live - that's why they have DNRs in the first place, so that patients whose condition and quality of life are such that resuscitation is not desired can make their wishes known.

Is it common for there to be no DNR? Yes, but then again it is common for people to want to live. What isn't common is for medical professionals to pretend that a DNR is in place and act accordingly when such is not the case.

You don't know what you're talking about,so be quiet for a little while and learn somethings.

1. The nurse who called 911 had no duty to act. The deceased was not her patient.

2. Just because there was no DNR does not mean people want to live. This is how the conversation between me and my 40-odd yr old sister went, in the months before she died, while suffering from Stage IV cancer - "What do you want...?"

Her: "I want this, this and this".

Me: Ok.

After that she made me her agent via a health care proxy. Did she (my sis) need a DNR? Absolutely not. When she was incapable of making her own decisions, the doctors and NPs contacted me, and I instructed them on what I wanted (which was what my sister instructed to me).


To repeat, the deceased was apparently not on the grounds of her facility when she became unconscious. There is no law that COMPELS anyone else to render aid, unless they have a specific duty (on duty anyone who is generally dispatched to a call or who maintain an emergency or general care facility).

If I am wearing scrubs, and 'scope around my neck, and a name tag that says "Dr. Gallium", if I am not at work at a medical facility, or if I have not been dispatched while on duty, or called onto active duty, I have no obligation or requirement to render aid to anyone.
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Old 03-02-2013, 22:30   #40
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I hope the family sues. If the deceased didn't have a DNR, I think they have a good shot at being compensated for total incompetence and indifference. Lazy and incompetent "assisted" care workers are fairly commonplace nowadays, I can usually count on at least one run a shift for- "code yellow, personal assistance", to pick an elderly person off the floor because the staff on site simply won't help.

My department has started documenting these runs and is currently challenging these "assisted" care facilities to do what families expect of them.

Your middle school is a more likely candidate for a lawsuit, based on your awful, piss-poor display of lack of reading comprehension, and inability to connect-the-dots.
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Old 03-02-2013, 22:39   #41
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Hmm...so grandma was in an assisted living facility, and her arrest was witnessed in a dining hall. What do you suppose the chances of her arrest being caused by an airway obstruction are? I'd say about 50/50. I don't know the transport protocols there, but I would imagine that the reason she was transported instead of being pronounced on scene, was due to the crews finding a reversible cause of death and being able to return circulation, for the time being anyway.

We can assume that she was reasonably ambulatory, able to function independently and free of diagnosed psychiatric disorder since she was in such a facility. Grandma had an ok life still. Hypothetically, let's say this nurse witnessed her choking prior to the code. Granted, we're assuming a nursing home staff member could recognize choking, but still...by their policy, all she can do is stand there and watch while waiting for EMS. Meanwhile, grandma dies when chest compressions would have likely cleared the obstruction. That may or may not have been what happened, but it's entirely plausible.

It's beyond me why anyone would want to live in such a place, or how anyone could work under such policies. Kind of makes you wonder what the policy is when fellow staff members or non-residents experience medical emergencies that a bystander could reasonably assist with, let alone someone trained to help.
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Old 03-02-2013, 22:39   #42
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Bayless died Tuesday at Mercy Hospital Southwest. Toomer told 17 News that is the policy of Glenwood Gardens that staff does not attempt CPR. Toomer said residents are made aware of this policy when they move into the building.

Bayless did not live in a nursing facility. She lived in the independent living facility where there are no nurses on staff to provide assistance, according to Toomer. It's somewhat of an apartment complex for seniors.

We also spoke to Bayless' daughter. She said she is a nurse and she remains satisfied with the care her mother received at Glenwood Gardens.

Independent living with no requirement of medical care. Family is ok with what happened. Why are you guys all worked up about this.
This + Gallium's post. I have been down this road with several relatives and have had to make the decision based on their wishes before they were incapable.

How many of the people that think the family has suddenly won the "Redneck Lawsuit Lottery" are the same people that complain about their fear of getting sued in an SD shooting situation?
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Old 03-02-2013, 23:09   #43
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[/B]
Bayless did not live in a nursing facility. She lived in the independent living facility where there are no nurses on staff to provide assistance, according to Toomer. It's somewhat of an apartment complex for seniors.
There WERE nurses present, as noted in the transcript of the 911 call. The statement by Toomer is false on this count.

As for the rest, company policy does not trump professional ethics, as noted by the medical ethicist cited in the article who described the incident as "pathetic".
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Old 03-02-2013, 23:11   #44
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Dr Gallium, are you a real doctor, or moreso a doctor in the way Dr Pepper is a doctor?

By the way, some states have duty to act laws that would require a bystander to do what is reasonably necessary to render aid. You're right, the supposed nurse did what she was obligated to. I'm assuming her employer knew the law and knew no such law existed. If not and one did exist...oops. Work policy does not supercede local or state law.

I admit, I'm a little new to the game. I'm a medic with about a year of experience on the job now. Out of 5 workable codes, I've got one fully intact save that was younger and cardiac in nature. Sure, most of the geriatric codes are turkeys, but not all of them. Like my previous post, if all she did was choke on dinner and code, that was completely reversible and she probably would have been fine. No matter how you slice it, it's a shame. A lawsuit isn't the answer, but the way we allow these places to treat our elderly is despicable. OlliesRevenge has a very valid point there.
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Old 03-02-2013, 23:16   #45
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You don't know what you're talking about,so be quiet for a little while and learn somethings.

1. The nurse who called 911 had no duty to act. The deceased was not her patient.

2. Just because there was no DNR does not mean people want to live. This is how the conversation between me and my 40-odd yr old sister went, in the months before she died, while suffering from Stage IV cancer - "What do you want...?"

Her: "I want this, this and this".

Me: Ok.

After that she made me her agent via a health care proxy. Did she (my sis) need a DNR? Absolutely not. When she was incapable of making her own decisions, the doctors and NPs contacted me, and I instructed them on what I wanted (which was what my sister instructed to me).


To repeat, the deceased was apparently not on the grounds of her facility when she became unconscious. There is no law that COMPELS anyone else to render aid, unless they have a specific duty (on duty anyone who is generally dispatched to a call or who maintain an emergency or general care facility).

If I am wearing scrubs, and 'scope around my neck, and a name tag that says "Dr. Gallium", if I am not at work at a medical facility, or if I have not been dispatched while on duty, or called onto active duty, I have no obligation or requirement to render aid to anyone.
Wrong on all counts.

First, you aren't the only one here who has been down the road of having a dying relative, thank you very much. Many of us here have AT LEAST as much experience on that road as you.

Second, the nurses present DID have a duty to act, if not a legal one clearly a moral one, and the medical ethicist cited in the article agrees.

Third, there has been nothing presented here or in the article indicating that the deceased woman was suffering from dementia or any other mentally debilitating issues which would render her incapable of making decisions regarding a DNR, nor is there anything in the article stating that her daughter was an authorized agent for such decisions - that's your private biases masquerading as fact.

Open you eyes and READ and you might learn something as well!
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Old 03-02-2013, 23:23   #46
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I imagine she will change her tune once an attorney makes her aware of the windfall that she potentially has coming in a lawsuit.
Perhaps she is satisfied with their actions because she anticipates a double payout.
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Old 03-02-2013, 23:54   #47
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Gallium, with all due respect, I think you are wrong on this. I'm pretty sure she was employed by the ILF and there fore had a duty to act unless she was not trained in CPR, not likely. If she had been a nurse visiting a relative, no duty to act. The nurse will be investigated, dimes to donuts.

Policy does not provide shelter from criminal or civil consequences. If a policy states that all shoplifters are to be summarily executed upon confirmation of finding merchandise. Granted I may have over played my hand on the example. I will also admit that withholding CPR is likely not criminal.

I would not dismiss Gallium's experience out of hand either. There are a myriads of dynamics in play with the decision to place a loved one in any facility. So tread lightly before you condem folks that need to do this. There but for the grace of God goes me.

An 86 year old will not spring back from a resuscitation routine. It all depends on the patients vitality. I've seen OLD 65 year olds that look like a stiff breeze would send them into cardiac arrest. I've also seen 90 year olds that were more like young 70 year olds.

The policy is questionable IMO.
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Old 03-02-2013, 23:56   #48
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Perhaps she is satisfied with their actions because she anticipates a double payout.
Naw, if that was the case she would be jumping up and down throwing a hisifit to strengthen her case.
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Old 03-02-2013, 23:58   #49
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Running CPR on a 86-88yr old...who here has ever done it successfully?
Me. CPR is successful just about every time you do it more or less correctly. It is only meant to move blood and oxygen through the heart, lungs and brain and keep the major organs "alive" and slow the death process down. CPR never was meant to restart the heart. It does happen occasionally as I've experienced. I had one patient in her 90s that coded and I did two compressions. She grabbed my wrist and told me "that hurts". Scared the crap out of me. I've been involved in over one thousand cardiac arrest situations in my career. BTW nursetim, my wife is a Risk Director and while her job is to protect the hospital from BS lawsuits and false accusations she spends the vast part of her time helping patients and the families with problems.

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Old 03-03-2013, 00:02   #50
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I'm not a legal eagle but, I think your dealing with a due diligence issue here.

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It is stuff like this that scared by ex-brother in law to divorce my sister. After being together for over 25 years and being childless due to his insistence, he suddenly wanted kids - after Obama-care became law, of course.

He realized what awaits him, in his elderly years without family to take care of him.
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