CALI woman dies after nurse refuses to do cpr.

[powderman]

http://www.whas11.com/news/national/194746201.html
 
Calif. woman dies after nurse refuses to do CPR  Associated Press  Posted on March 4, 2013 at 12:02 PM
Updated today at 12:37 PM       BAKERSFIELD, Calif. (AP) — A dispatcher followed general protocols when she pleaded with a nurse at an independent living facility to perform CPR on a woman who later died in California, a county official said Monday.
Earlier, Glenwood Gardens had defended its nurse, saying she also had followed policy in dealing with the 87-year-old patient.
 
At the beginning of the Feb. 26 call, the nurse asked for paramedics to come and help the woman who had collapsed and was barely breathing, according to a transcript of the call.
Dispatcher Tracey Halvorson urged the nurse to start CPR.
"I understand if your boss is telling you you can't do it," the dispatcher said. "But ... as a human being ... you know . is there anybody that's willing to help this lady and not let her die?"
"Not at this time," the nurse answered.
During the 7-minute, 16-second call, Halvorson assured the nurse that Glenwood couldn't be sued if anything went wrong with CPR, saying the local emergency medical system "takes the liability for this call," the transcript states.
 
Later in the call, Halvorson asks, "Is there a gardener? Any staff . anyone who doesn't work for you? Anywhere? Can we flag someone down in the street and get them to help this lady? Can we flag a stranger down? I bet a stranger would help her."
Kern County Fire Department spokesman Sean Collins said Halvorson had more passion in her voice than normal because she thought she was talking with a registered nurse who was refusing to save the woman's life.
"In her mind she had an RN there who was refusing to assist this lady," Collins said. "In this situation she felt the person needed to do something because she's in the same business as us, which is saving lives."
 
Halvorson is an experienced dispatcher and has worked for the county center for at least a decade. Collins said.
The woman was later declared dead at Mercy Southwest Hospital.
The executive director of Glenwood Gardens, Jeffrey Toomer, defended the nurse's actions, 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 facility 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.
A call to the facility by The Associated Press seeking more information was not immediately returned.

[SHOOTALL]

I don't know what rules they work under but when we take First Aid and CPR we are told we are not obligated to render help.
I have heard inspectors say they would not do so though they also are trained.
 All our people have access to the one way valve used foir breathinb to stop any thing from comming back into the givers mouth. That is a real concern as often people throw up while recieving help.

[Conan The Librarian]

If I'm lucky to make it to 87, but am living in assisted living, I would have a Do Not Rescusitate order in place anyway. Most likely the woman who died did too. That's a very common order and it makes a lot of sense. The news story should have stated whether there was such an order in place. It didn't but it implies there was no such order, given the response of the home.

[lakota]

I would hope that if the woman had a valid DNR order in place then the media would go public with it. Otherwise this looks like a gross dereliction of duty.  The nurse was charged with caring for these people.I do not know the legalities of being a nurse but as a paramedic I would have been obligated to treat if no copy of a DNR was available. It doesnt sound like the woman was a hospice patient. In my system there are 3 ways to withhold CPR. 1 is in the presence of a valid DNR order, 2 is if the person is a hospice patient and 3 is if there are injuried incomapatable with life. It doesnt sound like any of these conditions were met. Of course there could have been a DNR order but the media is just overlooking it to make this into a more sensational story?

[Old Fart]

I don't know if the hospital can release the info on a DNR. Privacy records may be preventing it. And like someone else said, it wouldn't make the news if there was one.

[Gun Runner]

According to her daughter she had DNR statement in her med. record. News media just blew the whole thing out of shape for a Head line story.

Gun Runner

[garbhead]

My 2 oldest sisters were in hospital room when our Mother stopped breathing. They had been visiting and she wasn't really in that bad a shape at that time. She had also signed the DNR deal.  The younger sister asked the nurse if they could just try "a little" to revive her?  The nurse told her that if the 2 of them wished to override the DNR, they could, but they would have to try 100% or nothing at all. They chose to honor Mom's wishes. I think it has haunted both of them to this day, but she had terminal cancer and it was just a matter of time probably.  She had just started chemotherapy the day before, so now I look at this as avoidance of prolonged pain and suffering for her and a blessing, although I miss her dearly.
I still have a message from her on my answering machine that I cannot erase. I still listen to it now and then...She died Mar 29, 2000.

[kennyd]

If this woman was in an independant living facility, and they did not have any agreement to provide care, they would not have had access to a DNR.  We do not know how bad the heart attack was, if there was other circumstances like cancer to consider, or if the wishes of the patient were followed.  Is this one of those facilities where you join, pay, and anything left after you are gone is theirs?


We had better get ready for more of these stories with the new healthcare stuff.

[pastorp]

Based on the media's record of sensationalism in their reporting stories I think we need the rest of the story before judging the nurse. 

Regards,

[ChungDoQuan]

If it was an INDEPENDENT living facility, that's pretty well the same as living in a condo--- they just do your yard work and maintenance, and sometimes provide a little security. There is probably a nurse clinic on the grounds, for convenience during vaccination season.  That's not the same as a nursing home, nor even an ASSISTED living facility. On the news, the woman's daughter, also an RN, said she was satisfied with what the facility did.

By the way, the chances of an 87 year old surviving a code is almost nil. Overall, only 25% of ALL codes survive to discharge, when the code is witnessed, IN THE HOSPITAL.  Surviving a code is about equivalent to surviving a bad auto accident, with multiple rollovers. Interestingly enough, the drug they use in code situations to restore the heart's normal rhythm has a half life of 42 days! That means you are going to be home after your heart attack, in some cases before the drug wears off. Why do you think the number one risk factor for having a heart attack is having a prior heart attack? US medicine (the "best in the world?") is like US business--- they do not usually take the long-term view.

[lakota]

amiodarone is no longer the drug of choice for a v tach/v fib arrest according to my last AHA ACLS refresher. Early defibrillation is your best hope in those cases anyway, and it nor amiodarone are used for an asystole arrest , but face it asystole is pretty much a done deal either way.

[ChungDoQuan]

They still use it an awful lot in the hospital. An awful lot. And, even if you don't start it in the field, the patient, if they get to the hospital, will probably get amiodarone anyway. They don't use bretylium anymore, either, but so many docs were so used to it that the only way they stopped was by making it all but impossible to get. Docs are notorious for not looking at things long term. They'll give you 80 mg of furosemide for your CHF, knowing full well that somewhere in the next 10-20 years if you're lucky, your kidneys will fail. I don't know all the details on the woman in the news, but, like I said, her daughter was ok with the facility's actions.