[US] Nurse refuses to perform CPR

[Nitrax]

My friend is a doctor in training and it is apparently very common for DNR at least on cancer patients gone very far. To prolong life when the patient is suffering badly is considered more unethical than not doing anything. These are patients who would probably take assisted suicide if it was legal, but passively "assisting" suicide is not illegal. Who makes these decisions I don't know.

[Catta]

Well there kind off is, there have been cases of elder homes rejecting the idea of mobile defrilliberators, because they wanted to die a natural death.

And I see nothing wrong in this case because of the daughters reaction, and because we do not have all the variables.

Der er lidt om det i den her kilde: http://www.genoplivning.dk/7-nyheder...e-fra-drg.html men ellers må du søge

Do you also remember the outrage when it became public that some doctors at several hospitals had started writing codes on patient charts that told the nurses and other doctors that they should not try to resuscitate - without the knowledge of the patient nor their next of kin.

[Alvito]

Jeeze....imagine that. You'd rather let someone die than break the rules.

She was 87 with a DNR, the nurse couldn't do anything as a result. ABC just reported the shock worthy part of the story and left out major details.

[Catta]

That is an exception to the rule, I work with the elderly and we have the same policy in place. It would not have just been the nurse being fired but if the resident had a DNR and it was not followed the resident and their family could sue the place as well. Unlike the nurse we do not have a full medical history of the patient and due to HIPPA laws it was none of the 911 operators business if the resident had a DNR in place. Most likely what happened was they had to go pull the resident and look for the DNR paper before they even started the process of doing CPR if it was called for. I don't see the nurse doing something willingly that would get her license revoked.

It doesnt state anything about a DNR in the first link - does it do so in the other links?

[Kasierith]

She was 87 with a DNR, the nurse couldn't do anything as a result. ABC just reported the shock worthy part of the story and left out major details.

So it's out that there was a DNR? That settles it, than. If the nurse had performed CPR her life as she knew it would have been pretty much over.

[Lushious]

Do you also remember the outrage when it became public that some doctors at several hospitals had started writing codes on patient charts that told the nurses and other doctors that they should not try to resuscitate - without the knowledge of the patient nor their next of kin.

No I did not, but this is not the case here?

Imo if the patient is demented (badly and of age) I would see no problem letting them have a natural death if the nearest family gave their consent.

This is comming from someone with a badly demented and 90 year old family member

[Flatspriest]

It doesnt state anything about a DNR in the first link - does it do so in the other links?

We will have to wait on the media to update the story once more facts are known. That way, the media gets more people to view their stories and get higher ratings...which is what they are after afterall.

[Kasierith]

It doesnt state anything about a DNR in the first link - does it do so in the other links?

It would explain why the daughter had no problem with the nurse's inaction. Collapsing from not being able to breath sounds like a chronic condition; going off of limited knowledge of course, I would say that the daughter and the retirement home knew what was coming, just not when.

As for people saying that the nurse didn't care.... I doubt that. I've worked in a hospital. It kind of fucks you up when you know there is nothing you can do to save someone, and in a situation where you know that and you know that even trying to help can make you lose your job, your license, and your financial security, it's pretty distressing to be able to do nothing but watch.

[Catta]

No I did not, but this is not the case here?

Imo if the patient is demented (badly and of age) I would see no problem letting them have a natural death if the nearest family gave their consent.

This is comming from someone with a badly demented and 90 year old family member

If there is a DNR there is no problem. If there is none then its still a problem. Even if demented and of age but with no DNR its a problem. It should not fall to doctors and nurses to choose who lives or dies. It should be up to the patients themselves or the family if they are not lucid.

[Ultima]

The care centre does not want to be liable for any deaths. They could be sued and lose millions/ be closed down.

The fact that they state in their contract that they won't perform such risks covers them on both sides.

[Catta]

The care centre does not want to be liable for any deaths. They could be sued and lose millions/ be closed down.

The fact that they state in their contract that they won't perform such risks covers them on both sides.

Im still not sure how one can hold them liable for a death if the death occurs with them trying to prevent it to the best of their ability when the alternative is that they just let people die.

[Toffie]

I remember a old guy in his 80's was doing psychical activities with younger friends, he ended up getting a heart attack - he got CPR by some danish kid and he is still alive today. I saw that in a CPR class, was really crazy.
Buttom line, atleast try instead of being a freaking cold hearted zombie.

Also, that law is stupid and should be changed like so many american laws.

[Yunru]

Its kinda pointless too save lifes of some old ppl if you lose your job for it. If the nurse was protected by law too preform CPR without being sued, well that would be another story.

But usualy its like this:
Retirement homes are made for ppl too die there. Once a family sends them there its a death sentence. (at least here)
When you try too care for this person at home.....well...i can tell you from my experience....its HELL!!!

[Deleted]

I would not give mouth to mouth, sorry but I'm not putting my health at risk. I would do chest compressions.

Unless there was a DNR, in which case do nothing.

[Alvito]

I remember a old guy in his 80's was doing psychical activities with younger friends, he ended up getting a heart attack - he got CPR by some danish kid and he is still alive today. I saw that in a CPR class, was really crazy.
Buttom line, atleast try instead of being a freaking cold hearted zombie.

Also, that law is stupid and should be changed like so many american laws.

It isn't a law, if you sign on your medical info that you do not want to be revived it is your choice. This isn't an American thing DNRs are in place and followed around the globe.

[Tuskcat]

There are plenty. One problem is that CPR laws change fairly regularly in terms of breaths and beats, and if you don't have the updated system (like if you learned it, say, 10 years ago) you did not perform the medical procedure properly and are thus vulnerable to lawsuit. Also, if you violate a DNR, you are instantly liable even if you performed the procedure perfectly. There are a dozen other ways that you can be sued over it; and the problem with being a medical professional is that in other situations, a court will side in favor of the person who performed CPR because of the concept that the person had no expectation of being informed on the fine parts of the law and thus ignorance was excusable. You don't get that benefit of the doubt with someone who is expected to know those laws, like someone in a nursing home.

I call bullshit if you are a civilian and let your training lapse they can't hold you to current standards though if your a medical professional and you're doing it wrong you should not be a medical professional anymore
and if you don't have the DNR in your hands you are not liable for it either
once more if you should know the procedure and preform poorly when you hold a license to work in that field thats your fault and you deserve the consequences
but joe blow after seeing some one collapse checks for a pulse and then starts pushing on their chest shouldn't expect to be sued

[Ephialtes]

The patient had a DNR, so refusal to perform CPR was entirely correct.

It was later revealed that Ms Bayless had signed a Do Not Resuscitate form, and it is against the policy of the retirement home to give CPR to residents against their wishes.

cant post the link but easy to find if you follow up on the story

[catablitz]

I am actually suprized that this discussion takes place. Am I reading correct? Does the argument of not letting someone die need further explanation? Do you US people find this natural? In many countries that nurse would be in jail by now.

[Kasierith]

I call bullshit if you are a civilian and let your training lapse they can't hold you to current standards though if your a medical professional and you're doing it wrong you should not be a medical professional anymore

I specifically addressed that in the second part of my post. Non-medical personnel are typically given the benefit of the doubt when it comes to updated laws. Anyone connected to health, even if its not someone directly related to personal medical care, is however, and is therefore vulnerable through even the slightest fault. That said, if someone seriously messes up performing CPR he can still be sued.

and if you don't have the DNR in your hands you are not liable for it either

Have a source on that? The DNR is present whether or not someone is aware of it. Mind, the possibility of a non-medical person coming in contact with someone with an active DNR is fairly slim.

once more if you should know the procedure and preform poorly when you hold a license to work in that field thats your fault and you deserve the consequences

If a DNR is present, your expertise does not matter in the eyes of the law.

but joe blow after seeing some one collapse checks for a pulse and then starts pushing on their chest shouldn't expect to be sued

He shouldn't expect to be sued. But it has happened.

[Ephialtes]

What most of the people in the thread who werent knee jerk responding was that they were assuming there was a DNR in place. Nurses do a have a duty to act under law to respond in a case like this unless there is a DNR.

---------- Post added 2013-03-03 at 11:23 PM ----------

and if you don't have the DNR in your hands you are not liable for it either

That is true for emergency response personnel like EMT's and paramedics, but not true for a nurse who is caring for a patient in a facility. We are responsible to have all the pertinent information from that patient's records, including DNR status. If we violate a DNR, we are indeed held liable