Sunday, March 3, 2013

When Lack of Information and ABC News Collide:

Below is the ABC News report about an 87 year old woman who collapsed in the cafeteria of her independent living facility.  The facility's protocol states that CPR is not to be started, but to call 911 and stay with the patient until EMS arrives.

The nurse who worked at the facility did just that.
She called 911, and that's when the communication went south.  She did not communicate well at all with the 911 dispatcher.  The two basically argued over what to do.
Both were flustered - I assume this is because the dispatcher thought the facility staff were letting a woman die, and the nurse there had a collapsed woman she cared about on the ground in front of her but was aware of her assigned position - to call 911 and sit and wait.

The dispatcher pleads with the nurse to start CPR, but the nurse says she can't.  She was following her facility's policy exactly as written, and I assume exactly as understood by every resident and their family.

I cannot find any reliable reports as to whether or not the collapsed woman had a "Do-Not-Resuscitate" order.  I don't know her medical history, her life expectancy, or really anything about her other than her name, and a statement made by her daughter afterwards.

The woman's name who collapsed and subsequently passed away is Lorraine Bayless.
Her daughter, who is also a nurse said she "was satisfied with the care her mother received."

Given all of that:  Here is the video:

First - that sounds horrific.  While I listened to it I thought to myself - "Just start CPR!  Why won't you help that poor woman?  You're a nurse, do your duty!"

Then I dug a little deeper and thought a little longer:
ABC News edited the 911 tape to make it as sensational and horrific as possible. The entire call shows the nurse at the independent living center to be much more concerned and caring than was shown.

I also was amazed that everyone is showing this as an example of a nurse failing to help a patient.  They are talking about criminal charges, shutting down the independent living center, etc...
They aren't talking about a person's right to die.  They aren't mentioning the fact that to perform CPR on a person with a DNR order is considered ASSAULT and carries criminal charges.

I do not know what happened here:  It may turn out that ABC news is right - and the nurse should have performed CPR and the facility made a HUGE lapse in judgment and will be held accountable.

BUT - the patient's daughter said SHE IS SATISFIED with the care her mother received.  Apparently the family knew this is what would happen, or they were aware it could.  Who gave ABC or anyone else the right to judge this nurse in this situation.  She may have done exactly what she was supposed to, and exactly what the patient and her family wanted - and she is being reamed for it.

ABC - Wait for the whole story before you paint people as villains, they may be the heroes.


Brat said...

While I am not a nurse or doctor, I do work in a hospital, and until recently I worked in records, so I saw many, many DNRs. If the facility states it is their policy not to perform CPR, and the resident or their power of attorney willingly signed a contract stating as much, I would say that is the legal equivalent of a DNR. I believe that an ill or elderly person of sound mind should have the right to refuse life prolonging treatment, especially one as potentially painful as CPR. People jump to the conclusion that a nurse wasn't doing her job, but in reality, seeing someone you care for collapse and being unable to do anything about it must be one of the most difficult aspects of their job.

Minneapolis child psychiatrist said...

Jumping to conclusions is so dangerous - thank you for probing into the situation more and understanding the nurse's situation. I'll agree with Brat and say that to stand your ground and follow protocol is probably very difficult, especially in situations like these when a life is on the line.

Simple Citizen said...

I start my child/adolescent fellowship in July - so I'm glad to know I'm in good company.

I wish news sources would spend the time digging deeper and thinking a little longer so we could get a more accurate view of things. But apparently that doesn't sell - so sensatioanlism reigns.