Termination of employment

[DanielMark]

I was recently terminated because I failed to initiate CPR on a patient who had been expired for about 40 minutes. Administration informed me it was "policy" or protocol even though there was not chance of reviving the patient.

Has anyone experienced this type of situation before?

The incident was reported to my State Board and I am waiting to hear.

Others thoughts would be appreciated.

Thanks,

DanielMark

[BadBird, BSN, RN]

Daniel,

You made a judgement call not to initiate CPR on an obvious dead person. I believe that the administrators were acting in a manner to cover their butts. Look at your situation as a learning experience, know your insitutions policy, always know if the patient is a full code or DNR (I always ask during report) and move on from there,you will always keep that experience in mind but don't let it keep you down.

[graciesgran]

That was really harsh. I would think the hospital would have just counseled you, and kept you on, especially with the nursing shortage. I would not have started CPR on someone who had no chance of survival. That would be cruel in my opinion.

[Tweety, BSN, RN]

Best wishes to you. In our hospital we must code all people without a DNR order. Even if we arrived and they are stone cold dead, and we all know they won't live, but we have to go through the motions if they are a full code. But this is a perfect example of how a facility doesn't support it's nurses when the sh*t hit's the fan. No counseling, no review of the policy, no support from risk management, just fired. They are so afraid of being sued, they think their case will look better without you, your are expendable to them.

Sorry for the rant. I truly hope things in the end work out for you.

[Tweety, BSN, RN]

Best wishes to you. In our hospital we must code all people without a DNR order. Even if we arrived and they are stone cold dead, and we all know they won't live, but we have to go through the motions if they are a full code. But this is a perfect example of how a facility doesn't support it's nurses when the sh*t hit's the fan. No counseling, no review of the policy, no support from risk management, just fired. They are so afraid of being sued, they think their case will look better without you, your are expendable to them.

Sorry for the rant. I truly hope things in the end work out for you.

[Agnus]

Moe,

You asked why we put folks though a code who are inappropriate for a code. WE DON'T THE FAMILY does. No MD writes a DNR without first gaining consent from the patient (if compentent) and or the family. There must be a consent for a DNR order to be written.

Oh, the litigation if they wrote DNR orders without consent, no matter how appropriate.

The best thing you can do is talk to family members, get the Docs to talk to them. Educate them because they really have no clue. The watch and believe too much TV.

That is NOT to say that you can talk sense into everyone. There is the idiot (we've had to deal with) who thinks that his 100 year old mother (adopted so he's in his 50s) will live forever and will recover and be cooking him dinner. She gets a pretty pension that he lives off too.

[DIPLOMATICRN4HIRE, MSN, RN]

It has always been an understanding with me that CPR is done at anytime a patient is found with no vital signs unless the patient is a known DNR, and even then a family memember can revoke that wish.

Reguardless of the amount of down time, CPR is started. If upon the start of CPR a family memember can stop the process, but they must have the Medical(Power of Attorney) Agreement and it documented in the chart. Once CPR is started it can only be stopped by an attending physican or the family memeber or the person that the patient designated as Medical Power.

If its a policy in your facitlity then it has been reviewed with you Im sure in that 12 minute orientation.

If you do hear from the board however just tell them what happened and it was apparent to you that the patient had passed ,(if family were in the room then state what they said as well and possibly get thier help in the situation) and explain your actions. Im not sure what the board will do. I dont know of anyone that this has happened to but Im sure it has.

Were there others in the room with you with RN licenses? If so what are they doing with them? Well on that scale anyone else in the room, ( that works for the hospital? all know basic CPR)and if so what did they do to them, they too know the policy , and what has happend to them? If nothing has happend to them then it is a biased case unless you are the Charge Nurse.

Zoe

[Going80INA55]

I left bedside nursing a year ago, but when I was there if someone (anyone) went down we coded them. Then when the md got there he could decide if he wanted us to stop the code.

The only exception to that was a DNR.

I AM NOT THE DOCTOR AND THERE FORE I AM NOT PAID NOR DO I HAVE THE AUTHORITY TO MAKE THE DECISION AS TO WHO HAS BEEN DEAD TO LONG TO NOT CODE.

If you did not feel he was going to survive you still had the option of a slow code. ALWAYS CYA.

[rstewart]

I am curious. As I understand the situation a licensed nurse in a health care facility discovered an unresponsive patient. Upon determining unresponsivness, rather than calling for help (calling a code) and starting CPR the nurse calls his/her supervisor. The supervisor responds, finds an unresponsive patient and likewise does not start CPR nor call for help believing the patient to be beyond help.

1) Was the first nurse reprimanded for failing to initiate BLS measures including starting CPR and calling for help?

2) I am assuming that the patient's appearance caused you to believe CPR would have been futile; but in a teaching facility particularly, what was your thinking which caused you to forgo getting a physician on the scene right away? As a house supervisor, was this the first time a situation like this came up?

I don't wish to be unkind. I am just trying to understand the thinking.