08RNGrad 2,183 Views
Joined: Jul 15, '12;
Posts: 41 (59% Liked)
; Likes: 100
My grandma was pretty recently diagnosed with ALS....she is 83 years old and until about a year ago she ran on the treadmill every night, played basketball with us, mowed 2 acres of grass by herself most of the time...this diagnosis has taken her very hard and it's so sad seeing her deteriorate. She is gradually losing her strength especially in her hands, having a lot of difficulty swallowing. I don't think you ever really understand what it's like until you see a loved one go through it or especially until you go through it yourself. I love my grandma dearly but I can't help but wish she would die from another cause (something quick and less heartbreaking) before she becomes a prisoner in her own body.
I often feel this same way about paraplegics/quads. At first I thought they were an ever loving PITA, having to micromanage, down to the millimeter, where the pillow goes. I thought they were very controlling, and I am ashamed to say that I was one of those nurses that would eye roll at their requests. I had a pt that wanted his water jug filled 3/4 with coffee, 17 sugars, 1/2 carton of whole milk, then nuke it for 49 seconds. He was also quite the story teller (read liar). While I was caring for him, a lightbulb went off.....these people have no control over anything that is or has happened to them. They are unable to urinate, often times have a colostomy to avoid having to wear a diaper and risk worse skin breakdown than they may already have. So, if it makes them feel in better control to tell me where to put a pillow or how they want their coffee, so be it. I can't say I wouldn't be the same way. I would rather volunteer to take these patients than some of my colleagues because it is heartbreaking to hear how they are talked about by the other staff.
Listen to the tape, the 911 operator did a great job of handling the situation.
We all operate within the policies and procedures of the facilities where we work. We still have the big fat manuals on the shelves in the nursing stations, as well as the same info on computer.
Every once in awhile one of us will get the 10 lb book down and look something up. Then we'll perform whatever procedure we're checking on, exactly as the policy manual tells us. We work within a defined perimeter of rules. Our profession is not kind to those of us who go rogue.
When I was a new nurse, I would probably have been cowed by the pushy 911 dispatcher, and performed the CPR. The outcome probably would have been the same, or worse, resulting in an 87 yr old on a vent.
As an experienced nurse, I would have done exactly what the nurse on the phone did. She followed the policy of her employer. I hope it was more than just following orders, and she knew something about the victim and family that made her say no. Either way, I don't have a problem with her choice.
Of one thing I'm absolutely sure. I never want to be in that nurse's shoes.
DNR is NOT RELEVANT.
I see some great comments here - but this was an assisted living facility. It is NOT a medical facility. It is like an apartment for people who need a little bit of assistance. Transportation and the like. They have activities. But they are not a skilled nursing facility or other similar place. They CANNOT have medical orders, as they are not a medical facility. Just like an apartment complex cannot have DNR for anyone.
The "nurse" sounds absolutely heartless in the recording. I'm disgusted with her. As a PERSON, she should have done something. The 911 dispatcher is literally begging her to get ANYONE and uses the words "as a person" in talking about how the resident was going to die. "So you're just going to stand there and let her die?" The dispatcher explained that she understood the policy and begged the nurse to get ANYONE. Someone off the street. She explained that the nurse could put ANYONE on the phone and they would talk that person through the CPR.
It makes me wonder... why do they have "nurses" in their employ AT ALL? I don't understand that. I just read on this board, it was a CNA or some such. Okay - why would they have a CNA or MA at a place like that and not allow them to do CPR??
You can hear the recorded call here:
Hear the Stunning 911 Call When a Nurse Refused to Give CPR to a Dying Woman | Video | TheBlaze.com
I think some people are confusing this with a nursing home. This was no such place. To help put some things in perspective I once had an elderly gentleman in the ICU for a head bleed, the facility (assisted living) called 911 only after other residents notified the staff. Later that night I found out he cared for his demented wife that was now in the apartment alone. Family was several hours away. I called the facility and spoke to the "nurse" and told her of the situation and asked if she could go check on the wife a few times during the night until the family arrived. Her response was shocking, she said the only thing she could do was call protective services.
The "nurses" there are not medically trained, many are UAP's to help with activities etc, some do offer housekeeping assistance or medication reminds, etc but the residents are supposed to be mainly independent.
Over the years I have heard techs, CNA's, MA's call themselves nurses. Just because in the recording the women claimed to be a nurse does not mean she was.
The fact that she did nothing would suggest to me, she was not a LPN/RN. I can not see how a LPN/RN would not offer help in that moment.
One of my best friends had a heart attack in the parking lot of a local eatery. CPR was performed and he lived to tell about it. Oh and he is going to have his 76th birthday next month because someone performed CPR. Granted he's not 87 but is it really our choice to decide?
What is the survival rate for 87 year old arresting outside of hospital? If a defibrillator is on hand...even if you try it you do no harm. But CPR can be devasting when applied to the wrong patient and an out-of-hospital arrest in an 87 year old is a lucky death for her. I can't believe so many people are willing to participate in CPR in someone who has zero chance of intact survival. We are supposed to people of science and do the best for the patient by using FACTS, not moral one-upmanship. And besides, we have no knowledge of the facts in this case and probably never will.
My biggest problem with this post is that I can only "like" it once. And I'm speaking as the daughter of an 82 year old nursing home resident, and not the ICU nurse that I also am.
I worked in assisted living for a while and despite it being assisted living we still did CPR and life saving measures when necessary. I wouldn't/couldn't work for a place like this as a nurse...as a human being who knows CPR I couldn't just stand by and watch someone not breathing. It's tough enough when you have a DNR patient that stops breathing to not want to do CPR. I don't understand how the 'nurse' in this situation couldn't or wouldn't on a still breathing patient. Sad..
Why am I upset about this?? A number of reasons.....management is "cracking down" on overtime, but there is always something else that gets added to our workload. I also feel strongly that everyone should be compensated for their time. When I am at work, I give it 100%, but I am not staying there after I have punched out to work for free. It also. Bugs me that management is aware of this, yet it continues. Will I make a big deal about it??? NO. I need to do my job and not worry about what someone else does.
I think nurses do do a disservice by working off the clock, is it doesn't let management know how much time it really takes to get work done. If doesn't seem to management that patient care hours need to be increased, they will keep added tasks.
Recently with the changes in medicare reimbursement based on survey of patients post discharge our hospital has added extra things that we are required to do. There are only so many hours in a shift and if new things or expectations are added at some point something has to give, whether cutting corners or increasing overtime. Sometimes the only time charting can be done is when the next shift takes over the actual care.
I see people do this at my work too. I think a lot of it is driven by fear or repercussions of management having to pay overtime.
When nurses work off the clock, either by working through their breaks or punching out and continuing to work, they do a disservice to all nurses. Employers will expect it and it promotes bad work environments.
We must stand up for our unpaid time. Those who don't screw us all.
I agree. Really most of the time, it doesn't matter who actually was involved, they will call that person "a nurse". Could have been a housekeeper for all we know.
The 911 operator was really aggravated by this! She sounded more caring than the nurse!! I understand that it is policy not to perform CPR but this nurse was so cold! She should have handed the phone to someone else at least!
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