May 23, 2013

The CPR Saga Continues

CPRAs more details have come out regarding the “nurse” who refused to perform CPR on a resident at an independent living center, so have the mixed opinions on how the situation should have been handled. I wasn’t all that surprised to see a large amount of people – healthcare professionals included – come out in support of the decision not to initiate CPR. The truth is, elderly people often do sustain serious injuries from CPR and rarely have positive outcomes, but is it really our job to make that end-of-life determination for the patient?

Dr. Peter Boling, a professor of geriatric and internal medicine at the Virginia Commonwealth University School of Medicine, said deciding not to perform CPR on a frail, elderly person, especially those with advanced conditions, may be the kindest and most appropriate response possible.
Source: http://www.bakersfieldcalifornian.com/health/x738927148/Decision-not-to-perform-CPR-may-sometimes-be-most-humane

The problem with that statement, is that we don’t get to make that choice. As healthcare providers, we have a duty to act. I agree that CPR in the elderly and chronically ill is traumatic and rarely effective, but that needs to be discussed with the patient and family BEFORE their heart stops. Regardless of our personal beliefs, we can’t just decide on our own whether or not somebody will have any quality of life as a result of our actions.

All the talks about whether or not CPR would have beneficial in this case are irrelevant. The issue at hand here is that the person who identified herself as a nurse to 911 dispatchers refused to perform CPR because she believed it would be a violation of her company’s policies and procedures. While such a policy wouldn’t have stopped me personally from initiating CPR, I can’t really blame her for interpreting the policy the way she did. After all, her boss came out on national TV and defended her actions and stated she followed their protocols appropriately. Kinda hard to hold her accountable when her own boss doesn’t even understand the policy. If you ask me, he should be the one on voluntary leave.

The family of an elderly woman whose death ignited a wave of anger after a nurse at her senior living community refused to give CPR released a statement Tuesday saying they have no plans to sue.

Lorraine Bayless’ family said she “personally selected” Glenwood Gardens independent living facility in Bakersfield knowing there were not “trained medical staff” and that she wanted to “die naturally…without any kind of life-prolonging intervention.”
Source: “http://www.bakersfieldcalifornian.com/health/x837006764/Family-We-dont-intend-to-sue-Glenwood-Gardens

I’m putting this one back on the family. If this is how they felt, they should have signed a DNR. A simple piece of paper would have saved all the controversy and drama. They bear a large part of the responsibility for this event.

I hope this story helps to make people realize the importance of making these decisions with their loved ones before these traumatic events happen. End of life decisions need to be made with the family, not the healthcare provider.

About Sean Eddy

I'm a paramedic in North Texas. I have been working in EMS for over 10 years now. I enjoy the outdoors, music, shooting, computers and fitness. I currently run DroidMedic.com, and MedicMadness.com . You can e-mail me at sean@medicmadness.com.

  • Medic Wicket

    If she was taking medicines, which I’m sure she was, doesn’t that violate her own “natural death” ideation?

    • http://www.medicmadness.com Sean Eddy

      I suppose, if you use that term literally. I think like many people in her situation, they just want to go peacefully without needlessly prolonging life and potentially causing suffering and handicap. Ideally, she would have put these wishes on paper and prevented this whole thing from ever becoming an issue.

  • P2P

    I totally agree with you. I could never place my finger on why I felt the way I did, but your post hits it right on the head. Great job!