Geek at the cool table, cool at the geek table. (aspiring2live) wrote,
Geek at the cool table, cool at the geek table.

One nurse's opinion...

Posted this elsewhere a couple of days ago, but I think it belongs here as well.

For those who may have heard about the 87 year old woman who stopped breathing at a nursing home in California and the call between a 911 operator and the “nurse” who was refusing to give CPR because the facility had a “policy”, I’m sure you’ve heard plenty of outrage over it, and may be outraged yourself. I want to speak up on this.

Firstly, the facility is backing the worker, which tells us right up front there is more to the story. They are on rock solid legal ground or they would hang her out to dry, meaning, there was obviously an agreement on how to proceed in such a situation already in place, most probably a signed agreement between the facility and the patient or patient’s relative. So, it is my opinion that there was no legal wrongdoing.

Secondly, the daughter said she was satisfied with the care provided to her mother. As you must know, if there was any hint of negligence she would be outraged, UNLESS she wanted mama to die so she could collect money or such. Possible, not likely.

Lastly, and this part is based on my personal experience, this lady was beyond hope the minute she stopped breathing. Yes, she may have been resuscitated and transported to a hospital, and all manner of lifesaving measures might have been used to prolong her death. But, at 87 years of age, her ribs and sternum would not have withstood the forceful and, yes, brutal procedure of chest compressions.

It is nearly guaranteed she would have had multiple rib fractures, possibly a sternum fracture, and a lot of soft tissue damage to her body, to include probable severe bruising to her lungs, as well as damage to her cardiac muscle. These things would be difficult to manage and overcome in a young person, much less in someone of that advanced age. I’ve personally felt the crunch of ribs and seen the aftermath. Believe me, the death that is almost definitely assured to occur within a few days is much less peaceful and comfortable than someone who simply stops breathing and dies in their sleep.

Anyone who has worked as a nurse in an ICU will tell you that there are “things much worse than death.” I once heard a trauma surgeon telling another doctor how to break the news of a patient’s imminent death to family members and it was such good advice that it has stuck with me. He said, “Tell them we can prolong his death, but we cannot prolong his life.” That is a very important distinction.

People who are “brought back” are frequently subjected to getting a breathing tube and a ventilator, are placed on powerful drugs to keep them out of pain and unconscious, and to keep their heart beating, and to keep their blood pressure up, and have numerous tubes placed in various orifices to maintain bodily functions over which they no longer have control. Believe me, this is a sugar-coated version of the reality. All of these measures, especially in an 87 year old, are very unlikely to result in a positive outcome for the family or the patient.

My feeling is that this daughter knew these things as truths, and did not want her mother to suffer the ravages of advanced “lifesaving” attempts. She may have even been prompted through conversations with her mother to pursue a “do not resuscitate” order or to sign an agreement not to initiate CPR. We just don’t have enough information on this event, but that hasn’t stopped all manner of outrage from coming forth directed at this facility, nurse, and daughter.

Until you’ve been there as a healthcare provider, patient, or relative, you cannot know what the right decision is for you and your family. But, based on the information we DO have, my opinion is that this lady was allowed to pass in the most dignified way her circumstances allowed.

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