Today, I am going to make a little change in my post. Instead of discussing additional ASCO Conference abstracts of interest to men with advanced prostate cancer (I will come back to them in short order), I want to respond to the latest public outrage that has been in the media.
A recent story has been about a nurse and her refusal to start CPR on an older women in a nursing home. The emergency 911 operator was called and the operator insisted that CPR be started immediately. The operator became hysterical and insistent, but the nurse declined. Later the woman was declared dead and the nurse has been held up to ridicule in the media.
Now, here is what I believe actually happened. This woman chose a nursing home that had a very specific and well publicized policy directing the healthcare providers not to resuscitate. The nurse was operating within the guidelines of the facility and within the guidelines of the patient.
This women herself did not have a DNR (do not resuscitate) order, but the facility she chose was very public and up front about their policy. Her choosing to go to this facility was a clear indication of her personal desire not to be resuscitated. Her family later confirmed that she did not wish to be resuscitated.
This woman wished was not to be artificially kept alive and not to be resuscitated. This nurse was carrying out her wishes and should not have been called on the carpet for her actions.
For a reason I cannot understand, the 911 operator or the 911 emergency service provider unfairly shared this tape with the media. The media, being the media, jumped on this and without balance made it seem that this nurse was evil. This was unfair, actually despicable.
We all have the right to decide if we wish to be resuscitated or kept artificially alive on machines. We all need to make this decision after searching our own hearts and discussing it with our family. Facilities are required to follow the directives they are given by the patient. All of us need to make our wishes crystal clear and make sure that we put these wishes in writing in a legal form.
Joel T Nowak, M.A., M.S.W.
I agree with all you say but in the circumstances it must be asked what the reason was for calling 911?
Then why call 911 in the first place? I have to disagree here. There’s a difference between being hooked up to life extending apparatus, against ones will, and performing simple cpr in the hopes of helping a patient recover from what might be a treatable condition. The fact that the victim’s (yes victim) family found the policy acceptable is mind boggling to me.
CPR is in violation of a DNR. I agree, there was no logic in calling 911, I can not explain that. – Joel
It is my understanding CPR violates a DNR order (which she didn’t have) only when the patient’s heart has stopped beating, and is no longer breathing. From what I’ve read, neither was necessarily the case here. The nurse acknowledged to the 911 operater that the woman was ‘barely’ breathing, and if so, likely had a pulse – not than any of her so-called caretakers bothered to check. Shameful.