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Home  >  EMS Topics  >  Cardiac Care  >  Family: Woman denied CPR wanted no intervention
March 06, 2013

Family: Woman denied CPR wanted no intervention

The developments were the latest twist in a controversy following release of a 911 tape

The Associated Press

SACRAMENTO, Calif. — The company whose employee refused to administer CPR to a dying woman said Tuesday that the employee wrongly interpreted its policy. But the elderly woman's family said she would not have wanted life-prolonging aid.

The family's statement to the Associated Press absolving an elder care home of blame came less than 1  1/2 hours before the company issued a statement saying the employee's failure to heed a 911 dispatcher's was the result of a misunderstanding of the company's emergency medical practices.

The developments were the latest twist in a controversy following release of a 911 tape that recounts a dramatic 7-minute conversation on Feb. 26 between a dispatcher and a nurse who refused to cooperate with pleas for someone to start CPR as firefighters sped to the scene. The dispatcher insisted that the woman who identified herself as a nurse perform CPR or find someone willing to do it.  Lorraine Bayless, an 87-year-old resident of Glenwood Gardens independent living home, later died.

Bayless' family said she was aware that Glenwood Gardens did not offer trained medical staff, yet opted to live there anyway. "It was our beloved mother and grandmother's wish to die naturally and without any kind of life prolonging intervention," said the statement. "We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens and is at peace."

The home's parent company, Brookdale Senior Living, later said, "This incident resulted from a complete misunderstanding of our practice with regards to emergency medical care for our residents. Glenwood Gardens is conducting a full internal investigation." The company said the employee was on voluntary leave during the process.

City fire officials say Bayless did not have a "do not resuscitate" order on file at the home. The family and the company have not commented

Glenwood Gardens is an independent living facility, and company officials say no medical staff is employed there. The woman who identified herself as a nurse to the dispatcher was employed at the facility as a resident services director, the company said.

The nurse's decision has prompted multiple state and local investigations.

The California attorney general was "aware" of the incident, said a spokeswoman, Lynda Gledhill. Bakersfield police were trying to determine whether a crime was committed when the nurse refused to assist the 911 dispatcher looking for someone to start CPR.

The nation's largest trade group for senior living facilities has called for its members to review policies that employees might interpret as edicts to not cooperate with emergency responders.

"It was a complete tragedy," said Maribeth Bersani, senior vice president of the Assisted Living Federation of America. "Our members are now looking at their policies to make sure they are clear. Whether they have one to initiate (CPR) or not, they should be responsive to what the 911 person tells them to do."

Bayless collapsed in the Glenwood Gardens dining hall on Feb. 26. Someone called 911 on a cellphone asking for an ambulance to be sent and eventually a woman who identified herself as a nurse got on the line.

Brookdale Senior Living said in a statement that the woman on the 911 call was "serving in the capacity of a resident services director, not a nurse."

The Tennessee-based parent company also said that by law, the independent living facility is "not licensed to provide medical care to any of its residents." But it added later that it was reviewing company policies "involving emergency medical care across all of our communities."

Bayless' family said she was aware that Glenwood Gardens did not offer trained medical staff, yet opted to live there anyway.

"We understand that the 911 tape of this event has caused concern, but our family knows that mom had full knowledge of the limitations of Glenwood Gardens and is at peace," the family's statement said.

The death shines a light on the varying medical care that different types of elderly housing provide, differences that consumers may not be aware of, advocates say.

Even if independent living homes lack trained medical staff, some say they should be ready to perform basic services such as CPR if needed.

The California Board of Registered Nursing is concerned that the woman who spoke to the 911 dispatcher did not respond to requests to provide aid or to find someone who might want to help.

"If she's not engaged in the practice of nursing, there's no obligation (to help)," agency spokesman Russ Heimerich said. "What complicates this further is the idea that she wouldn't hand the phone over either. So that's why we want to look into it."

The family said it would not sue or try to profit from the death, and called it "a lesson we can all learn from."

Associated PressCopyright 2013 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

"We regret that this private and most personal time has been escalated by the media," the statement said.

Comments
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Laura Blanchard Laura Blanchard Wednesday, March 06, 2013 9:27:34 AM Lets leave this alone now. Enough is enough. Let the family grieve in peace instead of constantly being interrupted by the media.
Douglas Cremeans Douglas Cremeans Wednesday, March 06, 2013 9:44:57 AM to me it sounds like the family is glad shes gone. heres my question, and if the answer is yes, then i fully agree, let it go....ready, heres the question....did the family have a medical power of attorney? if not, then the Rn should be fired and stripped of her license. she identified herself as a health care provider, and then withheld emergency medical care. regardless of the fact that she "was not employed as a nurse" she still took an oath to help save lives....disrespectful to the entire nursing profession.
Mike Ledgerwood Mike Ledgerwood Wednesday, March 06, 2013 10:22:14 AM Douglas Cremeans, Have you ever responded to a facility like this? Its apparent you haven't. Its called an Advanced Directive. Most people in these facilities have them. The patient did NOT want CPR performed and according to family had made that wish clear to the facility.Power of Attorney has nothing to do with lawsuits. Do you even know what a Power of Attorney is? Concerning your comment about taking an Oath, you might want to educate yourself on the oath and what the healthcare profession is about. It is NOT about violating a patients wishes. Here is the English translated version of the Hippocratic Oath notice it doesn't say anything about performing treatment against a patients wishes: To hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine, and to regard his offspring as equal to my brothers in male lineage and to teach them this art - if they desire to learn it - without fee and covenant; to give a share of precepts and oral instruction and all the other learning to my sons and to the sons of him who has instructed me and to pupils who have signed the covenant and have taken an oath according to the medical law, but to no one else. I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice. I will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect. Similarly I will not give to a woman an abortive remedy. In purity and holiness I will guard my life and my art. I will not use the knife, not even on sufferers from stone, but will withdraw in favor of such men as are engaged in this work. Whatever houses I may visit, I will come for the benefit of the sick, remaining free of all intentional injustice, of all mischief and in particular of sexual relations with both female and male persons, be they free or slaves. What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself holding such things shameful to be spoken about. If I fulfill this path and do not violate it, may it be granted to me to enjoy life and art, being honored with fame among all men for all time to come; if I transgress it and swear falsely, may the opposite of all this be my lot.
Dennis Scales Dennis Scales Wednesday, March 06, 2013 10:45:06 AM According to the article, no she did not make it clear legally to the facility, it states that there was no DNR, read the 6th paragraph.
Jake Stein Jake Stein Tuesday, March 12, 2013 5:49:17 AM So Dennis, what about all of the Paramedics who also do the same thing? Shouldn't they also be fired and stripped of their license. Go over to any other EMT forum like EMTlife and you will see them bragging about determining who lives or dies. You complain constantly about bullcrap transports with 87 y/o nursing home patients but you want to criticize this.
Crystal Young-Reynolds Crystal Young-Reynolds Wednesday, March 06, 2013 9:35:29 AM There was a misunderstanding involving the policy and thankfullly, this time, the family and the resident did not want life saving measures taken. But what if this same situation had happened to another resident who WANTED life saving measures taken? It does not change the matter that the family is okay with what proceeded, but that there was a misunderstanding involving a policy with regards to life sustaining measures.
Dee Sims Dee Sims Wednesday, March 06, 2013 9:40:47 AM That's what DNRs are for..she has an obligation REGARDLESS if she was an "acting" nurse on scene. Sorry, I agree the family should be left in peace but ignoring this would be a grave mistake and policy should change. Sounds more like back-peddling to me. Oops doesn't cut it.
Ken Scofield Ken Scofield Wednesday, March 06, 2013 9:44:00 AM First and foremost, my sincere condolences go out to the family. I agree they should be allowed to mourn in peace, & I respect their decision. As a licensed health care provider myself, this case raises a lot of concern for how this was handled. I think pursuing criminal charges would be weak at best, but I do believe that ethical issues are the key problem here. Not that the facility doesn't provide health care, rather, in that once one identifies themselves as a (nurse, doctor, emt or paramedic, etc) then they have a duty to act, based on a higher standard society holds them to. Fortunately, cases like this are rare. However, the rarity of the case doesn't excuse the need for a full investigation, so that we may learn from it.
Marc Kamphefner Marc Kamphefner Wednesday, March 06, 2013 11:38:58 AM Isnt this what DNRs are for ?
Ken Scofield Ken Scofield Wednesday, March 06, 2013 11:53:53 AM There seems to be question about if the patient had a living will, DNR, or other health care directive. But yes, thats what they're for.
Doug Romines Doug Romines Wednesday, March 06, 2013 10:04:41 AM I guess it gets down to the laws regarding her "duty to act", which probably vary from state to state. But honestly why be a nurse if you are not interested in helping people?
Raymond Haring Raymond Haring Thursday, March 07, 2013 3:04:22 PM You forgot to add that sometimes helping people may be to let them go with dignity.
Jake Stein Jake Stein Tuesday, March 12, 2013 5:51:15 AM To Doug it is all about the merit badge of a "save" regardless of the patient's wishes or quality of life. A nurse has much more opportunity to see what a "save" actually is especially in a nursing home since that is where most all EMS saves end up.
Shawn Binkley Shawn Binkley Wednesday, March 06, 2013 10:08:37 AM I agree that that family should be able to mourn and my condolences go out to them as well. This brings up so many points as we all in the fire/medical industry see nearly every day. Why do families and the assisted living/nursing homes not do a better job on having DNR's on hand? Why do the facilities at large not work better with the agencies that respond 911 to them?
David Hamilton David Hamilton Wednesday, March 06, 2013 2:16:11 PM This women id herself as a MEDICAL PROFESSIONAL, which should be a crime and she should be punished to the fullest excint of the law.
Jonathan Barfield Jonathan Barfield Thursday, March 07, 2013 7:11:04 PM DNR's are ridiculous. Everyone already knows they're gonna die someday. Their hope is to go peacefully. People usually only get DNR's because they have some type of illness and expect to pass soon. But why should you have to carry something around to serve as a constant reminder that you're going to die... And that when you do, you don't want people sticking stuff in you like a pin cushion.
Melinda Teaster Williams Melinda Teaster Williams Friday, March 08, 2013 7:03:54 AM OK I have many issues with this, 1st DNR - only means once the heart has stopped completely, and no breathing remains. DO NOT ATTEMPT CPR, this does not mean let them lay and suffer, for the love the women could have just gotton choked and a few chest compressions may have made all the difference, not the traditional hemlichbut any way, 2nd living in a location that doesn't provide MEDICAL CARE is not the issue, CPR IS MORE TIMES THAN NON INITIATED BY THE LAY PERSON, because 911 can tell step by step how to do CPR. 3rd MORALS, ETHICS, how do you as a "NURSE" stand and watch another HUMAN die before you? I do not care what the policy of the facility is or not.
Melinda Teaster Williams Melinda Teaster Williams Friday, March 08, 2013 7:05:12 AM OK Folks re-read, this lady DID NOT HAVE A DNR.
Renee Teaster Renee Teaster Friday, March 08, 2013 7:18:54 AM thats crazy I don't think I could ever stand by and do nothing
Renee Teaster Renee Teaster Friday, March 08, 2013 7:21:39 AM why even bother saying Im a nurse if your not going to do anything
Melinda Teaster Williams Melinda Teaster Williams Friday, March 08, 2013 7:36:51 AM Me eiter working or not
Nathan Wickham Nathan Wickham Friday, March 08, 2013 9:13:19 AM Why call an ambulance is the first place,
Nathan Wickham Nathan Wickham Friday, March 08, 2013 9:13:37 AM In*
Diane Annas-Calkins Diane Annas-Calkins Saturday, March 09, 2013 12:30:53 AM Take a peek at this link, seems they have more issues going on than just non-trained staff who are RN's and LPN/LVN's - and classed as a SKILLED NURSING FACILITY with non-trained staff? Is that a trick question? Do they hand out meds? Then they better damn well be trained. http://www.skillednursingfacilities.org/directory/ca/bakersfield/glenwood-gardens-snf/555771/ My son's an EMT in California and through his education, he was taught that he had a duty to act and unless he has physically SEEN a DNR, he is ethically bound to perform CPR. So, how an RN refuses is beyond me (doesn't matter that she wasn't working in the role as an RN), her RN ethics dictated her obligation. Man, I dont' want to get old if this is what I have to look forward to.

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