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Nursing: You Wanna Know What I Think?

CPR ‘Refusal’: When Does Policy Override Judgment?

Published March 11, 2013 9:19 AM by Pat Veitenthal
I have been sitting on this story for a week now. I had a real hard time not knee jerking an opinion like I usually do, because I wanted to see if my knee jerking predictions were going to be correct concerning the outcome. All were, except one.

The story I'm referring to is the one about the nurse who allegedly refused to do CPR on a resident in a senior living facility in California. The resident died at the hospital after EMS transport.

There are so many issues here and just as many opinions! Of course, most fellow nurses were horrified at the alleged refusal. Then the legal-eagles and the ethicists chimed in. They were horrified too. But wait a minute, was she right or wrong? Well see now, that's the thing. She said was following her facility's POLICY. Hmmm...And at first, her facility released a statement that the nurse had acted according to their policy. Of course after a few days of national news and outcries of righteous indignation, the facility back-pedaled and stated that the nurse "Misunderstood the policy."

Baloney I say. I believe the ONLY way a nurse would refuse to give CPR is if it was drummed into her not to by the facility that employed her.

If you listen to the 911 call carefully, she never actually REFUSED to turn the phone over to another person, there didn't seem to be another person there willing to start CPR. She also remained calm and professional throughout the entire call. I'm not sure I could have, with the dispatcher putting pressure on me like that. (But then again, I would have been doing CPR and not heard her.)

One of the biggest surprises to me was that the family stood behind the nurse and the facility. That's where I was wrong. I thought sure they would sue. Call me an optimist, but I'm going to say there is no lawsuit because the daughter of the deceased is also a nurse and is showing compassion for a colleague.

But I promise you, this isn't over yet. Why? Because the California State Board of Nursing hasn't been heard from yet. And I bet that's when the CPR will hit the fan.

posted by Pat Veitenthal

4 comments

1st question- was the patient a "DNR" or did her orders say keep comfortable, but no pounding on chest etc.  There are many different version of the DNR. Some allow you to give breaths but no compression or just the opposite.  Had family been talking about making a DNR but hadnt completed the forms. So lets "Get the rest of the story" before judging.

Velma, RN April 9, 2013 4:45 PM
Houston TX

Pat, I am an optimist too. I believe there is for more to the story. There's ALWAYS more to the story, but popular media tends to drop it before all the facts are revealed. What the redeeming facts could be? Well, that's where I'm at a loss.

Lorettajo Kapinos, ED - RN March 11, 2013 10:46 PM
Northampton MA

Good point about being a tech, but even in that case, the policy would remain unchanged, and techs and CNAs know CPR.

Just as a fun footnote, "do know harm" applies to MDs and the Hippocratic Oath, which is actually a misquote. "Do no harm"" most likely came from the Hippocratic writing, Epidemics. The Florence Nightingale pledge makes no such promise either, except with regard to ourselves, or drugs. The International Council of Nurses pledge, however, does promise "to spare no effort to conserve life..."

Pat Vee March 11, 2013 12:02 PM

Are we sure this lady that called 911 was really a "nurse" I understand that you are suppose to follow P&P, but not to give CPR? What about "do no harm"?  Maybe she was a patient care tech or a nurse aide.

Tammy, Education - RN, BCIT March 11, 2013 11:14 AM
Westampton NJ

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    Pat Veitenthal, BSN, RN
    Occupation: Per diem nursing supervisor and cruise ship nurse
    Setting: Community hospital and cruise ships
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