When is it okay to break the rules?

Image via seniorliving.org

Drama in California! Police are currently investigating whether any criminal wrongdoing has occurred in the handling of a recent emergency at Glenwood Gardens, an independent living facility.

Apparently, an 87-year-old woman died after a nurse – following the facility’s policy – refused to provide CPR to her after she collapsed in a dining room. The facility is, of course, standing behind their nurse in the investigation.

When the nursing home called 911 after the collapse, police sent the call to the Bakersfield Fire Department, where the dispatcher told the nurse to perform CPR. The nurse refused, explaining that the facility’s policies prevented her from doing so.

“I understand if your boss is telling you, you can’t do it,” the dispatcher said. “But … as a human being … you know, is there anybody that’s willing to help this lady and not let her die?”

“Not at this time,” the nurse answered. They continued to volley back and forth for seven minutes, as the dispatcher asked the nurse to try and find someone outside, not affiliated with the home, who could help. Nothing worked out and the woman passed away at the ER. So what exactly is the policy on CPR? The executive director of Glenwood Gardens, Jeffrey Toomer says that “In the event of a health emergency at this independent living community our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives. That is the protocol we followed.”

What do you readers think of this story? Should the nurse have broken the rules? Would you have? Do you think rules like this are important? We’d love to know what you think in the comments below.

Source: Huffington Post

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9 Responses to When is it okay to break the rules?

  1. cechastain

    I feel or I guess I’m hoping that the news reports have left something out. I did read in one article that the woman’s daughter, who is a nurse, was not upset about what happened. One article did state the members of the community are advised about the policy before moving there and sign an agreement. It sounds almost like a DNR. I’m hoping that these statements are true and no nurse would refuse help unless there were a valid reason.

  2. saturn567

    I honestly don’t agree with the policy, we should try to save the patient unless their code status stated DNR

  3. vinlf_sara

    That is the most ridiculous thing I have ever heard. She is a disgrace to the entire nursing community. She not only showed her lack of character, she also has shown she has a lack of integrity as well. She should be ashamed to call herself a nurse. To watch another human being die when you have the education and the skills at hand to potentially prevent it is just disgusting.

  4. nursey

    In the facility where I work, we go by the patients/residents chart. If “full code” is listed, we initiate CPR and call 911. Staff stays with the person until help arrives. If they are a “DNR”, we usually call the family to inform them their loved one is failing, so they can visit and make any changes on the chart. Otherwise, we make them comfortable, use proper pain management, and assist the family as needed. I wonder on this facilitiy’s policy- if staff is told not to resusitate, it should be clearly stated that it is the resident’s wishes. Also, why would you call 911 if they were a DNR anyways? Seems like the nurse was placed in a comprimising situation. I would resusitate unless otherwise documented.

  5. ebrowne8

    It is not all that clear the person at the center was indeed “a nurse”. Also, it would be protected information if the client was a DNR. I don’t see a licensed nurse potentially violating professional responsibility just because an employer may be instructing them to do something contrary to the state’s code of practice/conduct. We do things all the time that are required by our professional standards of practice when the employer is not up to speed on those things.

  6. lalalolita

    At the facility (assisted living/independant living) that I work at, we are not allowed to do CPR either. This policy was not there when I first stated there (or at least it wasn’t enforced). Now that they are “enforcing it”, I have verbalized mulitple times that I do not agree with it. Fortunately as of right now, the only people that have passed away were hospice or passed away at the hospital. I don’t agree with companies being able to enforce a DNR policy unless the resident/patient agrees to it.

  7. sublimeaurora RN

    We don’t have all of the information. 1) We don’t know if the woman who talked to the 911 dispatcher is a nurse. If she was a nurse, I’d like to think that she would have done what was medically necessary to save the elderly lady. 2) We don’t know if the decedent was, in fact, a DNR. She could have had a modified code status and was against CPR, but medicinal interventions could have been performed.

    Another media source I heard this story from said the daughter, who is a nurse, would have been okay with the facility performing CPR.

  8. sublimeaurora RN

    “The family of a California woman who died after a nurse at her independent living home refused to provide CPR says she chose to live in a facility without medical staff and wanted to pass away without life-prolonging intervention.”


  9. Granny RN RN

    A lawyer once told me: ‘It is always better (in a malpractice suit) if the patient died.’ Let’s be real here-MONEY makes a LOT of things ‘go away’.
    We also must keep in mind that the liberal media thrives on misery and controversy. There is no mention of a DNR order or any other type of understanding between this patients’ family and the facility.
    We are also seeing lesser-trained and inexperienced nurses put into positions of responsibility at these ‘old age homes’. Often there may be only ONE RN over the whole facility.
    However, in the absence of cardiopulmonary activity a trained, licensed person does NOT ‘wait for emergency personnel to arrive’ before beginning CPR and applying an external defibrillator. ALL healthcare providers are required to maintain basic CPR skills and certification in facilities which receive Medicare funds.