Old folks home?

Steve -

This is an example of media hype - twisting a news story to make it as salacious and attention getting as possible. I saw this story yesterday and looked into the facts. Pure media driven outrage - and a lot of people willing to buy into it and comment from a platform of ignorance.

Many nursing homes have procedures that are followed when a patient is in a medical crisis - such a crisis is not unusual in such facilities for good reason (end of life) and there are protocols to follow.

This home had a clearly defined emergency procedure and the patient's family was aware of it and agreed. My mother's assisted living facility has the same restrictions and we are aware of that. The nurses and staff are responsible for taking care of her needs during her lifetime - not a trauma room staff.

The 911 Dispatcher is NOT a nurse, not a paramedic, not a health professional nor does she have any control over the care facility. The 911 operator overstepped her bounds several times and also by releasing this story to the media. Once she was informed of the protocols the dispatcher should have sent the EMTs as requested and backed off.

The patient was 87 years old - CPR on such a patient is risky and seldom effective. There is no story here except that an old person died at the end of their life.

The care facility did nothing wrong - the nurse followed instructions - the family had agreed to those procedures - the patient was 87 yrs old and at the end of life.

The "outrage" about this headline ignores the physiology of the aged and the reality that death will happen. I feel sorry for the nurse as this story should not have been released to begin with. From all accounts, the EMTs arrived within minutes.

I appreciate the points Kay made. I just want to comment on the above. From experience I know how healthcare costs are broken down. It takes a certain number of people to care for each patient. Everyone from the facility admin to the janitor is figured into the cost. Then there's food, laundry, heat, AC and numerous other fixed costs as well.

It's been a while since I've provided care in such an environment but I think it would be safe to say that even in the most modest places each patient has at least a half dozen care givers allotted to them and that's on the thin side. Some of these people are licensed pros commanding high pay while others are less skilled and get considerably less.

Of course, when figuring expenses, all the patients and all the workers are added together along with fixed costs and an average figure is derived. In healthcare admin speak it's considered overhead and called operating cost per patient. Sometimes the difference between a profitable day for a facility and a losing day comes down to a single worker being present or not. That's how thin the margins are sometimes.

$150 wouldn't cover three days of even the most basic care. People think costs to care for seniors is outrageous. Maybe. But there are many, many state and federally mandated rules that must be followed. Some folks think inpatient healthcare is a gold mine for the facilities offering it. Not even close. These places operate on very thin profit margins.

What I'm wondering is why I always see (at least here) that staff has to have certifications in things like first aid and CPR to get jobs in these places. So why are they not allowed to use them? If your facility does not ALLOW you to use these skills it seems pretty imbecilic to require them for hire.

I can't see why anyone anywhere that is certified in CPR would be denied the right to use it. That is also imbecilic. Just make people sign a waiver when they put relatives in the home that if a care worker can't resuscitate the person, they are not to be held responsible for the fact the person insists on checking out of the hotel despite a little aid given.

Everything is just more bizarre to me all the time.

The difference between a DNR and providing CPR seems pretty wide. I mean, would you deny the Heimlich maneuver to a man choking on a chicken bone? "Nope. It says here, do not resuscitate... so don't help him... let him choke... let him choke. Hey, mothers? You might want to get your small children out of here. This might get ugly... Hey look! He's trying to use a knife to reach down his own throat to dislodge the bone! Hold onto your hats, folks! Let's see if he can do it!!!"

I really don't see the reasoning behind trained staff refusing to perform CPR...

I do, however, respect the idea of a DNR. But those are two different things.

I can certainly see this being a case of Media Hype .... the media does this all the time. I must admint I do not know all the facts ( I won;t get them from the media of course) Was there a do not resesitae order in place? Was is meant that the facility would not allow her to perform CPR? Too many unknowns for me to really have a educated opinion.

That story is very disturbing and has actually been on my mind to some degree since I read it yesterday. My advice to anyone here is: GET RICH ASAP

Seasoned--

Let me pose this to you:

You work for a company, have a family to feed, and obligations to meet. You don't have time for IM, your busy working and raising a family.

You will lose your job, lively hood, retirement plan, and insurance for your entire family if you violate the terms of your employment.

You are presented with a situation where you could take action for a perceived injustice, or lose everything that you have worked the last 15 years to accomplish.

An 87 year old woman who was dying as it was, could have lived XYZ more days/hours/minutes, or died anyway if she would have provided assistance that she was not trained, nor allowed to perform.

So, she loses her job, and her entire family is out on the street. Or an octogenarian who has lived a full life passes on, as she was meant to.

Needs of the many outweigh the needs of the few. It's harsh, but that's life. Go campaign for healthcare reform if you want to change it.