So wrong on so many levels...


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Excellent William:

I just got it in an e-mail. And I listened to it. Now I am convinced.

They are culpable. The patient was clearly winding down and initiating CPR makes sense because it was the only available mechanism to keep blood pumping.

Despicable people.

I would not let a dog go that way.

A...

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Authorities have just released the chilling audiotape of the 9-1-1 call, where the 87-year-old woman at the Glenwood Gardens Retirement Facility in Bakersfield, Calif., was passed out on the dining-room floor.

When the dispatcher asks, “Is she breathing?” the caller replies, “‘Is she breathing?’ Barely.”

When asked to perform CPR, the nurse can be heard saying, “Yeah, we can’t do CPR at this facility.”

The dispatcher then says, “OK, then hand the phone to the passerby. If you can’t do it, I need, hand it to the passerby, I’ll have her do it. Or if you’ve got any citizens there, I’ll have them do it.”

“No, no, it’s not,” the nurse says.

Complete audio of the 9-1-1 call can be heard here:

The dispatcher said, “Anybody there can do CPR. Give them the phone, please. … This woman’s not breathing enough. She’s going to die if we don’t get this started.”

With time a crucial factor, the female dispatcher tries desperately to convince the nurse to take action, lamenting, “I don’t understand why you’re not willing to help this patient. Is there anybody that works there that’s willing to do it?”

“We can’t do that,” the nurse says. “That’s what I’m trying to say.”

“Are we just going to let this lady die?” the dispatcher says.

“Well, that’s why we’re calling 9-1-1,” the nurse replies.

“Is there a gardener … any staff? Anybody that doesn’t work for you, anywhere?” the dispatcher asks.”Can we flag someone down in the street and get them to help this lady? As a human being, I don’t, you know, is there anybody that’s willing to help this lady and not let her die?”

The nurse replies, “Um, not at this time.”

It was too late to save the woman by the time paramedics arrived.

“Our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives,” Jeffrey Toomer, executive director of Glenwood Gardens, said in a statement to NBC’s “Today” show. “That is the protocol we followed.”

Maribeth Bersani, of the Assisted Living Federation of America, told CBS News: “There’s no requirement that the people in the building be trained to perform CPR, so a company could state in a policy they don’t want anyone to initiate CPR.”

Jack Ford, a legal analyst for CBS, called the scenario “morally reprehensible,” and said the question involves, “a legal responsibility and legal liability.”

Ford said: “What’s the agreement that this woman and her family had with this home, and … it was a residential facility, not a nursing home, assisted living. Very different if it was that. So if in their agreement they say specifically, ‘We do not provide emergency medical care. We will get somebody for you,’ then that could shield them from some problems. Then other question is, what are your reasonable expectations. When they sold this as a sales pitch, did they say, ‘Look, we have wonderful workout facilities, wonderful dining facilities and we have medical people on site here.’ Well, you know then, despite what might be in the agreement there, you have a reasonable expectation.”

As for the woman who refused to help, Ford said she was apparently told something as an employee.“

“She may well be in a tough position,” he noted . “If she was told by her employers, ‘You cannot do this, if you do, you’re in violation, and you’ll lose your job.’ Now you have a woman being told, do I try to save someone’s life and by doing so, do I risk my own job for doing it. That’s why you have to look to the employers. The reality is, some states, you are starting to pass Good Samaritan laws that say you can’t be sued if you try to stop and help somebody, the reason is people sue you sometimes if you try to stop and help somebody. You have to look at the culture of society here, the litigious nature of society. It just – it’s a terrible tragedy.”

--------------------------------------------------------------------

That 911 operator deserves a medal for her execution under extreme stress...admirable professional and a heroic human being.

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I listened to the tape. The staff was incompetent--they had no 911 protocol except calling 911. The first caller couldn't even come with the address, etc. The dispatcher didn't know much beyond technique. The lady was breathing and unconscious. If she was breathing her heart was beating. Five breaths a minute is going to be enough if the heart is beating sufficient to move enough blood to the brain, but if it were she probably wouldn't be unconscious. If you have a heart attack and arrive at the hospital unconscious you have a 90-95% chance regardless of age of death or permanent brain damage. If I had been there I'd have done chest compressions only until the medics arrived being careful not to use excessive force. Two or three minutes in the woman was toast. That was the only time to save her for the ICU and medical-save-your-life trauma resulting in likely death weeks or months later with very poor quality of life. A competent nursing home would have called 911 while chess compressions were already being given. To have a policy against staff giving CPR in such a case is homocide on the person responsible for it and a potential tort against the company.

--Brant

it's going to get worse

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Giving CPR to an 87-yr old woman could have resulted in multiple broken ribs. If she was breathing her heart was beating. I've not heard of CPR being needed if the patient was breathing. They should have administered oxygen at least. The 911 operator was not qualified to decide if CPR was called for in this case, only to give instructions on technique. If a heart attack and no heart beat I will do chest compressions only. If breathing, nothing. Drowning victim gets chest compressions for the first minute or two then standard CPR. Assuming the woman was not choking on food she could have suffered a stroke, heart attack, lung embolism or the rupture of an aneurysm if not outright splitting of an artery. If I had been there and congruent with the facts as reported I would have asked for oxygen. I would not be an employee at a facility with that blanket protocol with everybody standing around doing the stupid. Many nurses will let shit happen as long as they aren't contradicting the doctor's orders. A few of them have run into me over the years, to their regret. Once I had to let my father's surgeon dump on me because winning the argument would have been pointless. There are good and bad and in between nursing homes. The bad ones--well, to start with bed sores = bad. My soon-to-be 95 yo uncle has spent the last several years bed-ridden in a nursing home in Ohio. His friend and lawyer--next door neighbor--got him into the place and the care couldn't be better. I cannot imagine, however, any circumstances where the use of CPR would be appropriate in his case. Oxygen, sure.

--Brant

edit: reading the story the second time the 911 operator was not competent to determine if CPR was appropriate or needed in this case and didn't know what she was talking about respecting starting CPR--the reporter was also incompetent in her story as written--this whole thread has been a pain-in-the-ass--and head--for me to read and, no, I did not listen to the dispatcher, for if she said something germane not reported . . .

In short, doing CPR on a person with a fragile skeleton is a life threatening action. It could be that CPR for the Old Lady was not the right course of action.

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In short, doing CPR on a person with a fragile skeleton is a life threatening action. It could be that CPR for the Old Lady was not the right course of action.

Bob:

She was dying. What, short of using a bottle opener on her chest, would CPR have endangered.

Come on Bob, let's focus here, the individual, should they decide to get involved, which I would have, is attempting to maintain basic blood flow to the lungs and brain until competent medical personnel arrive.

A...

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In short, doing CPR on a person with a fragile skeleton is a life threatening action. It could be that CPR for the Old Lady was not the right course of action.

Bob:

She was dying. What, short of using a bottle opener on her chest, would CPR have endangered.

Come on Bob, let's focus here, the individual, should they decide to get involved, which I would have, is attempting to maintain basic blood flow to the lungs and brain until competent medical personnel arrive.

A...

An air hose down her throat perhaps. There is more than one way to airiate the lungs.

I learned in my CPR class the doing CPR on babies and frail old folks requires a different approach. Breaking the ribs can puncture a lung.

Ba'al Chatzaf

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In short, doing CPR on a person with a fragile skeleton is a life threatening action. It could be that CPR for the Old Lady was not the right course of action.

Bob:

She was dying. What, short of using a bottle opener on her chest, would CPR have endangered.

Come on Bob, let's focus here, the individual, should they decide to get involved, which I would have, is attempting to maintain basic blood flow to the lungs and brain until competent medical personnel arrive.

A...

An air hose down her throat perhaps. There is more than one way to airiate the lungs.

I learned in my CPR class the doing CPR on babies and frail old folks requires a different approach. Breaking the ribs can puncture a lung.

Ba'al Chatzaf

Yes Bob, so did I.

So, for example, if you are selecting a club to hit on a 150 yard par 3, do you pick a one (1) driver out of the bag?

Of course not, you select the club that your mind tells your muscles to direct the ball, taking into account the wind and the nature of the landing area that you are projecting your evaluation of all of the complex factors that make your swing worthwhile.

You then use the tool that you decided was the appropriate instrument and you act.

In this specific situation, how would you have acted in those seven plus [7+] minutes?

A...

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It could be that CPR for the Old Lady was not the right course of action.

Bob,

Possibly. We'll never know.

But at least we know for a fact that NOT doing that CPR was not the right course of action. The Old Lady died.

Michael

But she followed protocol... if she had done CPR and something had gone wrong, now there's someone to blame.

If they were going to pay for CPR training, to provide this "service", the cost of living in the place would be higher. I still don't get what is so surprising about this... there's been way worse stuff that's happened at retirement centres.

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It could be that CPR for the Old Lady was not the right course of action.

Bob,

Possibly. We'll never know.

But at least we know for a fact that NOT doing that CPR was not the right course of action. The Old Lady died.

Michael

Do you know how CPR is done? You have to press or on the zyphoid process with is the middle spot on bottom arch of the rib cage. An old lady has brittle bones. Press too hard and you crack the ribs possibly puncturing a lung.

Young ribs can take, maybe not old ribs.

I have had the CPR course and I was told to be very careful with old patients For infants an entirely different technique is required.

Ba'al Chatzaf

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But she followed protocol... if she had done CPR and something had gone wrong, now there's someone to blame.

This comment could have come right out of Atlas Shrugged...

Dayaamm!

Calvin,

One day you might want to introspect on the difference between reality-based thinking as opposed to rule-based thinking. I wrote a pretty clear post about it above. Granted, it's not a paragon of philosophical elocution, but it's a pretty good introduction.

Humans make rules. You can negotiate them. Reality has laws that are nonnegotiable. For instance, if you leave a dying person alone, guess what? They die. That's reality. It doesn't matter who's to blame. Reality trumps the blame-game every time.

It looks like the only shot the old lady had to still be alive was for someone to break the human-made rule. And, what's really galling to me, all they had to do was follow the orientation of a trained person on the telephone who said her organization would assume the liability.

Looks like the old lady just wasn't worth it to the folks around her.

I once wrote that I would give you time to work through some of the ideas before trying to discuss something with you again. This is a great opportunity to think through the difference between the metaphysical and the man-made. (Rand even has an essay by that title.)

Michael

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What?

I could just as easily said anyone trying to defend the old woman is a character from AS. It doesn't matter that she was living in a building that has a policy against giving CPR... she needed it.

"Someone to blame" does not refer to the emotional toll of being shamed by others, I meant that there would be consequences.

If a stranger is drowning, and you aren't sure how well you can swim, you probably shouldn't jump in... I'm pretty sure that's an example Rand used.

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Press too hard and you crack the ribs possibly puncturing a lung.

Jeez,

Maybe you should inform the dispatcher. I'm sure she didn't know that.

Thank goodness the old lady was not producing three breaths per minute during the call (according to the count the dispatcher had the nurse make). There's nothing like dying fast. What a close call! The dispatcher was saved enormous embarrassment.

A broken bone would be a terrible fate for a dead person. Imagine the suffering...

Michael

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It could be that CPR for the Old Lady was not the right course of action.

Bob,

Possibly. We'll never know.

But at least we know for a fact that NOT doing that CPR was not the right course of action. The Old Lady died.

Michael

But she followed protocol... if she had done CPR and something had gone wrong, now there's someone to blame.

If they were going to pay for CPR training, to provide this "service", the cost of living in the place would be higher. I still don't get what is so surprising about this... there's been way worse stuff that's happened at retirement centres.

I'll say this simply: the law does not necessarily reflect what is moral and we can still make our own judgement calls. Not everything is an economic transaction. I reasonably assume that that nurse has CPR training.

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Press too hard and you crack the ribs possibly puncturing a lung.

Jeez,

Maybe you should inform the dispatcher. I'm sure she didn't know that.

Thank goodness the old lady was not producing three breaths per minute during the call (according to the count the dispatcher had the nurse make). There's nothing like dying fast. What a close call! The dispatcher was saved enormous embarrassment.

A broken bone would be a terrible fate for a dead person. Imagine the suffering...

Michael

How about a punctured lung?

Question: Have you taken a CPR course?

Ba'al Chatzaf

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It could be that CPR for the Old Lady was not the right course of action.

Bob,

Possibly. We'll never know.

But at least we know for a fact that NOT doing that CPR was not the right course of action. The Old Lady died.

Michael

But she followed protocol... if she had done CPR and something had gone wrong, now there's someone to blame.

If they were going to pay for CPR training, to provide this "service", the cost of living in the place would be higher. I still don't get what is so surprising about this... there's been way worse stuff that's happened at retirement centres.

I'll say this simply: the law does not necessarily reflect what is moral and we can still make our own judgement calls. Not everything is an economic transaction. I reasonably assume that that nurse has CPR training.
Samson, There is so much that's correct in what you say - given our contemporary context of law and capitalism, as compromised as they are. Sadly correct, and badly wrong.

In admittedly purist terms, none of it is really just "an economic transaction". It is all and only a moral interchange between individuals.

Following that, the law should not be the maker of morals but their defender.

The Trader Principle is much broader than economic (I believe) involving all kinds of exchange of human values; and individual rights and non-initiation of force pertain here, too.

However these are all one package deal, that can't be isolated - a package which draws its moral base from rational self-interest. Pulled apart these elements can

be trivialized: divide and destroy.

Outside of that, what can be said to that large or small proportion of our fellow citizens who would bargain their independent minds for one more day of societal approval and State-supplied security?

With this episode, how possibly does a person deny her full range of individuality

- her instincts too - except through pathological self-lessness?

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Back after a long hiatus... life getting in the way.

I read this recently. Sad. It's one thing to not know how to administer first aid; it's another to stand idly by and watch anyone perish (especially with a 911 operator directing CPR). Legality/policy BS.

I'd rather go to jail trying to save someone's life than the opposite. It's a matter of conscience... of getting a good night's sleep after the event transpires. But when someone's mulling what the consequences are going to be for assisting one in need, there's something wrong with the system.

Good or bad, that woman will have to live with the knowledge that her inaction eliminated any chance of life for that poor woman.

~ Shane

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Back after a long hiatus... life getting in the way.

I read this recently. Sad. It's one thing to not know how to administer first aid; it's another to stand idly by and watch anyone perish (especially with a 911 operator directing CPR). Legality/policy BS.

I'd rather go to jail trying to save someone's life than the opposite. It's a matter of conscience... of getting a good night's sleep after the event transpires. But when someone's mulling what the consequences are going to be for assisting one in need, there's something wrong with the system.

Good or bad, that woman will have to live with the knowledge that her inaction eliminated any chance of life for that poor woman.

~ Shane

Hey man! Good to see you - long time.

Well said.

After it all I kinda feel sorry for the nurse. She'll have a long time to think it over.

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Back after a long hiatus... life getting in the way.

I read this recently. Sad. It's one thing to not know how to administer first aid; it's another to stand idly by and watch anyone perish (especially with a 911 operator directing CPR). Legality/policy BS.

I'd rather go to jail trying to save someone's life than the opposite. It's a matter of conscience... of getting a good night's sleep after the event transpires. But when someone's mulling what the consequences are going to be for assisting one in need, there's something wrong with the system.

Good or bad, that woman will have to live with the knowledge that her inaction eliminated any chance of life for that poor woman.

~ Shane

Damn boy, I was actually getting worried about you!

Glad you are OK. Yep, life does interfere with OL. Something about reality not giving a damn about forums, festivities and other fine pursuits.

I completely agree with you.

For example, I was in CVS about a year ago and a young man [damn, almost everyone is a young man to me now!!] had a seizure and everyone just stood around while he was on the ground.

I acted. I directed the store personnel to get me something to put under his head. I pointed to another person and directed them to call 911 and then I cradled the individual and made sure that he would not hurt his head during his seizure.

I did not consider what the respective "protocols" were in the State of New Jersey. Frankly, I do not give a fuck. There was a human being in distress and I acted, within my knowledge, to protect him and waited until EMS folks arrived.

It is fascinating to see folks respond to someone who takes control in an emergency situation. There are leaders and followers in life.

It is that simple.

A...

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It could be that CPR for the Old Lady was not the right course of action.

Bob,

Possibly. We'll never know.

But at least we know for a fact that NOT doing that CPR was not the right course of action. The Old Lady died.

Michael

But she followed protocol... if she had done CPR and something had gone wrong, now there's someone to blame.

If they were going to pay for CPR training, to provide this "service", the cost of living in the place would be higher. I still don't get what is so surprising about this... there's been way worse stuff that's happened at retirement centres.

I'll say this simply: the law does not necessarily reflect what is moral and we can still make our own judgement calls. Not everything is an economic transaction. I reasonably assume that that nurse has CPR training.
Samson, There is so much that's correct in what you say - given our contemporary context of law and capitalism, as compromised as they are. Sadly correct, and badly wrong.

In admittedly purist terms, none of it is really just "an economic transaction". It is all and only a moral interchange between individuals.

Following that, the law should not be the maker of morals but their defender.

The Trader Principle is much broader than economic (I believe) involving all kinds of exchange of human values; and individual rights and non-initiation of force pertain here, too.

However these are all one package deal, that can't be isolated - a package which draws its moral base from rational self-interest. Pulled apart these elements can

be trivialized: divide and destroy.

Outside of that, what can be said to that large or small proportion of our fellow citizens who would bargain their independent minds for one more day of societal approval and State-supplied security?

With this episode, how possibly does a person deny her full range of individuality

- her instincts too - except through pathological self-lessness?

The law doesn't really have to do with morality, not on an individual level, anyway. We have it to keep order. Rand used the word justice a lot, where it did not apply. Her version of "a ruthless devotion to justice" was really a devotion to a set of rules necessary to keep order. It is not whether something is fair or not, in one person's circumstances, but whether or not everyone would be able to do the same thing in their own, separate sets of circumstances.

I do not understand the guilt being associated here with following orders the way the nurse did. How can we know what personal risk she considered with engaging in the act? I'm simply looking at it from a legal standpoint, and if it is the facility's policy, and it is no secret, then what can you do? You may as well feel guilty about every dollar you spend on yourself and every hour you relax because you could be making and donating money to help feed starving children.

I don't think we should blindly follow "rules", I think we should consider what could happen--and that includes how other human beings will react.

If you think you'd rather go to jail for saving a life than sit idly by, why not accept equal responsibility for every other person you don't help? If you are willing to accept jail time in order to save a stranger's life, in what way are you NOT making a sacrifice. If knowing that one person died and you could have saved them if only you had been willing to go to jail, is too much to live with, how can you not look at the world and go insane? There are many more opportunities to help people in desperate need at much lower costs...

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Press too hard and you crack the ribs possibly puncturing a lung.

Jeez,

Maybe you should inform the dispatcher. I'm sure she didn't know that.

Thank goodness the old lady was not producing three breaths per minute during the call (according to the count the dispatcher had the nurse make). There's nothing like dying fast. What a close call! The dispatcher was saved enormous embarrassment.

A broken bone would be a terrible fate for a dead person. Imagine the suffering...

Michael

How about a punctured lung?

Question: Have you taken a CPR course?

Ba'al Chatzaf

I learned CPR in 1965. It was subsequently modified to increase the number of compressions per minute and, recently, to only compressions. Compressions were called for in this case as there apparently wasn't any do not do that order from the woman or anyone else with POA.

--Brant

(changed computers)

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