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| Shown is the main gate of Glenwood Gardens in Bakersfield, Calif., Monday March 4, 2013, where an elderly woman died after a nurse refused to perform CPR on her last week. The central California retirement home is defending one of its nurses who refused pleas by a 911 operator to perform CPR on an elderly woman, who later died. "Is there anybody that's willing to help this lady and not let her die," dispatcher Tracey Halvorson says on a 911 tape released by the Bakersfield Fire Department aired by several media outlets. |
BAKERSFIELD,
Calif. (AP) -- A nurse's refusal to give CPR to a dying 87-year-old
woman at a California independent living home despite desperate pleas
from a 911 dispatcher has prompted outrage and spawned a criminal
investigation.
The harrowing 7-minute,
16-second call also raised concerns that policies at senior living
facilities could prevent staff from intervening in medical emergencies.
It prompted calls for legislation Monday to prevent a repeat of what
happened Feb. 26 at the Glenwood Gardens in Bakersfield.
Loraine
Bayless collapsed in the dining room of the retirement home that offers
many levels of care. She lived in the independent living building,
which state officials said is like a senior apartment complex and
doesn't operate under licensing oversight.
"This
is a wakeup call," said Assemblywoman Mariko Yamada, chair of the
California Assembly Aging and Long-term Care Committee. "I'm sorry it
took a tragedy like this to bring it to our attention."
Yamada
cautioned that while it's not yet known whether intervention would have
saved the woman's life, "we want to investigate because it has caused a
lot of concern and alarm."
Independent living
facilities "should not have a policy that says you can stand there and
watch somebody die," said Pat McGinnis, founder of California Advocates
for Nursing Home Reform, a consumer advocacy group. "How a nurse can do
that is beyond comprehension."
In all her years of advocating for the elderly, McGinnis said: "This was so horrifying. I've never seen this happen before."
State
officials did not know Monday whether the woman who talked to the 911
dispatcher actually was a nurse, or just identified herself as one
during the call. She said one of the home's policies prevented her from
doing CPR, according to an audio recording of the call.
"The
consensus is if they are a nurse and if they are at work as a nurse,
then they should be offering the appropriate medical care," said Russ
Heimerich, spokesman for the California Board of Registered Nursing, the
agency that licenses health care providers.
The
executive director of Glenwood Gardens, Jeffrey Toomer, defended the
nurse in a written statement, saying she followed the facility's policy.
"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," Toomer said. "That is the protocol we followed."
Toomer
offered condolences to the woman's family and said a thorough internal
review would be conducted.
He told KGET-TV that residents of the
facility are informed of the policy and agree to it when they move in.
He said the policy does not apply at the adjacent assisted living and
skilled nursing facilities.
Multiple calls to the facility and its parent company seeking more information were not returned.
Unlike nursing homes, which provide medical care, independent living facilities generally do not.
"These
are like apartments for seniors. You're basically living on your own.
They may have some services provided by basic nursing staff, but it's
not their responsibility to care for the individual," said Dr. Susan
Leonard, a geriatrics expert at the University of California, Los
Angeles.
Residents of independent living
communities can still take care of themselves, but may need help getting
to doctor's appointments. In skilled nursing facilities and nursing
homes, many residents require around-the-clock care.
Staff
members are "required to perform and provide CPR" unless there's a
do-not-resuscitate order, said Greg Crist, a senior vice president at
the American Health Care Association.
Bayless
did not have such an order on file at the facility, said Battalion Chief
Anthony Galagaza of the Bakersfield Fire Department, which was the
first on the scene. That's when firefighters immediately began CPR,
continuing until she reached the hospital.
Dr.
Patricia Harris, who heads the University of Southern California's
geriatrics division, said the survival odds are slim among elderly who
receive CPR. Even if they survive, they are never the same. She said she
would override the home's policy and risk getting fired "rather than
watch somebody die in front of me."
During the
call, an unidentified woman called from her cellphone, and asked for
paramedics to be sent to help the woman. Later, a woman who identified
herself as the nurse got on the phone and told dispatcher Tracey
Halvorson she was not permitted to do CPR on the woman.
Halvorson
urged the nurse to start CPR, warning the consequences could be dire if
no one tried to revive the woman, who had been laid out on the floor on
her instructions.
"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.
Halvorson
assured the nurse that Glenwood couldn't be sued if anything went wrong
in attempts to resuscitate the resident, saying the local emergency
medical system "takes the liability for this call."
Later
in the call, Halvorson asked, "Is there a gardener? Any staff, anyone
who doesn't work for you? Anywhere? Can we flag someone down in the
street and get them to help this lady? Can we flag a stranger down? I
bet a stranger would help her."
"I understand
if your facility is not willing to do that. Give the phone to a
passer-by. This woman is not breathing enough. She is going to die if we
don't get this started, do you understand?"
The woman had no pulse and wasn't breathing when fire crews reached her, Galagaza said.
Sgt.
Jason Matson of the Bakersfield Police Department said its
investigation so far had not revealed criminal wrongdoing, but the probe
is continuing.
First responders say often it's hard to find someone willing to provide CPR in an emergency.
"It's
not uncommon to have someone refuse to provide CPR if they physically
can't do it, or they're so upset they just can't function," Kern County
Fire Department Deputy Chief Michael Miller said. "What made this one
unique was the way the conversation on the phone went. It was just very
frustrating to anyone listening to it, like, why wasn't anyone helping
this poor woman, since CPR today is much simpler than it was in the
past?"
