A nurse’s refusal to assist a dying woman in a California senior living facility marks an ethical failure
A disturbing account of inaction has recently come to light. Even more disturbing is the fact that the inaction was during a life-or-death situation. On Feb. 26, a nurse in a California retirement home refused to administer CPR to a resident of the home who had just collapsed. Even though the resident was not breathing well, the nurse refused to do anything beyond calling 911. This incident highlights a high degree of moral abandonment and should prompt anyone in similar situations to act in an opposite manner.
It seems incomprehensible that the nurse — who no doubt has CPR training — would refuse to help another person in dire need of assistance. Yet her employers are defending her lack of action. Apparently, the nurse adhered to the retirement home’s protocol for situations in which emergency medical aid is needed. The home’s executive director explained that in such instances, employees are told to call 911 and then wait by the person who requires medical assistance. The nurse, by the home’s standards, was doing her job well.
Despite the fact that the nursing home defends its employee, this incident should anger most people. Most infuriating is the recording of the nurse’s 911 call, which can be found online. In the recording, one can clearly hear the nurse assert that there was nobody in the vicinity who could properly assist the collapsed resident. The emergency dispatcher — obviously upset by the nurse’s responses — urged the nurse to either help the woman or get someone who was willing to do so. Still, no help was found. The resident died soon after reaching the hospital.
The behavior exhibited by the nurse is unacceptable not just for nursing home staff but for anyone. Nursing home rules aside, allowing that woman to die was an ethical abomination. There must have been people nearby who would have not been as comfortable with neglecting a dying person. It seems reasonable that if the nurse was uncomfortable helping someone in such dire need, she would have at least attempted to find someone who is willing to provide aid. Was the nurse really so concerned for her job that she was willing to do nothing but watch as another person was dying in front of her? In a situation in which care can be administered to a person on the verge of death, the moral transgression of not helping the person is far worse than any employment consequences that may come later. The resident should have been helped, regardless of the nursing home’s rules. The woman did not have a Do Not Resuscitate (DNR) order on file. Thus, the nurse knew that she was at liberty to do everything in her capacity to assist the woman and still did not. Indeed, not administering CPR or doing something to help the resident seems like a violation of everything she should have learned in nursing school. The nurse acted in direct opposition to the Nightingale Pledge (the nursing equivalent to the Hippocratic Oath).
I would hope that in a similar situation, most people would make the split-second decision to attend to a fellow human being before worrying about what consequences their decision may have on their jobs. It is understandable that the nurse valued her employment and did not want to put it in jeopardy. That being said, the situation in which the nurse found herself was not one in which fulfilling her duty as a health-care professional would have been considered reckless or foolish. In fact, administering help to the woman would spoken to the nurse’s competency. Despite the fact that the nurse would have been technically breaking the rules by assisting the patient, it would seem sadistic of the nursing home to fire her. Saving the life of one of the home’s residents by doing her trained job does not seem like reasonable grounds for termination.
In light of events such as this, one must also look at the nursing home executives. It is hard to conceive of any benefits such a bizarre set of employee rules generates. Obviously the retirement home hires nurses for a reason. They do not simply allow anyone to care for their residents. The qualifications and knowledge nurses have allows them to competently care for the home’s residents. Why, then, does the home not allow its nurses to assists residents when they need it most — by intervening in an emergency situation? I can see how the home is worried that nurses may try to do too much in certain situations where paramedics or physicians can offer more effective help, and liability is an issue all independent-living facilities face. Nevertheless, administering a basic treatment such as CPR while paramedics are on their way seems like the least that a nurse could do. If there are other nursing homes with similar regulations, then change should be enacted to ensure that home employees are not afraid of doing their jobs properly.
The nursing home says it plans to conduct an internal investigation of the incident. There is little to investigate, though. The nurse shamed her profession by not helping a person in acute medical need; the nursing home governs its employees by a set of rules that stifles potentially life-saving action; and the death of the resident as a result of the nurse’s inaction is a tragedy that never should have happened. Hopefully, if other nurses and nursing homes take this incident to heart, a similar situation will not occur.
Alex Yahanda is a senior associate editor for The Cavalier Daily. He can be reached at firstname.lastname@example.org.