Nurse Refuses to Give CPR; Senior Dies: Ethical Problem or Legal Issue?

Case/Issue Summary

A nurse made state news in February after she refused to carry out cardiopulmonary resuscitation (CPR) on a woman aged eighty-seven years. The old woman had collapsed in the dining room inside the retired community from where she lived.  The news shocked many people who learnt that nurses do not know what is expected of them in such cases as individuals understand that nurses were supposed to care enough by providing CPR. The news story includes fire department dispatcher from Bakersfield, California, who was pleading with a staff member a nurse by profession at a senior living Facility (Carolyn Rosenblatt, 2013). After the nurse declined to provide the eighty-seven years old woman who had collapsed with CPR, the nurse decided to call 9111 requesting support from police. The nurse reported that the old woman had stopped breathing which made the dispatcher to ask her to start providing the old woman with CPR. However, despite being a staff member, the nurse refused to provide CPR. Instead,  the nurse supported her action by claiming that the facility had implemented a policy w directing staff despite their profession to always call 911 in case of emergency situations such as those. Also, the administration recommended that the staff member can only attend to the person requiring assistance, but should not perform CPR.

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The nurse further responded that although she was a nurse, she could not allow any other senior citizen who lacked the knowledge of performing CPR to do it. She claimed they were in the dining room where they were not supposed to provide CPR. The dispatcher continued to argue with the nurse for more than seven minutes. Unfortunately, having no CPR provision, the old woman died (Carolyn Rosenblatt, 2013). Later, it was discovered that the nurse was not practicing as a nurse, but an administrator. The dead person’s family reported that one of their relative never wanted intervention hence they did not intend to complain about the manner in which the facility handled the matter.

Identification and Evaluation of all Main Possible Solutions

The possible solutions for the case are that the nurse if she was indeed one as had informed 911 operator, had the responsibility of caring for the resident irrespective of the policies and her uncertainties. By attending to the old woman, it would have acted as a sign of both ethical and professional obligation. The other possible solution was to rush the senior woman to the nearest medical center where she could acquire medical care.  Additionally, the nurse together with the other individuals in the living room could have called a medical practitioner who would come to carry out the CPR on the old woman. Moreover, the nurse could not have called 911 but instead saved time by immediately providing CPR to the old woman. The primary commitment of the nurse could have been directed to the old woman who could have been in line with the American Nurses Association ethics code.  The facility’s policy did not mean that it superseded the obligation of a nurse towards the old woman.

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Even though by providing CPR to the old woman was against the policies, there could have been no severe law offense consequences. There are laws of good Samaritan which provide legal protection to any individual who gives reasonable assistance to people who are ill, injured, in peril as well as those who are incapacitated, more so to nurses and doctors (Pozgar, 2014). Another possible consequence would have been criticism from the company since the nurse could have violated their policy which indicates that no one had the duty to provide CPR to any patient in the senior community. A similar significant consequence of the possible solution would be relying on a medical practitioner from the outside could not have been useful given that the medical practitioner could not arrive in time. Provision of the CPR to the old woman could have negatively affected the nurse as she could have violated the community policy which was against the rule of CPR inside the living facility. In the solution, the ethical principles upheld that the nurse as medical personnel could not have stood by and watched the old woman die. It is unethical for medical staff and other individuals.

Nurses knew their specific obligations in times of emergencies such as the one experienced and needed to care enough about it. Besides, nurses are not supposed to be found relying on the 911 dispatcher who in most cases refuses to hand the phone to any passerby to have the dispatcher instructing someone else to the administer CPR.   The possible consequence involving going against the policies to carry out CPR is more significant than the others since the nurse knew that by so doing, she could be violating the administration of the company.  The consequence of having the medical practitioner from outside coming to attend the old woman could have occurred since it could take a significant amount of time for the medical practitioner to arrive. The possibility of providing CPR to the woman by the nurse upheld the ethical values of nurses more than the other ways as a nurse is supposed to provide care to anyone to save their life first.  The possible solution which is better than others is having the nurse carrying out CPR.

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Decision Statement and Defense against Weaknesses

The best solution towards the case of the old woman is having the nurse carrying out the CPR despite the limitation of the policies of the company. There is the need for exceptions in the nonhealthcare residences which can apply during the time of emergencies such as the one involving the old woman.  When a nurse is in the scene where there is an emergency, they should look forward to doing what they are trained which distinguishes them from normal people. Therefore, the best solution to the case involving the senior, the nurse needed to administer CPR immediately when the old woman stopped breathing. Even though the nurse was not allowed by the policies to carry out CPR to the old woman, the nurse could have gone ahead having in mind that there exist laws of good Samaritan which provide legal protection to any individual who provides reasonable assistance to people who are ill, injured, in peril as well as those who are incapacitated, more so to nurses and doctors.

Other possible solutions were rejected for particular reasons. First, the potential resolution of involving a medical practitioner from outside the senior residence was likely to have adverse consequence. The idea of having the outsider medical practitioner to attend the old woman could have failed since it could take a significant amount of time for the medical practitioner to arrive. Second, the possible solution of making the old woman to the nearest medical center could not have helped the senior woman since she needed immediate attention as she had even stopped breathing. The resolution of having the nurse immediately attending the old woman is a perfect way that allows the nurse to exercise her professional duty. Also though the policies of the senior residences did not allow anyone to carry out CPR, the systems cannot supersede the obligation that nurses have to a resident, patient or even a passerby (Fowler, 2008).  When a senior joins a living facility, it does not mean that their right to life should be revoked by the policies of the existing plant.

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The nurse had the duty of providing care to the old woman regardless of her uncertainties or the policies both as an ethical and a professional obligation.  The resolution is well protected by the Good Samaritan regulations which postulate that they give defense against the torts which could be arising from any attempted life rescue. The recommended action plan is that the nurse could have gone ahead to provide CPR. The Good Samaritan laws would attend any objection towards the provision of CPR by the nurse. Someone might object the decision since it is against policies of the residence facilities. Nevertheless, the nurse is obligated to initiating CPR whenever she finds a person with no pulse. The process serves as a resolution aimed at saving a life of the senior which other solutions are likely not to achieve.