A recent news story generated passionate commentary in the lay press about whether or not a nurse working in a nonnursing role had a duty to perform CPR on a resident of an independent living facility who'd collapsed while eating in the dining room. This nurse allegedly refused to perform CPR on the resident despite a 911 dispatcher's pleas, citing "facility policy" that prohibited employees from providing assistance and directed staff to await emergency responders. The resident ultimately died. A facility spokesperson reportedly supported the employee's actions and their "policy." Later accounts revealed that the family of the resident, who was 87, stated she wouldn't have wanted CPR. I hope that was indeed the case.
This situation brings to the forefront some very distressing societal issues. Most worrisome are the arguments that ensued in the media against intervening in an emergency. Reasons included fears about lawyers, liability, and confusion over Good Samaritan laws. Collectively, these arguments legitimatized the "facility policy" that kept the employee from aiding the resident. I wonder if expectations would be any different if a "facility policy" proponent needed emergency care.
What happens to our humanity if we promote following a policy over saving a life? Apparently our risk-averse culture is enabling common sense and ethics to take a backseat to actions influenced by fears of real or imagined liability.
Plain and simple policies should not stand in the way of saving lives. To be clear, I'm not referring to situations that involve people with known advance directives or "do-not-resuscitate" orders-or even scene or personal safety issues that would place a rescuer in harm's way and potentially increase the number of victims. There are certainly legitimate reasons to stand back. But to make a conscious decision to watch someone die when basic interventions may help flies in the face of human decency and all we've been taught as nurses. It also undermines the very fabric of the "Chain of Survival" concept advocated by the American Heart Association in support of performing CPR.
Medicine was founded on the principle of, "First, Do No Harm." As we celebrate Nurses Week, my personal plea is that we act to assure that our society doesn't devolve to the principle of, "First, Do Nothing."
Until next time-
Linda Laskowski-Jones, MS, RN, ACNS-BC, CEN, FAWM
Editor-in-Chief, Nursing2013 Vice President: Emergency & Trauma Services Christiana Care Health System, Wilmington, Del.