Life Goes On...

Some years are better than others. I guess that's true for most of us. So far, this year seems to be possibly one of the more productive ones, which is nice, especially after last year. Last year was horrible: we lost several family members died; we had a hard time getting rid of what turned out to be the roommate from hell (yes, it was someone we had known for years); and, of course, the various odds and ends that make a life.

In July, my son-in-law died. While his health was not the greatest, his death was not expected. But considering the medical care he got - or, rather didn't get - he passed away. (Yes, he'd gone to the hospital, three times in his final ten days or so; the hospital totally dropped the ball. That's another story.) His mom had come down to see him in the hospital; fortunately, she got to see him before he died.

Then, over the next few months, my mother began to die in earnest. Her health, which hadn't been the greatest for years, began deteriorating rapidly. While my sister, A., still lived near me, we'd tried to get Mom and our second step-dad to move near us to make life easier, "just in case." Then my sister moved to Colorado, then literally across the country. We still tried getting Mom and step- to move here, but it wasn't happening.

A. flew back and forth to Mom's, reporting to me on what was happening. It wasn't pretty. There were assisted living facilities, skilled nursing facilities, the whole bit. Then step-dad had a stroke and, within a month, had died at his daughter's home. (Again, another story...) A. mentioned bringing Mom out to live near her. But Mom's health was too precarious.

"If you want to see Mom while she's alive, you'd better come soon," A. said during one phone call. Mom was days to weeks from dying. "I'll even pay for your airfare."

Unfortunately, I was in the middle of a crisis here at home. A friend had needed a temporary place to stay and I'd offered to let him rent a room temporarily; he overstayed by his welcome in short order. (Word of advice: if a person's family doesn't want that person moving in with them, that's not a good sign.) I finally had to go into bitch-mode to get him out, after he'd become increasingly unpleasant and verbally abusive. I couldn't fly out to see Mom, knowing that the now-ex-roommate was still there, giving my sons M. and J. all sorts of grief.

By mid-November, Mom and roommate were gone. While Mom's passing without having seen her hurt, at least A. and I knew she was no longer in pain, while ex-roomie's leaving was the definite high-point of the month.

Over the next few months, A. and I spoke a few times. We discovered one final Christmas present from Mom, which surprised both of us.

Now, with March of the new year here, things are looking up. Life, while far from perfect, is running a lot better than last year. While my "kids" (all adults) and I still have things to work through (this is, after all, real life; there are almost always bumps and uh-oh moments), we're hanging on.

Here's hoping for the rest of the year.

Ethics, In Work and Real Life

There are certain things most of us take for granted. One of those things is that if someone has any kind of medical knowledge, whether it's basic first aid (and I'm including knowing CPR here) or the most knowledgable, skillful doctor, and a person in proximity to that person suddenly needs CPR, the knowledgable person will help out. If, for some reason, he or she can't help, that person will summon help. While waiting for EMS to show up, that knowledgable person will either do CPR and/or get a nearby person to help with it. That is what most of us would hope for.

So, what is with the nurse in the California assisted living facility who, last week, allowed an elderly woman to die, rather than start CPR on her?

In case you're unfamiliar with what I'm referring to, here is a link to the story from the LA Times ("Nurse refused to give CPR to elderly woman who later died"): http://latimesblogs.latimes.com/lanow/2013/03/nurse-refuses-to-give-cpr-to-elderly-woman-who-later-died.html. Also, here is a link to the story, as covered by the Today Show: http://www.today.com/video/today/51024816/#51024816.

So, picture this: You send your loved one to an assisted living facility. You figure it's not a nursing home, but a place where your loved one (Mom, Dad, husband, wife, whoever) will get assisted living. There are nurses in the facility. You figure, okay, if something happens, the nursing staff will help out, especially if that something is something medical.

In this case, the elderly woman went into cardiac arrest. The nurse who discovered this called 9-1-1. On the 9-1-1 tape, the dispatcher is heard saying that CPR needs to be started while EMS is in route. The nurse then states that she can't do CPR. The dispatcher says she (the dispatcher) will talk the caller through how to do CPR, at which point, the caller states that she's a nurse, but the assisted living facility's protocol will not allow her to do CPR.

During the call, and before EMS has arrived, the dispatcher pleads with the nurse to find someone, anyone to do CPR on the elderly woman; yet, the nurse refuses to do so. The dispatcher says that the elderly woman will most likely die without CPR, yet the nurse refuses to get someone to start CPR, refuses to start CPR herself. And yes, the woman did die.

Another point that bothers me: the elderly woman's daughter has no problems with this, stating that her mother got "good care" at this particular facility. Good care? I'm sorry, but if a facility has caused your loved one's death, either directly (by giving that person the wrong medication, the wrong death, pushing him or her down a flight of stairs) or indirectly (not doing CPR, not giving care in a timely manner), that is NOT "good care." (I happen to have a unique perspective on this, in that a similar thing happened to one of my loved ones. I didn't decide that he had gotten "good care"; rather, I contacted a lawyer.)

First off all, if a facility decides that its medical personnel are not allowed to give medical care to its residents, even in (or especially in) an emergency, that facility needs to let its residents and their families know this in no uncertain terms. I don't know if this facility did, but I would feel having families and residents sign something to this effect, as well as have signs prominently displayed in common living areas so that everyone knows exactly what's what.

Secondly, doctors take a Hippocratic Oath, part of which is to "do no harm." I'm not sure if nurses are required to take this oath, too, but it would seem that if someone goes into one of the medical professions - EMTs, paramedics, nurses (RNs, LPNs, etc), doctors, technicians, and all forms of medical personnel - it would be to help others. If a person is not going to help others, while that may be legally allowed (and this seems questionable in this case), it would be ethically required. If you (or I) have the knowledge to do CPR on a person and there is a person in your care who needs CPR (or even a passer-by needs it), you might not have a legal obligation to do CPR, but you and I would have an ethical obligation to do so.

Personally, I don't know how that nurse can sleep at night.