No, the company covered their behind long ago. You can’t expect Brookdale (I had not noticed it was them, I had the impression it was some small company operating one or two homes) to be this foolish. Their guidelines no doubt stated that in an emergency, employees should call 911 and wait with the resident. Gamanit heard that on CBS (see above) but it is quite obvious, given that Brookdale are no amateurs. These guidelines, when brought to the courtroom or to the case study at the next medical ethical conference, do not mean one should stand by, but rather, administering help as appropriate. We are well aware the employee might have been told by her supervisor – or more likely, lead into believing – that she should do absolutely nothing. This was not official policy and not in writing. Chances are it was not even actually said (recording devices being cheap and easily available). I expect instead that the paragraph “in the event of an emergency” was next to the blurb about the facility being not licensed to offer medical care and liability for employees who do so (including scary remark such as “will lead to immediate termination”). Of course the employee is a scapegoat, but she made her bed and has not yet realized how uncomfortable it’ll be to sleep in it.
In addition, she can hardly blame the facility and their rules, because throughout these long minutes she did not ask her supervisor, much less management, for clarification of guidelines. A supervisor would have instructed the employee to start CPR on this particular patient. Yes, had she involved a supervisor, the employee might have created a few problems for herself (especially if she is incapable of driving home the point that investors and brandname assets must be protected and we can’t allow media to jump on this sort of stories). But nothing in comparison to her situation now.
Now there is a mess, and the employee still thinks she can get away with it, because that’s what always happened in the last X years she worked at this job, and moreover, the family of the deceased are supporting her, and the deceased’s daughter is a nurse. She does not realize the piling up of mistakes upon mistakes, nor the seriousness of her situation; she probably feels relieved that “elder abuse” charges were dismissed (they were blatantly absurd of course), she probably was pleasantly surprised by the non-confrontational and sympathetic attitude of police and prosecutors, and I expect she is not getting much of a legal counsel at this time. And yes, according to a statement from the family, a DNR document now surfaced, after the local fire dept confirmed there was no DNR on file – the silence of Brookdale speaks volumes. There is also a document, signed by the deceased’s personal physician, indicating stroke as the cause of death.
This incident might or might not spark a change in legislation requirements for assisted living communities. It might or might not spark an extension of failure to care, unprofessional conduct etc. It might or might not spark a greater uniformity of regulations nationwide (see e.g. RN disciplinary codes in California vs Tennessee). In any event I expect future guidelines of Brookdale’s facilities to address in more detail the issue of assistance while waiting for EMS (I expect employees to be briefed there is no change in policy, only in wording). Other similar providers are already doing so. As for Brookdale “We are conducting a company-wide review of our policies involving emergency medical care across all of our communities.” Also, Brookdale have put the employee on leave and are now promising a “thorough internal review of this matter”.
In the meantime, from Brookdale’s statement to the media.
“This incident resulted from a complete misunderstanding of our practice with regards to emergency medical care for our residents”.