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Policy questioned after nurse refuses to do CPR

Just moments after answering a call from a senior independent living facility, a 911 operator can be heard pleading with a nurse who refuses to perform CPR on an elderly woman. NBC's Miguel Almaguer reports and former prosecutor Star Jones and TODAY contributor Dr. Roshini Raj discuss the case.

A California 911 dispatcher begs a nurse at an independent living facility to perform CPR on an elderly woman who collapsed, fell unconscious and was barely breathing. 

During the 911 call, the dispatcher desperately tried to get the nurse to find someone who would try to save the 87-year-old woman if she wouldn't perform CPR herself.

“Is there a gardener ... any staff? Anybody that doesn’t work for you, anywhere?” the dispatcher asks, according to the 911 call, which was heard on TODAY Monday. “Can we flag someone down in the street and get them to help this lady? As a human being, I don’t, you know, is there anybody that’s willing to help this lady and not let her die?”

“Um, not at this time,” the nurse says. 

Despite the 911 dispatcher's request, no member of the staff at Glenwood Gardens in Bakersfield, Calif. would administer CPR. The nurse at the assisted living facility told the 911 dispatcher it was against company policy to administer the potentially life-saving technique.

The head of the facility said the nurse did follow company policy.

The elderly woman was eventually rushed to the hospital, where she was pronounced dead. 

“Our practice is to immediately call emergency medical personnel for assistance and to wait with the individual needing attention until such personnel arrives,” Jeffrey Toomer, executive director of Glenwood Gardens, said in a statement to TODAY. “That is the protocol we followed.”

The elderly woman's daughter, a nurse, was satisfied with her mother’s care, and the facility is conducting a thorough review, according to a report on TODAY Monday.

The call and the response are raising questions over policies at some senior facilities.

Under California law, unlike at a nursing home, staff members at independent living facilities are not legally required to provide medical aid, according to Mary Winners, an expert on senior care.

“It’s really more like a hotel where they will offer you concierge services, you’ll get meals, they’ll have housekeeping, they’ll change your bed, but you can’t even get care,” she told TODAY.

The dispatcher offered to instruct others on how to perform cardiopulmonary resuscitation if the nurse wouldn't do it. "I don't understand why you’re not willing to help this patient,” the dispatcher says.

TODAY contributor Dr. Roshini Raj said she disagreed with policies like Glenwood’s, and said the nurse had a moral obligation to help.

“It’s certainly shocking where you hear a nurse saying she can’t perform CPR on a patient who clearly needs it,” she said on TODAY.

“There is certainly, I think an ethical obligation to do it,” Raj said. “On the other hand, I suppose this nurse was worried about, she was in jeopardy of losing her job because of this policy.”

In this case, CPR could have made a big difference, Raj said, noting that the brain starts to die after four minutes without oxygen. “Every minute was crucial here and that’s why the dispatcher was so desperate to start it,” she said.

The policy allowed the facility to limit its liability, said Star Jones, a former prosecutor and TODAY contributor, noting that the living center has the right to limit the services it will provide.

“The problem then becomes, are we looking at a legal responsibility or is this a social responsibility?” Jones said, adding that certain factors, like whether the facility accepts federal Medicaid or Medicare funds, may play a role.

“I’d look at all the facts before I’d say this facility did the right thing,” Jones said. “She may not go to court, but she does have to go to bed at night and I’m not sure she’s going to be able sleep well.”

And on the subject of liability, Raj pointed out that good Samaritan laws protect people who attempt to perform CPR.

“Even if you’re not trained in CPR, if you attempt it in good faith to help someone, you’re not liable,” she said.