A Nurse's Duty in a Healthcare Setting
If the nurse is working as a nurse, he or she has a duty to perform CPR when an individual at the workplace is not breathing and/or has no pulse. A search of the California Board of Nursing Website produced several cases involving nurses who lost their licenses for failing to start CPR on a patient who had no pulse and/or respirations. In one case, the nurse worked at a hospital and came upon a patient who appeared to her to be dead. There was no DNR order. The nurse called a physician but didn't initiate CPR. The Board believed the nurse's allegation that she thought the patient was dead; however, because of other allegations, the Board revoked the nurse's license and then stayed the revocation and put her on probation.
In another case, the Board invoked similar discipline when a nurse did not perform CPR on a patient hospitalized in a psychiatric facility. In a third case, a nurse did not initiate CPR because he thought the patient was a "no code," when in fact there was no DNR order. His license was also revoked but he was put on probation. The charges against these nurses were unprofessional conduct, negligence, and incompetence.
There are several distinctions between these cases and the Bakersfield case. In the California Board of Nursing cases, the patients were in facilities where healthcare was provided. In the Bakersfield case, the woman was in an independent living facility. Furthermore, in the Bakersfield case, the nurse apparently wasn't working as a nurse. It could be argued that if the nonpracticing nurse held herself out as a nurse, then she should be held to the standard of a nurse. During the 911 call, she said that she was a nurse. If she was not going to perform as a nurse, she should have let her license lapse and/or never mentioned to anyone that she was a nurse.
An Associated Press story quoted a spokesperson from the California Board of Nursing. "If she's not engaged in the practice of nursing, there is no obligation (to help)," agency spokesman Russ Heimerich said. "What complicates this further is the idea that she wouldn't hand the phone over [to a bystander] either. So that's why we want to look into it."
Nurses in Other Capacities
It is clear that in a healthcare facility a nurse must initiate CPR and whatever other emergency system the facility has in place when finding a patient with no respirations and/or no pulse. It is also clear that an individual (even a nurse) who encounters a pulseless person on the street has no legal duty to initiate CPR. The individual on the street can follow his or her conscience.
What is unclear, and worth thinking about, is the responsibility of a nurse who is not working in the capacity of a caregiver in a facility that doesn't provide healthcare services. Is it her responsibility to do her best and attempt CPR? Is it her responsibility to call for help from other staff and/or residents? Is it her responsibility to follow whatever policy the facility has in place? The spokesman from the Board of Nursing indicates that she should have handed the telephone over to someone else. However, putting the responsibility on an untrained bystander senior citizen, when you are a nurse, isn't a great choice.
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Cite this: Is a Nurse Obligated to Perform CPR? - Medscape - Mar 26, 2013.