End of life decisions should not be second guessed

All day yesterday the FOX news network went after the nurse in California who refused to perform CPR on an 87 year old woman at an assisted living facility, a nurse who had the misfortune to have her refusal broadcast nationwide endlessly by FOX News right up to the point where I write this at 11:00 pm Eastern Time. Breathlessly assuming that they knew best, too-highly paid talking heads, from Shep to Greta, proclaimed to the world, that they knew more than the nurse extant on the ground dealing first-hand with the situation. To me, this smacks of some military medical service officer thirty miles in the rear of the actual ground combat screaming over the radio at a medic as to how to treat a wounded soldier. It is oh so easy to be self-righteous and certain when you observe from a safe distance.

I spent almost ten years in a non-profit, community hospice organization back when we were trying to convince the medical community of the worth of the concept of palliative care and the need to just let people who had reached the end of their life's journey to do so without fruitless medical interventions that needlessly prolonged the pain of their passing. One of my most difficult tasks was to convince nursing home and assisted living facilities directors to simply acknowledge the dignity of their residents and allow them to pass in peace in the comfort of their familiar beds rather than loading them into the back of an engine-thrumming, lights-flashing ambulance, where emergency personnel would pound on their chests and stick needles into them during a frantic race to a hospital emergency room:

Where they died anyway with neither peace nor dignity.

My message always was simple: permit them to exit life in the familiar warmth and quiet of their room, temporary though it might be, it was their home of the moment, and far superior to the back of an ambulance or under the cold glaring lights of an emergency room cubicle.

Ask yourself this: Who do you suppose had a better understanding of that 87 year old woman's chances of surviving a wild ride to the emergency room, FOX News, Shep Smith, Greta Van Susteren, or that nurse attending the patient? Who was on the ground, providing immediate care and had a better idea of what the patient's true condition was, that nurse, Shep or Greta? I think most who read this know the answer to that question.

Nurses are the combat medics of civilian life, always subordinate to the second-guessing of physicians and medical administrators, but also always being those with the warmest fingers on the vital and spiritual pulses of their patients. When a doctor feels ego-driven or ethics-driven to prolong a life that has reached its end, it is often the nurse who is first to recognize the reality that it is both futile and not in the patient's best interest. What none of us should do is to second-guess these nurses' on the ground judgments until we know much more than what's revealed in a 911 recording:

Or on Fox News ...