Guest Columns

What would Jack Bauer do?

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Anthony Cirillo
Anthony Cirillo

In past posts I have written about passion and purpose and about losing your story and being in the moment. Today let's talk about common sense.

You probably read, heard or seen the story of a facility where a resident service director refused to give a female resident CPR because it was against company policy. The woman later died at the hospital. Glenwood Gardens released a statement Wednesday saying they were conducting a review.

Here are some of the details from a CBS report. This took place at Glenwood Gardens in Bakersfield, CA after 87-year-old Lorraine Bayless collapsed in the dining room and was barely breathing. Here is some of the dialogue from the dispatch call transcript.

Dispatcher: “We need to get CPR started.”

Glenwood Gardens: “Yeah, we can't do CPR at the facility.”

The staff member said providing CPR is against her company's policy.

Dispatcher: “Anybody there can do CPR. Give them the phone, please?” the dispatcher said. “She's going to die if we don't get this started. Do you understand?”

Dispatcher: “I don't understand why you're not willing to help this patient.”

Dispatcher: “Is there anybody that works there that's willing to do it?”

Glenwood Gardens: “We can't.”

Dispatcher: “Or are we just going to let this lady die?"

Glenwood Gardens: “Well, that's why we're calling 911.”

During the seven minute, 16 second call, the dispatcher begged the service director to perform CPR or put someone on the phone who was willing to try.

Bayless was part of the independent facility at Glenwood Gardens, which is separate from the skilled and assisted nursing facility.

Regardless, common sense is defined by Merriam-Webster as, "sound and prudent judgment based on a simple perception of the situation or facts."

The simple perception here was a woman was dying and needed CPR. Sound and prudent judgment would have been to perform it or move out of the way and get someone else to do it.

Jim Taylor writing in Psychology notes, “If common sense was common, then most people wouldn't make the kinds of decisions they do every day. People wouldn't buy stuff they can't afford. They wouldn't smoke cigarettes or eat junk food. They wouldn't gamble. And if you want to get really specific and timely, politicians wouldn't be tweeting pictures of their private parts to strangers. In other words, people wouldn't do the multitude of things that are clearly not good for them.”

So maybe we need to teach common sense. There is much debate on whether you can. You might be able to help employees learn to reason through their decisions and actions quickly and confidently. But fast-tracking decisions is no guarantee that someone will do the right thing.

Could this incident be confined to this one particular person? What if another nurse in the same facility made the 911 call? Would he/she have listened to the dispatcher and performed CPR?

Maybe this is more about the culture and leadership in this particular company. How much latitude do you give employees when it comes to solving problems, even if it means violating the prescribed rules?

I was an obsessive fanatic of the television series 24. (Yes, I have spent an entire weekend watching an entire series. Don't pretend you haven't been there.) Kiefer Sutherland is Jack Bauer, an agent with the fictional Counter Terrorist Unit, which works to protect America from terrorism plots.

Jack always faces tough situations but always seems to do the right thing, at least for the country. There are always choices and consequences. And he almost always bends the rules.

How about your organization?

What is the right thing for your residents, your patients?

Is the culture of the organization such that employees will do the right thing or follow the rules so steadfastly as to avoid common sense and maybe even cause harm?

Do you plan for scenarios such as the one that happened in California and walk staff through possible solutions?

Do we need to go as far as having Ethics Committees as our hospital counterparts employ?

I don't have the answers. But common sense tells me a woman needlessly died and some people consider that tantamount to murder. What would Jack do?

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Guest columns are written by long-term care industry experts, ranging from academics and thought leaders to administrators and CEOs.

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