Nursing Home Advance Directives ....

Asked over 2 years ago - Baltimore, MD

My wife is a nurse at a skilled nursing facility in Maryland. A patient collapsed and she failed to give CPR because the patient did not have an advance directive. Her supervisor told her that she still had an obligation to provide CPR even in the absence of an advance directive. Fortunately, the patient survived, but wife is worried that she or facility will be sued. Are nurses required to provide CPR in the absence of an advance ? It happened 3 wks ago, but we are nervous everytime the phone rings or mail comes wonderfing if it is a lawsuit. One supervisor told her she did the right thing and the other said she did not. Will she lose her license? We can't afford an attorney, do we need one? What is an advance directive? Wifey is too emotional to even explain it to me.

Attorney answers (4)

  1. Mark William Oakley

    Contributor Level 18

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    Answered . Lawsuits for personal injury are not filed three weeks, or even within months, of the incident, and you should not be worrying about every knock on the door or phone call. It does not happen like that. An advance directive has no bearing on this situation. When someone suffers a medical emergency, medical care should be provided as appropriate for the situation. Nobody is required to have an advance directive, and its primary purpose is to express a person's wishes in the event they are in a terminal comatose condition that cannot be reversed (brain dead), and that they do not want to be kept alive in a vegetative state indefinitely when they have no hope of ever being revived. It is NEVER used to deny emergency medical care when the person can still be saved and recover from the medical condition. As for the risk of a lawsuit, did the woman suffer any additional injury solely due to CPR not being performed? Without injury, there is no claim. Any such claim would be primarily against the nursing care facility in any event, and be covered by the facility's insurance, which would cover your wife as well. For your wife to be sued, it would have to be established that your wife had a duty to perform CPR, which is unclear. Whether your wife's employer will fire her over this incident, that is really impossible to say. If it is part of her duties to perform emergency medical procedures like CPR, and she failed to do so in a situation that called for it, then her employer could possibly use that as a basis to terminate her.

  2. Martha Ann Knutson

    Contributor Level 11

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    Answered . As Mr. Stewart notes - the details are the hard part in cases like these. While I also agree that insurance is what helps minimize the consequences of what's already taken place, you and your wife might find some of the information linked below about Advance Directives on the Maryland Attorney General's website to be useful personally and for the next situation she encounters.

    Although Advance Directives have been an available option for many years, it is estimated that less than 10% of the population has executed one. So there is a high likelihood your wife will run into a similar situation again.

    This response is intended to provide general information, but not legal advice. The response may be different if... more
  3. Timothy Kent Hobbs II

    Contributor Level 11

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    Answered . Is she a member of a union? They often provide legal representation for members.


    Timothy K. Hobbs II
    Attorney at Law
    Glendora CA
    Web Site: Hobbs Law Group
    Email: t.hobbs@hobbslawgroup.com

    The answers on this discussion board are general in nature and NOT intended as legal advice. Responding to... more
  4. Marc Edward Stewart

    Contributor Level 16

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    Answered . She should not be worried about getting sued. The purpose of a suit, if any is filed, is to get money from the nursing home company or an insurance policy (just like a car wreck). The plaintiff doesn't care about your personal finances. Further, the lawsuit cannot strip your wife's license. It doesn't work that way. If she gets named in her own capacity (in addition to the NH), and a verdict comes down for the plaintiff one day, she might get a little mark with the state nursing board. But it would not be devastating. In the meantime, her employer and/or insurance company would pay for the legal counsel and all case expenses. She's have no out-of-pocket expense.

    I sue hospitals and doctors when they hurt or kill people. My job is never to demean a defendant, injure their career, or even suggest that they are terrible practitioners. It's like a simple car wreck...I argue that one this particular day they did something wrong. We're all human. That's why we have insurance -- for mistakes. Bottom line: defendants often get way more worked-up over this process than they need to be.

    Now, for the medical answer: if there was no advance directive or a DNR, then yes, CPR was likely required by the nursing standard of care. Of course, everything...and I mean everything...is fact-dependent. The devil is in the details.

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