I asked an ICU nurse with 15 years on the unit for her most controversial opinions. She didn't hold back:
1. Doing chest compressions on a frail 95-year-old isn't "saving a life." It's just cruel.
"On TV, CPR looks like this: a few pushes on the chest, a gasp, and the patient sits up and talks. A 1996 study in the New England Journal of Medicine watched medical dramas and found 77% of TV patients survived the arrest right away and 67% survived long term. Real life looks nothing like that."
"Real CPR means pushing the chest down at least 2 inches, 100 to 120 times a minute. On a frail body, ribs break. Post-mortem studies find rib fractures in roughly 30% to 60% of adults who get CPR, and the risk climbs with age."
"And survival is low. In a study of more than 430,000 Medicare patients 65 and older who got CPR in the hospital between 1992 and 2005, 18.3% survived to leave the hospital. Older age, more chronic illnesses and living in a nursing home all pushed the odds lower."
"I'm not saying old people don't deserve CPR. If a 95-year-old understands the odds and wants it, that's their call. What I'm saying is that most of the time, nobody explained the odds. The default is to do it, and the family finds out what it means while it's happening."
"And 'Do Not Resuscitate' doesn't mean 'do not treat.' A DNR patient still gets antibiotics, fluids, pain control and real medical care. It just means that when the heart stops, we let them go peacefully instead of breaking their chest first."
Here's the rest of her list. 🧵
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