Nursing home crisis is all about ‘perception,’ despite facts


Lorraine Bayless died last week at 87, we now understand, from a massive stroke. She had a “do not resuscitate order” [though one was not on file at the assisted-living facility where she lived] and her immediate family says it’s satisfied with her treatment at Glenwood Gardens  in Bakersfield, CA.

So what’s all the fuss? Why the national headlines? Why are local TV stations across the country doing stories with “their” nursing home administrators asking them what they’d do in this situation? Why are commentators pulling so hard on this thread like it could unravel societal fabric?

The story is that a nurse at the non-medical, assisted-living facility called 911 when Mrs. Bayless suffered her stroke. The nurse, citing company policy, refused to perform CPR or find someone else willing to do so.

Hence, crisis.

The crisis that persists for Glenwood and its corporate owner, Brookdale Senior Living, results from perception. We perceive the nurse’s decision as outrageous and the company that ordered it immoral.

The criminal investigation announced Monday into the case stems from the same thing. California regulators say the nurse involved was required to perform her clinical duties regardless of other orders. [Some states, like New York, have “good Samaritan” laws designed to shield well-meaning people from liability lawsuits if they try to help save a life. This nurse apparently didn’t feel she had adequate protection.]

The root of what makes this a crisis is a key to understanding how to manage crises and, in the larger arena, shows why CEOs and others should plan in advance and train for a crisis. We all have them. Get ready now. Decide how people inside and out will perceive your decisions.

The facts, taken clinically, meaning objectively, probably point to everyone doing what they were supposed to had this all happened in private. In other words, if Mrs. Bayless were at home, suffered a stroke and died according to her wishes, this would be a non-issue.

But when the nurse called 911 and refused to perform CPR, it became a national morality play. The outrage in the questions and voice of the 911 operator, Tracey Halvorson, are apparent. She’s stunned that no one would help this dying woman. She’s especially upset when the caller identifies herself as a nurse. We share her outrage.

That’s because we perceive ourselves and our society and caring, heroic, life-saving. Most of us have learned CPR and could do a reasonable version of it if called on for a few minutes before EMTs arrive. First responders teach CPR in our schools. Some states require defibrillation paddles in public places.

Thus an intentional order that blocks CPR, apparently in favor of liability prevention, is perceived as a callous, profit-first decision by the corporate owners. People outraged at such a me-first call flooded web sites to warn prospective customers away from the company’s facilities.

And this sparked a national debate on what’s right. The company, with facilities in 36 states, did little in the way of easing this crisis. It had Glenwood’s administrator issue one statement, but it’s remained corporately silent. Bad move. It’s stock price has remained stable, trading near its 52-week high, but that’s not always the best indicator of how a crisis is playing out. Resident census over a year will tell more.

Regulatory and criminal proceedings will string this along for months. Certainly, it could be worse for the company. The family could be outraged and threatening to sue. Mrs. Bayless could have had a resuscitate order. Surely, legislatures will try to create laws to avoid this.

But the lesson here for the rest of us is that emotion rules in a crisis and if the public perception, fueled these days by Twitter and Facebook, is that you were negligent, callous and uncaring, your business will suffer.

The content of this blog is about crisis management and mismanagement in a digital age. It originates with Steve Bell, who spent 30 years as a journalist for the Associated Press and in four top editor positions at The Buffalo News. He is now Partner/Director of Public Affairs at Eric Mower + Associates, one of the nation’s largest independent advertising, integrated marketing and public relations agencies, with seven offices in the Northeast and Southeast. Learn more about EMA at http://www.mower.com. Steve’s blog is based on his own opinions and does not represent the views or positions of Eric Mower + Associates.

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About steveoncrisis

The content is about crisis management and mismanagement in a digital age. It comes from Steve Bell, who spent 30 years as a journalist for the Associated Press and as managing editor and editorial page editor at The Buffalo News. He is now Partner/Director of Public Affairs at Eric Mower and Associates, one of the nation's largest independent advertising, integrated marketing and public relations agency with six offices in the Northeast and Southeast.
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