A transcript of the 999 call shows how the nurse disagreed with the emergency operator’s advice
A nurse has been suspended after deciding a care home resident was dead following a 32-second assessment and refusing to perform CPR when told to do so by a 999 operator.
Melissa Papandrea was working at Poplars Care Centre in Maidstone when the resident stopped breathing on November 7, 2022. A tribunal heard she concluded the man had already died before rejecting instructions from an emergency call handler to begin life-saving resuscitation efforts.
Ms Papandrea told the ambulance service, “I’m a qualified nurse and I can tell you by looking at the resident that he has passed”, during the call, adding, “His heart has stopped”, according to The Mirror.
Despite being told by the operator to begin CPR while the man “was still warm”, and as he did not have a ‘do-not-resuscitate order in place’, the nurse refused, saying “there’s no point”, a transcript revealed.
The Nursing and Midwifery Council (NMC) were given access to the conversation, which showed the nurse and emergency operator disagreeing over whether the resident should be resuscitated, wasting time as he lay dying.
“If he’s still warm, you need to start CPR”, the operator said, to which Ms Papandrea replied: “No, I’m sorry, that isn’t possible because he is deceased. I’ve had this argument before with the emergency services. There is no cardiac output. I’m not commencing CPR.”
The man was then pronounced dead, with a subsequent inquest concluding that the resident had died from bowel ischaemia, caused when the blood supply to the intestines is restricted or cut off. However, the NMC tribunal has since ruled that Ms Papandrea did not carry out an acceptable clinical assessment before deciding there were irreversible signs of death.
“The requirement to undertake a proper clinical assessment as to whether [the resident] had signs of irreversible death was a fundamental tenet of the nursing profession”, said The Fitness to Practise Committee, chaired by Derek Artis.
“Fellow professionals would consider a failure to follow guidelines in such circumstances to be appalling.”
Ms Papandrea’s decision had seemingly been based on her own subjective assessment, the panel was concerned to hear. The proceedings’ report added: “The panel was particularly concerned that Ms Papandrea’s decision that [the resident] had irreversible signs of death was based on her subjective opinion. She could not have known whether or not there might have been a different outcome had CPR been commenced.”
The report also described how, when a first responder reached the care home, Ms Papandrea was asked to assist with resuscitation but witnesses said her chest compressions were not deep enough. Eyewitnesses claimed the nurse had said she “did not want to break his ribs,” before the responder took over.
Ms Papandrea has since acknowledged that her handling of the incident was “a serious error in clinical judgement” in a written submission to the panel.
She said: “I formed a subjective belief that they were deceased and that resuscitation would not be successful. I recognise now that this was an assumption rather than a clinical conclusion that I was appropriately qualified or authorised to make.”
Ms Papandrea was suspended for 12 months, with the sanction due to be reviewed. A separate 18-month interim suspension was also imposed to cover any appeal period. The Maidstone care home was rated ‘Good’ at its latest Care Quality Commission inspection in August 2024.
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