good Samaritan or emergency care doctrine

Specialties Emergency

Published

A nurse comes upon a traffick accident where there are injured unconscious people lying on the highway. The nurse is aware that first aid interventions are sanctioned by:

a. Good Samaritan act

B. Emergency care doctrine.

Thank you in advance for your help.

Specializes in ED, critical care, flight nursing, legal.
Of course if you are driving by an accident and decide not to stop and help and someone recognizes you and says "oh that lady/man is a nurse and they didn't stop to help"...you can get sued for that also. So, I guess you just can't win.

Not true! No state has made it illegal/actionable NOT to provide care, unless you are obligated by prior relationship or job responsibilities. No one, laypersons or healthcare providers, are mandated to provide care to an accident victim that they happen across outside the scope of their job responsibilities. There have been some attempts in the past by some states to pass such a law, but none have ever done so. Some countries in Europe do have such a law that requires others to help, including laypersons, as long as those actions are reasonable and do not put that person in harm's way. Of course those countries provide a high level of immunity from liability when someone is "forced" to rended assistance.

To address the Good Samaritan law of the various states: Each state has it's own version and you should become familar with it if you are going to consider rendering aid in such a situation. In general, these laws provide "an exception to liability" as long as there was no "gross neglience" on the care providers part. Most cover acts of "omission" (you forget to do something)and even outright errors however, you must act within the scope of your training, whatever that level is and not expect "renumeration" (payment). There is also a Federal law, signed into effect by Bil Clinton, that is essentially a Federal Good Samaritan Act. It is mostly applical to airline travel, as the legal concern over providing immunity from liability to those who rendered aid on a plane was, which State's laws were applical to any lawsuits that may have arisen from such action. In other words, if you helped a heart attack victim while enroute from NY to California, which state retained jusrisdiction in the event of a law suit? The State the flight originated from or landed in, or over that state the event transpired?

As far as handing off care to EMS, there are no concerns about abandoment for allowing a lesser trained indiviual (i.e. RN stops to provide care and paramedic responds from EMS). The EMS system retains full control and liability for the patient and can, for example, refuse to allow continued care from a bystander if they feel so inclined. As a former paramedic, I have personally asked doctors and nurses on scene to excuse themselves, and on occasion successfully enlisted the assistance of law enforcement for those who assumed they could ignore my request. Of course when you are acting within the scope of your job, for example at the hospital, there indeed may be genuine concerns about turning care over to a lesser trained individual, such as a paramedic for a transfer to another facility. But that is a whole different situation.

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Specializes in ED, critical care, flight nursing, legal.
Of course if you are driving by an accident and decide not to stop and help and someone recognizes you and says "oh that lady/man is a nurse and they didn't stop to help"...you can get sued for that also. So, I guess you just can't win.

Not true! No state has made it illegal/actionable NOT to provide care, unless you are obligated by prior relationship or job responsibilities. No one, laypersons or healthcare providers, are mandated to provide care to an accident victim that they happen across outside the scope of their job responsibilities. There have been some attempts in the past by some states to pass such a law, but none have ever done so. Some countries in Europe do have such a law that requires others to help, including laypersons, as long as those actions are reasonable and do not put that person in harm's way. Of course those countries provide a high level of immunity from liability when someone is "forced" to rended assistance.

To address the Good Samaritan law of the various states: Each state has it's own version and you should become familar with it if you are going to consider rendering aid in such a situation. In general, these laws provide "an exception to liability" as long as there was no "gross neglience" on the care providers part. Most states cover acts of "omission" (you forget to do something)and even outright errors however, you must act within the scope of your training, whatever that level is and not expect "renumeration" (payment). There is also a Federal law, signed into effect by Bill Clinton, that is essentially a Federal Good Samaritan Act. It is mostly applical to airline travel, as the legal concern over providing immunity from liability to those who rendered aid on a plane was, which State's laws were applical to any lawsuits that may have arisen from such action. In other words, if you helped a heart attack victim while enroute from NY to California, which state retained jusrisdiction in the event of a law suit? The State the flight originated from or landed in, or over that state the event transpired?

As far as handing off care to EMS, there are no concerns about abandoment for allowing a lesser trained indiviual (i.e. RN stops to provide care and paramedic responds from EMS). The EMS system, once on scene, retains full control and liability for the patient and can, for example, refuse to allow continued care from a bystander if they feel so inclined. As a former paramedic, I have personally asked doctors and nurses on scene to excuse themselves, and on occasion successfully enlisted the assistance of law enforcement for those who assumed they could ignore my request. Of course when you are acting within the scope of your job, for example at the hospital, there indeed may be genuine concerns about turning care over to a lesser trained individual, such as a paramedic for a transfer to another facility. But that is a whole different situation.

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Specializes in ED, critical care, flight nursing, legal.
if you drive by a crash site (two or more vehicles acting stupid to cause a crash, no accident) and do not bother to stretch your neck and look, just drive on you will have no one to answer to, but your conscience.

on the other hand, if you happen to look and say "wow there is injuries and that one looks unconscious ..." now technically you have started tx, initial assessment has been done.

now if you keep on driving we could call that abandonment....

what we need is to use common sense and 'just do it!!'

it was just this lack of common sense and worrying about what act, statue, or law we might be treading on that brought the slow to no response to katrina.

a nyway, next time your first thought should be, - can i live with the decision i am about to make? if the answer is yes, then you have nothing to worry about.

just my 2cents:innerconf

sorry to say your assumptions about what constitutes the initiation of treatment is incorrect. simply thinking to yourself that there are injuries and what you might do to assess and treat them is not considered rendering care. besides that, how would the courts prove that you "thought" about said assessment and care? bottom line, if you want to offer aide and can do so safely, and you provide that care without gross neglience and within the scope of your training without renumeration, there is almost no chance that you would have a judgement made against you for doing so. could someone initiate legal action against you, sure. but as someone else has already noted, you can be sued by anyone, at anytime, for anything! it's the ability to indeminify yourself from a judgement that's important and you can do that by acting as noted above and being familar with your states laws.

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Specializes in Emergency.
You cannot be sued if you don't stop, nor can you be sued if you pull over to sit there and watch. And unless you're comfortable/familiar with prehospital care, I don't know why you'd want to. I'm an ER nurse and I don't stop at accident scenes.

You are right. To make a successful claim of negligence, a plaintiff must first prove you had a duty to act. No state holds that a mere bystander, regardless of training level, has a duty to act.

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Puhleeze!!!!!

Stay with the pt to the ER 'cause you can't hand them over to an EMT!?!?!?!

Huhlo, you must not have a decent EMS system there!

I am a lowly firefighter/emt (with over 30 years of experience, despite the limited training the navy hospital corps gave me) and have had doctors hand over pts at an accident because they cannot deal with the pressure of working outside the sterile and controlled hospital environment! And I have had fine nurses who stopped to help and were happy as clams to hand over pts to ems.

In fact, by law, in my district the fire department is responsible (under the county medical director) for all ems; superceding some doc who happens to stop by. I can recall being called to doctors offices many times because, let's face it, an experienced emt has done more defibrilation then most docs in private practice. Not to mention actually being called to the er for a cpr call!

And just for the wind-up, I have stopped to help (off-duty) and been alone, caring for multiple red pts, anxiously waiting for someone to drive by (pre-cell phones, of course) and was very happy to see the volunteers arrive on seen. However, I did not feel compelled to jump in the helocopter and go to the er as I could not surrender my pt to a flight medic!

Gimme a break!!!!!!!!!!!!

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Actually, a UK nurse was struck off because she drove past the scene of an accident in her uniform and someone at the scene wrote down her licence plate!

No, I do not think we can be sued if we drive by a car wreck and do not stop to render aid.
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Specializes in CCRN, CNRN, Flight Nurse.

EMS joke......................

Until proven otherwise, all 'bystander' doctors are proctologists. Never turn your back on them. :chair: :sofahider

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Specializes in CCRN, CNRN, Flight Nurse.
Actually, a UK nurse was struck off because she drove past the scene of an accident in her uniform and someone at the scene wrote down her licence plate!

I would venture to guess things are very different depending on which side of the Big Pond you're on. To my knowledge, that has never happened in the US. The uniform preferred by 99% of employees these days is scrubs. Even the housekeepers wear them!

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i have always been tought in my cpr class that fi you stopped you would bre procted under the goos sermitan act. but as a doctor oe nurse cant you be procted under mal pratice insurance so if you do stop adn help someone and your a lpn or an rn or a doctor. so im not sure if it would be good sermitan or emergency care doctorin.

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Hi Roxan,

Yeah, I think it is different! On a different note to the topic, we had a debate with the hospital last year about the practicalities of ED nurses wearing scrubs and how it would be better for infection control etc only to be told we were going into traditional uniform "to fit in with the rest of the hospital"!

I would venture to guess things are very different depending on which side of the Big Pond you're on. To my knowledge, that has never happened in the US. The uniform preferred by 99% of employees these days is scrubs. Even the housekeepers wear them!
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Specializes in Peds Cardiology,Peds Neuro,Pedi ER,PICU, IV Jedi.
On another note, you could be in deep doo-doo if you stop to offer help and then hand off care to an EMT. If you take the patient (stop for a roadside assist), you stay with the patient to the ER, and hand over care to someone with a larger education than you. Please no flames, my hubby is an EMT and a great one, but as an RN with 4 years education and 15 years experience I can be held liable if something happens to the patient that I handed over to an EMT with 1 year of school no matter how much experience s/he has.

The key here isn't "larger education" but "specialized education"...and EMTs aren't just the band aid toting toddlers they're often thought to be. You would not be asked to hand off care to an EMT, but to a paramedic - who, in this case, is the emergency care expert. He is the eyes, ears and hands of the physician in the field. As for EMTs, in many instances they are highly trained and experienced, especially in areas such as airway management. While many are not trained to intubate, they can perform other procedures and/or maneuvers that are equally as effective. I'd rather an EMT bag my patient than most any other person.

The other thing is to stay within your scope of practice. The Good Sam Act only provides protection for those who do exactly that. If you, in good faith, execute care that falls within your scope of practice, you should be okay.:)

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Specializes in Oncology, BMT, Chemo.
:rolleyes: What I remember from what little legal we had as seniors in undergrad, if you stop to give aid, you are expected to perform at at least minimal standards within your scope of practice. As long as you have done that, you cannot be held liable for any wrongdoing. This assumes you are a licensed practitioner and know your scope of practice.
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