[RoxanRN2003]

Originally Posted by ragingmomster

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.

Unless you know the techs on the EMS crew (and they know you), if you attempted to maintain control of the patient after they took over, most likely, you would end up in 'bracelets' for interferring with the duties of EMS personal (at least on my scene you would). Not to mention, you have no protocols/standing orders to act under. They do. A BSN and 15 years experience doesn't mean squat in prehospital medicine. If you have any doubt, check with your local EMS, as well as your state BON, to see what their protocol is for handling 'bystander' RNs, MDs, and unfamiliar off duty EMS personal. You'll be surprised.

PS...... EMS experience = 18+ years (12+ as EMT-P)

[CrunchRN]

Totally need to hand off to the trained 1st responders (EMS) - I know I would practically kiss their feet for taking over!

[JMBM]

The question is not very clearly drafted. "Good Samaritan" rules are created by state statute and so can be different in each state. In general, these laws say that any person who volunteers their help is immune from a claim that they negligently provided care. You must be a true volunteer. Someone with a duty to help, like an EMS responder, would not be covered. Also, the acts protect the volunteer only from claims of negligence. If the claim is gross negligence or intentional harm, then the Good Samaritan protection doesn't apply. (Gross negligence is usually defined as an act with the knowledge that you are likely to cause harm.) .... Now, the emergency care doctrine is usually considered the same as implied consent. Normally, any person can refuse care. If someone is unconscious, a caregiver is entitled to assume that the patient would want care and would give consent. The rule doesn't really have anything to do with volunteering or not. ..... So, neither rule really "sanctions" care - but of the two, I'd guess that (b) is closer.

[Snow1278]

I have stopped to help at accident scenes a few times, always if there is an accident. I have never had to do CPR thank God! One time at Wal Mart found a gentleman having a seizure on the floor by the litter. I just helped him out until the EMS got there, gave them the information I could and left. I did not have any negative results, but felt better for helping those people. It is difficult when you stop though, because sometimes you never know.

[BillEDRN]

Originally Posted by MereSanity

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.

[BillEDRN]

Originally Posted by MereSanity

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.

[BillEDRN]

Originally Posted by vm56

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

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.

[JMBM]

Originally Posted by neneRN

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.

[Fireguy]

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!!!!!!!!!!!!

[ClaireMacl]

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!

Originally Posted by Dixielee

No, I do not think we can be sued if we drive by a car wreck and do not stop to render aid.