Should I Have Stepped In?? - page 3
So last night right as we were about to fall asleep we heard what sounded like fireworks outside our apt. Then we heard people screaming. We thought it may have been gunfire since we also saw the... Read More
Mar 23, '07If the officers were putting up the crime scene tape (and I'm going to base this on my 10+ years of law enforcement experience) there was nothing left to do. Police are trained in CPR and they carry protective equipment. The injury was probably to the point of it being an obvious death which is why none of them were doing CPR.
And.....I'll just add my 2 cents here - your safety far, far, far outweighs anything else. There is a HUGE difference between stopping at a car accident to render care and rendering care in the middle of a gang related gun battle in front of your house.
Mar 23, '07No one can tell you if you did the right thing or not. They can only guess if they may have done the same. Only you can decide and it sounds like you choose correctly for yourself at that time. Do not doubt what you did. Believe me, I'm a second guesser and it will eat you alive. Your instincts told you something your heart did not. Listen to your instincts.
When I first saw your post, 'scene safety' popped into my head. There was no way you could of known if the other man walking around was the one who did the shooting or even the family member could have been the one. PD's mind may have been in the same place, the safety of themselves and their partners comes first. I can only guess, but had you gone into the scene, PD would of turned you away. Because they would have had someone else to look after. On a violent and confusing scene that's not something they want to be responsible for.
Trust your actions and yourself. :icon_hug:
When you step out of the relatively safe "walls" of med/surg and geriatrics, and step into a situation you have no training or experience in, I'll respect your GUESS a little more. A car accident and a shooting are two very different situations. A shooting is going to make the safety voice in my head scream a lot louder then a wreck, period.
Also, just because PD is there does not mean it is safe. I have had a patient force me into a locked room with them alone, while PD watched. This patient had called because they were having homicidal thoughts. Because they were not under arrest PD did not search them. I had no idea what this person was capable of and I was cornered in a room with them. PD was close by, this patient was in my dominion, I was not in theirs, I thought I was safe. I was proved very wrong. I was lucky a very scary situation ended with only me getting a big lesson.
My lesson for you is; Don't belittle how someone feels or acts if you were not there or if have no experience similar to the situation.
Mar 23, '07Quote from firefightingRNIt's my understanding that law enforcement are never supposed to give first aid or cpr due to possible litigation. They call for the ambulance and secure the scene until they arrive. I'm not sure if this is 100% true in all states, but that is what I have been told by officers in my area.As I read the scenario there the only thing i could think was "scene safety". Given the fact that there was a shooting there, a crime scene and the whole bit, i can't say i blame you for not running out there. It may not have been safe for you.
Police are by and large cpr trained and if there was a true concern i am positive that they would have been administering cpr instead of processing the scene.
You have no duty (legally) to act unless you have been delegated /assigned that patient or scene. You may ethically feel like you need to do something, but that is a different situation.
Mar 23, '07Wow...a lot of big emotions on this one! Let's not get carried away with pointing fingers. OP asked for an opinion that's it. Jill gave hers, if you don't like it then post your own, but don't belittle other's opinions, it defeats the purpose of the board.
My opinon? I don't know what I would do. Blood I can handle, gun shots is a different matter...scary stuff. I guess I would revert back to my CPR training...scene assessment "no gas no glass no fire no wire no crazy that might shoot me". So, the police have enough on their hands without a dead nurse to deal with too...
my two cents.
Mar 23, '07I don't think I would have intevened. Even though law enforcement was there, it doesn't make the scene safe. I've spent time waiting in the ambulance while the police put up crime tape and totally clear the scene of everyone except victims and law enforcement before EMS is allowed in. Until I have confirmation on the radio from the LEO in charge, that the scene is safe, I stay put. The last thing LEOs need is an extra person running around their crime scene to either contaminate evidence or become another victim because the scene was not totally secure. Also, they are going to be looking for familiar faces to render aid...they probably aren't going to let people they don't know (or at least can't identify as part of the rescue team) anywhere near a shooting victim. I have gloves, goggles, barrier masks, and a BVM in my car, but I don't go running in to a crime scene until I know I am safe...and the mere presence of police does not make a scene safe.
Here...the police are trained in CPR and do intervene as needed, but again not until the bad guys are secure.
I think you did the right thing...
Mar 23, '07I will say that there's a difference between the police who have been trained, and someone in the medical field. Sadly many police officers who may be trained might also not have the medical compassion that nurses would. I sadly know some police who might not care to try and save someone if they were poor or an "unfavorable" color. (not my feelings, other people's)
I think it's very normal to feel overwhelmed and fearful, but I would take it as a learning experience and try and offer assistance next time you are faced with an emergency.
Mar 23, '07What a situation! Fear gets to all of us sometimes. Upon assessing safety, I probably would've gone down myself. Even introducing yourself as a nurse or lending an extra set of hands is enough: if you aren't needed for anything, they will tell you. As cotjockey mentioned, ask someone BEFORE you cross the crime scene line. I don't believe that you should've stepped in and done CPR willy-nilly, but I do think it would've been prudent to at least state your availability to help.
Quote from AirforceRNIt's one thing to post a differing opinion from the majority, but to tell the OP she "should be ashamed" when OP is clearly already torn and labeling her a "coward" goes beyond stating contructive criticism. That's tactless name-calling.Wow...a lot of big emotions on this one! Let's not get carried away with pointing fingers. OP asked for an opinion that's it. Jill gave hers, if you don't like it then post your own, but don't belittle other's opinions, it defeats the purpose of the board.
Mar 24, '07As an EMS provider, I usually don't want the extra set of hands unless they are properly trained. There is nothing more frustrating than having a CNA from the local assisted living or an RN who works at family planning trying to get involved in patient care or questioning my care. I'm not saying CNAs or family planning nurses aren't wonderful, but they have their place...and unless they have emergency training, a scene involving a GSW just isn’t it. Too many people assume that because you are a nurse that you can handle all situations and it just doesn't work that way. I don't know anything about family planning, but I can work a trauma with the best of them.
There is nothing wrong with offering to help, but to be honest, more often than not, unless it is a huge scene that we are going to be on for a long time, people who are not a regular part of our team are often more of a hindrance than a help...especially when tension or emotions are running high. If you want to get involved, take an EMT class or offer to help out at MVAs, when people choke in restaurants, or when little old ladies fall down the steps at church. Leave the violent scenes and the dangerous scenes and the crime scenes to the professionals. This scene just sounds too volatile for anyone who doesn’t HAVE to be there to even try to get involved.
We have a logic behind what we do, who we treat first, who we treat last, and who we simply do not treat at all. It is not based on compassion, but on the better good for the better number...and no one I know whether nurse, doctor, EMT, LEO or whatever would simply leave someone for dead.
I know this sounds pretty terse and I apologize for that…Last edit by flashpoint on Mar 24, '07
Mar 24, '07Quote from jill48As the daughter of a police officer, parent of a police officer and the MIL of a former vice officer, as well as a dedicated gun owner, I say:She said the police were there. Is that not safe enough for you all?
HECK NO, IT IS NOT SAFE ENOUGH!!!!!!!
I have had loved ones go into "safe" situations, and washed the resulting blood stains out of their clothes/destroyed the bloody uniforms in the aftermath, or visit them at the hospital.
A helpful bystander can become a victim way too easily
If one wishes to offer to the police on the scene from a distance, AFTER major dust has cleared, "Hi, I am training in health care and know CPR, can I be of assistance?", that is one thing. Otherwise, stay out of the way.
The last thing anyone needs is another body in the street to process.
Not to mention that often the injured may also have weapons on their persons or dangerous items in their pockets. And their companions can also pose a danger.
While I have done CPR outside the hospital, going into the site of a shooting has other hidden dangers to it that I would hesitate to risk.
Mar 24, '07:angel2:Quote from jill48I agree if there is something you can do as a NURSE!!! to have helped then yes she should have helped. I was not there so I don't know nor do we know all the details of the situation ..But take it as a learning experience and move on. Remember there are not always going to be protective equipment around for you can use to protect yourself you may not always have gloves on hand as you are tought to wear in school but there are items you can get by with using. I think at one time or another eveyone as a nurse has been in some situation where we have stopped to help a bystander. I always seem to be on vacation with my children when this happens to me. I have done CPR and helped stop bleeding on a person when I was on vacation with nothing around but if I did not step in as a nurse and provided the care CPR that I am trained to do , I know the lady would have died right there in front of her family and my children. we don't always have an emergancy bag within reach. But as Nurses we are trained to provide first aid and work within our training to help people.Yes. I HAVE come upon situations and pulled over my car and got out and walked up to the police and offered my help. I WOULD lose sleep if I could have helped, but didn't. r. Gimme a break!
Mar 24, '07Quote from jill48She said the police were there. Is that not safe enough for you all?
Actually no. As I said earlier I've run EMS for 7 years or so and have been in some very similar situations. I know of at least 2 cases where the police felt they has secured the scene after a shooting only to have the shooter return.
In one case the shooter jumped out of the closet of the apartment and shot the EMT on scene dead. He was the only person in the room because the police had already "secured" the scene. In the other, a shooting victim was being loaded into the back of an ambulance when the original shooter walked up to the stretcher and shot the victim in the head. These are rare but not unheard of instances. For a different kind of personal danger, a nurse I worked had contracted Hep C after doing mouth to mouth on a 12 year old that had hit his head on the side (open wound) of a pool and nearly drowned, his parents hadn't told anybody that he was infected.
I understand your anger over leaving a patient that could theoretically be saved and I applaud your courage and pulling over at accident scenes to help, however, in my opinion, personal safety is first and foremost. Can you honestly tell me that you'd be OK with being shot or contracting, say, HIV just so you can say you were being a hero? As nurses we're always thinking 2 steps ahead. EMS is no different, but safety for ourselves and other rescuers is always most important.
Mar 24, '07The OP also said she actually NEVER had to do CPR. This scene was NOT a good time for her to do her first one. Not at all.
I as a seasoned nurse, having done many rounds of CPR wouldn't have gone into this scene. It's too unsafe. She's too green. That's just common sense.