Ok, so let me set the scene and see what you think.
10yrs ago myself and 2 american nurses start at the same time at the same boarding school, with no school experience, just ED. We had no one to show us the ropes, and the headmaster told us we had free reign to do what we see fit.
Anyway, the setting: Ambulance is 30mins away, and the village doctor is away for night, on a rare night off, and so the closest emergency GP was 30 minutes away, which is the same distance as the hospital.
Anyway, we get a call to the gym as a kid is screaming. I get there, and he's landed on his left shoulder, and it is obviously dislocated. We get him on a table, lying face down, and the affected arm hanging off it as it's the most comfortable.
Now, you suddenly realise how alone you are - no x-ray, no doctor nearby, no nothing, except a first aid bag. I call my colleagues and they dash over to lend a hand.
The problem seems like a simple dislocation, and it's easy to see as the kid is tall and skinny, and his collar bone looks ok, but he is screaming the place down. We are about to call the ambulance, when one of my colleagues tells me she has helped put dozens of shoulders back in, and she wants to do it.
I don't know what to say, as it's out of my scope of practice, but the ambulance is 30 minutes away, and by the time the kid get to hospital, that's an hour away, plus I don't relish the idea of driving him screaming in a car down a windy, wet road at night with him like this. I don't know what to do, the kid is screaming bad. So I stand back and watch.
My friend rolls up a sheet, wraps it around his shoulder, and around her waist, and slowly, every so gently pulls, and - pop - the relief is instant. The kid is so relieved.
After assessing the arm/shoulder, we can't see any sign of a break, and he's got a strong radial pulse, and his arm is nice and warm, and he's profusely happy for what my colleague done.
We give him some ibuprofen, a sling, and send him to the doctor in the morning, who congratulates us on a job well done, although does of course do any x-ray to make sure there is nothing broken in there.
To this day, I don't know if we did good or bad. I've discussed it with colleagues and have had people say we did good, and others say we over stepped our bounds.
Your thoughts.... and I hope I've given enough info this time.
