I attend a fairly good size church. Sunday there was a medical emergency, fortunately the person did not need an AED. My church refuses to purchase one due to liability. They are afraid some one will use it without knowing how to. I have explained, so has other nurses and a paramedic about the good samaritan law would protect them.
Anyway, we want to put together an emergency kit, something that would be useful, just in case. But we must do it within the realm of our license, thus no drugs, other than aspirin.
The church does have an oxygen tank, so I want a non rebreather mask, aspirin, gloves, stethoscope, bp cuff. I also thought about making a cheat sheet in the box, for CP and stroke guidelines.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Exactly,
Another thing I forgot to point out, is we do have a MD available as well, so for the 02 use, we would be covered.
Well....you are going to do what you need or want to do. I think you are putting yourself in a precarious situation. I think you should do the very basics. For your liability. Is the MD going to step forward and say he'll handle this? I really think you should reconsider. I am sure that you identified the 911 operator as nurse/EMT/Medic/MD which prompted the vitals question for they normally do not ask the caller's the patients vitals.
Well bless you for your big heart. Tread lightly and carefully but you seem to feel this is the right thing to do. I wish you the best.
Don't count on the MD in your congregation "covering" the orders. He's introducing himself to a HUGE liability if he does, especially if he wasn't present. We investigated this thoroughly a couple of years ago when I was on the Board of my church.
This is not wilderness medicine. Get a pre-prepped first aid kit with bandaids, neosporin, ace bandage, ice pack, a few OTC meds, etc. I would continue to push for an AED. You can use OPA's and a BVM or a face shield without a medical order, and I'd recommend that. Anything else is going to put someone on the line for "who ordered this". For the OTC meds, if they're just made available and the patient self-administers (or a parent administers to the kids) then no medical personnel have given a med without an order.
I am not understanding why taking VS is a delay in calling 911. Person A calls 911. Person B slaps in the cuff and taks vitals. \
As far as your church not wanting to be liable, could you gather the documentation of the good samaritan laws and submit them to the Church? Clergy are not lawyers, so they might not understand how these laws work. Having that AED could save someone's life. Not having one because of an erroneous assumption of liability will be tragic if someone dies because of it. You could also include that they only respond to shockable rhythms anyway. I could slap AED pads on myself and turn it on and nothing would happen unless i was in Vtach or Vfib. Laypersons often don't know how they work. They think it is like TV where the rescuer charges the unit and delivers the shock.
Specializes in Emergency, Case Management, Informatics.
From an ER nurse and from a former EMS standpoint, vital signs prior to my receiving the patient are for the most part of very little importance to me, unless they're coming from EMS. It's nice to have extra data, but it's not something that is going to change EMS's treatment of the patient, your treatment of the patient, or the hospital's treatment of the patient.
If you're going to act under Good Samaritan laws, you need to stay well behind the line that delineates Good Samaritans from practitioners. In fact, the more equipment you have available, the more the law is against you if something goes wrong.
If you have an MD who is willing to be a medical director for your church clinic, then by all means have him/her write up a list of protocols, get a bunch of equipment, and go nuts with it (so long as it doesn't interfere with EMS or delay response times).
If you do not have an MD who is willing to be a medical director with written protocols, you need to decide where you draw the line, and that line needs to be very clearly in your favor if the patient has a negative outcome?
My advice is to go with what others say. Get an AED (cite AHA's resources showing improved outcomes) and stick with BLS supplies. No oxygen. MAYBE aspirin, but the patient should give it to themself. No other drugs.
If the church isn't even willing to get an AED, I doubt they'd be willing to let you have a clinic set-up. Leave it be and call 911.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
I am not understanding why taking VS is a delay in calling 911. Person A calls 911. Person B slaps in the cuff and take vitals. \
As far as your church not wanting to be liable, could you gather the documentation of the good samaritan laws and submit them to the Church? Clergy are not lawyers, so they might not understand how these laws work. Having that AED could save someone's life. Not having one because of an erroneous assumption of liability will be tragic if someone dies because of it. You could also include that they only respond to shockable rhythms anyway. I could slap AED pads on myself and turn it on and nothing would happen unless i was in V Tach or V Fib. Laypersons often don't know how they work. They think it is like TV where the rescuer charges the unit and delivers the shock.
As you continue on your nursing journey to become a nurse you will begin to understand and make decisions yourself. I wish more schools spent more time on ethics and liability.
In a court of law, and I am not a lawyer....just a very experienced RN who has been around the block in the ED/Critical Care/EMS-trauma flight, the law is based on what a "reasonable and prudent practitioner" would do in this situation and what is "usual and customary". The problem with these arguments as they are open for debate and discussion.
A huge portion of the population does not take vital signs when 911 is being called (that is now the standard)....so the "time it takes to take them" to call 911 comes into debate. It can be argued that the time it took to "find the B/P cuff and stethoscope" to take the vital signs, and possibly be heard on the 911 tape....what's the B/P-----Pause, Pause, Pause----when that information means absolutely nothing to the 911 operator....OR...the ambulance/EMT/EMT-P responding. Valuable seconds that can bite you later.
It may seem insignificant on paper but as those moments tick by.....can be interpreted in hindsight as valuable seconds that would have made a difference.
The dispatcher hearing the vitals is rolling their eyes thinking...."Like I really need this information"........the dispatcher relays that information to the first responders and they roll their eyes, look at each other and bust out laughing......"Yeah, like that has anything to do with anything, at least we knowing.....they have a pulse.
If there is a bad outcome and some unthinking person makes the comment.....if only you called a little sooner. All your actions will now be called into debate and scrutinized to see if they involved any delay in treatment that caused deleterious harm to the patient. While you might not be found guilty of "delay of treatment", "incompetence", and "unprofessional conduct" or "negligence" the lawyers, court fees, time spent, court fees, depositions and all else that is a part of this process is personally taxing and financially devastating.
Then if you say "I'm a nurse from xyz Hospital" they can sue you over your confidentially/non compete agreement that you sign upon hiring that you sign at the beginning of employment. For I an sure it says that you will NOT represent yourself for the hospital when you are not on duty but will conduct yourself accordingly.
After you have gone through the courts for the civil liability lawsuit. Your hospital for breech of agreement you will be dealing with your state nursing board for negligence.
Really not worth the liability of taking the time to check the B/P when the only information necessary is whether or not they have a pulse, are they breathing, are they awake, and are the oriented.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
The AED is like on TV.....It analyzes the rhythm. It will tell you whether or not a shock is advised. It charges itself. It tell you to get back. It will shock the patient. Analyze the rhythm. Shock again or tell you to continue CPR. Just like TV....it delivers the same shock as the ones on TV and the hospital.
The question at the end of the day is......will this information, at this time, overall change the treatment of the patient by having this information available......in this setting...right now. If the answer is no...it is not needed. and to do it can place you at risk.
For me.....I'm in public. It looks like someone is having a heart attack. I tell someone to call 911 now. There is a middle aged male sitting on a chair they are ashen and diaphoretic rubbing their left arm and chest. They state they are a little SOB.
The patient is alert I check the pulse....good and steady. To make small talk I ask them for allergies and meds. Has this happened before? do they have a history? If they are diaphoretic...get a cool cloth. Nothing to eat or drink unless you think hypoglycemia or they could use a significant med like their own Nitro. Loosen tight clothing.
I ask if they are diabetic (diaphoresis can be low blood sugar) If they have nitro I will help them administer their own medicine. EMS arrives. I tell them the patient took his own nitro, has a heart history and is allergic to xyz.....they take over and I continue shopping.
That is all that is necessary. I am there in case they go unconscious from a lethal heart rhythm and need CPR performed and pray that EMS arrives soon. Apply the AED if available. That is all the EMS needs and wants.
It is that simple....remember to KISS the patients cheek. Keep It Simple Silly.....
As you continue on your nursing journey to become a nurse you will begin to understand and make decisions yourself. I wish more schools spent more time on ethics and liability.
The poster ahead of you already explained to me why VS are not needed, which I did not know before. If experienced nurses think VS are important, then I think it was a reasonable thing to be confused about. I don't think calling into question my schools ethics standards was necessary.
Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
The poster ahead of you already explained to me why VS are not needed, which I did not know before. If experienced nurses think VS are important, then I think it was a reasonable thing to be confused about. I don't think calling into question my schools ethics standards was necessary.
I didn't call any standards in question. You have completely misunderstood my intention.
I simply made a statement that nursing schools today need to spend more time on ethics and the law for our graduating nurses so they may protect themselves. It is perfectly reasonable to be confused ....you can see by the post there is always more than one side to every story.
I am truly sorry if you were offended for I only meant to help clarify it for you and I really want you to be the best nurse you can be. Nursing is all about gathering information and making the best decision. My statement has NOTHING what so ever to do with your school.
I wish you the best on your nursing journey.:loveya:
Specializes in Emergency, Case Management, Informatics.
The poster ahead of you already explained to me why VS are not needed, which I did not know before. If experienced nurses think VS are important, then I think it was a reasonable thing to be confused about. I don't think calling into question my schools ethics standards was necessary.
I didn't get the perception that Esme was calling your school's ethics standards into question. Esme was just pointing out that the majority of nursing programs do not spend much time on how to protect yourself legally. Between LPN school and RN school, I know that VERY little of my formal nursing education included how to protect myself in various legal situations. I learned most of what I know through self-study and anecdotal data from other nurses and EMS practitioners.
Take a step back, take a deep breath, and don't take it personal. :)
Anna Flaxis, BSN, RN
1 Article; 2,816 Posts
Agree with the others; BLS with AED.