Accident Scenes: Do You Always Offer Assistance?

mscsrjhm · Jul 7, 2004

The Good Sam Law (in my state) may protect us somewhat but can be overturned if we accept a reward or payment for professional services, then we will be held under higher scrutiny. A famous case here in Texas which is used in legal seminars is the nurse who allowed family members to pay for cleaning of her uniform soiled while assisting at an accident scene. She was succesfully sued later for some attorney concocted lapse in professional duty at the accident scene. It involved less than perfect immobilization of a fractue and apparently the attorney proved harm was caused by her negligence. So...be careful out there nurses.
We must know we take a risk if we stop but we do have to follow our own consciences and live with ourselves if we walk away too. I tend to leave accident rescue to the professional EMS and police whenever I can personally. Not to say I haven't helped, but I am cautious.

They tell us alot of things in nursing seminars. You are right, gotta think for yourself.

hypnotic_nurse · Jul 8, 2004

The only ones I stop to help are the barking, meowing, tweeting variety of accident victims (and actually, those are the only kind I've ever run across).

teeituptom, BSN, RN · Jul 8, 2004

What if I passed out on the golf course and my body was in your way?

By the rules of golf I could take a drop and play a round you

ICUnowOHN · Jul 8, 2004

I always stop. I can't NOT stop. And it seems like I'm always right in the right place at the wrong time. I have begun carrying a "JumpKit" with me in my car. I have had cars flip end over end across the median and land in front of me. I have had a van with a 30 foot trailer attached, roll and slide across 3 lanes of interstate right in front of me. I was the first one that stopped that had any medical training. I just provide the best care I can until the 'medics arrive. I never enter a scene that isn't safe, I have a wife and 3 kids to consider. I don't usually stop if there is already EMS/Fire Rescue there. I sometimes ask if they need any more help. I would hope someone would stop for me if I needed help. I don't do anything beyond my scope of training, and I have my own liability coverage. That may not be enough protection, but, I can't NOT help. I'm a nurse. It's not just a job, it's who I am.

RN4NICU, LPN, LVN · Jul 8, 2004

I see by the wife/kids reference, you're also a man. That protects you a little (but not completely). We had a problem in the area a few years back with staged "accidents" used to lure abduction victims...they were abducted by the "victims" of the apparent accident when they stopped to help. These people were later found dead - raped, mutilated, etc. The local news media was urging citizens to call 911 and move on when coming across an accident scene. Unfortunately, sickos are more and more common these days.

DG5 · Jul 20, 2004

I don't usually stop - there always seems to be someone like another nurse or doctor there at the scene, but you can't help stopping to help if its a life and death situation. I heard a crash outside my mom's house. A car had gone through the wall. There was a young man inside bleeding profusely from his brachial artery in the arm. I just had no time to think, I had no gloves on, nothing and I put my fist in the hole for the 45 minute wait for the ambulance. It was excruciating watching this guy losing so much blood, wondering if he was going to live or die. I just kept on talking to him, the ambulance was so late! Only after the adrenaline stopped pumping did I have these awful worries about exposing myself to Aids, etc. It was scary. It was onlly afterwards also that I learnt I was pregnant at the time. When I went to see my gynae, I asked him to do an Aids test at the same time. His office assistant phoned me up to say "your test is positive" I nearly collapsed with fright. But she went on to say, "Oh, sorry, I mean, your pregnancy test! The other one was negative." I will never stop at a scene again and put myself at jeopardy like that again if I can help it!

Ruby Vee, BSN · Jul 20, 2004

When Hubby and I lived in Seattle, we got on a plane at Dulles, headed home after a week in DC. As we were waiting in the boarding area, we ran into a physician we worked with and had a nice little chat. He (Ric) was sitting about five or six rows ahead of us on the plane. Two rows ahead of us was a gentleman in African garb who was coughing and hacking quite a bit. All we could see was the back of his head, really.

The flight attendant made an announcement that they were looking for a doctor on board, and as Hubby and I slid down in our seats to look inconspicuous, we saw another flight attendent stop next to Ric's seat. Next thing we know, he's sliding into the seat next to the coughing guy -- where he stayed the rest of the flight, administering oxygen, holding the guy's head while he barfed (who knew a physician could do that?????) etc. Every once in awhile, he'd catch Hubby's or my eye and smile this exasperated little smile -- but he never asked us for anything. (If Ric had asked us for anything, we would have been there in a flash!) When we got to Seattle, we had to wait for the medics to take the guy off the plane before we could leave.

When we got home, there was a little message on our answering machine inviting us both to report to the ER on our way to work to be screened for SARS. It was the beginning of the SARS epidemic, and we were scared silly for a couple of weeks. All OK, though, and Ric got a free flight to somewhere tropical for his trouble.

I still won't volunteer unless it's obvious that there isn't anyone else with medical training.

At our old church in Seattle, there was one woman that went down during the service a few times. On each occaision, there were people vaulting over the pews to be the first one to get to her to help, and 911 claims the congregation jammed their switchboard calling it in. There are usually others there with arguably better training (I'm an ICU nurse -- what good am I without my technology?) and far more eagerness to get involved.

Ruby (who has a distinct memory of a young nurse shaking the poor woman and shouting ("Annie, Annie are you OK?")

MrsWampthang, BSN, RN · Jul 20, 2004

By the rules of golf I could take a drop and play a round you

:rotfl: :rotfl: :rotfl:

MereSanity · Jul 20, 2004

This has probably already been addressed (I only read some of the threads), but here goes anyway...The legal considerations of being an "off-duty" professional rescuer include...

-A duty to act... (applies to public safety officers too), failure to adhere to this duty could result in legal action.

-Standard of Care...including providing care according to your level of training.

-Negligence...If you do not follow the standard of care or your failure to act results in someone being injured or causes furthur harm you may be considered negligent.

etc, etc.

There are Good Samaritan Laws that help protect people willing to give care (check laws in your state).

Guess there is more responsibility with this job than we thought. I completely understand though that sometimes we don't want to have to be "the one" to take the responsibility when all you want to do is mail a letter (or whatever). :uhoh3:

Had an interesting experience when I took my sister and BIL to Portland International this morning: as I was pulling into the terminal, we saw a woman lying on the ground with several people standing around, looking frantic. Of course, I'd rather NOT have to be a nurse on my days off, but there were no EMS around, and these people looked like they had no clue as to what to do, so I jumped out of the car and ran to the scene. The poor lady, who was of indeterminate late middle age, had just been pinned between two cars and had sustained probable crush injuries from the hip to the knees....it didn't appear that she'd lost much blood, but as I assessed her she started to shiver violently and I knew right away she was going into shock---her pulse was rapid and thready, and she was beginning to fade out. There was a bystander who volunteered his recently-acquired CPR skills if needed, so I knew we could keep her going if we had to, but at the same time I was hoping we wouldn't have to!
So I yelled for someone to find me something to cover her with, and luckily another bystander had a couple of fleece blankets in his truck.....otherwise, there wasn't much I could do for her except hold her hand and keep her talking, and thank goodness someone had already called EMS, because they got to the scene about two minutes after I'd arrived and took over from there. Now I'm back home, hoping she's OK, because she was beginning to look pretty bad just before the paramedics got there..........and I'm wondering, does everybody here feel that being a nurse requires them to assist at accident scenes, or whenever they see someone in distress?
I don't mean when there's an ambulance on the scene and the REAL experts are available---I figure the EMTs are a whole lot better equipped and better trained in emergency situations than I am---but when it's obvious someone is in trouble medically and you can't tell whether anyone at the scene is trained to deal with it? I wanted nothing more than to get my people to the terminal---we were running late anyway---park my car, and get some lunch before they had to board, but I just couldn't NOT stop to see what was going on and try to help.
In these lawsuit-happy times (despite "Good Samaritan" laws that help protect first responders, nurses are still held to a higher standard than the average guy-on-the-street), I'm always nervous about treating strangers, even though I've rarely had occasion to do so. But again, I can't just walk away......and yes, I have to admit it made me feel pretty darn good to leave a scene knowing I've helped, if only a little. :)

rjflyn, ASN, RN · Jul 20, 2004

...The legal considerations of being an "off-duty" professional rescuer include...
-A duty to act... (applies to public safety officers too), failure to adhere to this duty could result in legal action.
-Standard of Care...including providing care according to your level of training.
-Negligence...If you do not follow the standard of care or your failure to act results in someone being injured or causes furthur harm you may be considered negligent.
etc, etc.
There are Good Samaritan Laws that help protect people willing to give care (check laws in your state).
Guess there is more responsibility with this job than we thought. I completely understand though that sometimes we don't want to have to be "the one" to take the responsibility when all you want to do is mail a letter (or whatever).

Im going to disagree here. Typically one unless you are on the job you have no duty to act and stop at an accident scene, unless you are involved in said accdident. How are they going to know your a medical professional if you don't tell them. Hence I dont advertise the fact all over my car like some people do- found this to be mostly newbies in my experence. The standard of care is not ever going to be met unless one is working as most often its illegal to practice as a medic unless one is on the job, as far as nursing goes 90% or better are going to be totally out of their environment. No offense but I dont want a nurse who has worked in a LTC for 20 years who has no idea about trauma caring for me at an accident scene, exeept maybe to stop bleeding- ive seen said nurse pull a person from a car because the thought they saw smoke- more often its just steam from the radiator.

You did get the Good Samaritan part right, being that you might get sued but these law should protect you unless you start doing things you know you shouldnt be doing. :rolleyes: Rj

MereSanity · Jul 20, 2004

PLEASE DO NOT REVIVE THIS THREAD...I am allowed to have my opinions.

This information came out a the "Legal Considerations" chapter of a Professional Rescuer book put out by the American Red Cross. It says that you open yourself up to lawsuits if you do not stop. How do you know that your neighbor "Bob" didn't just happen to see you drive by and mentioned it to someone after the "victim" ended up brain dead because there was no one to give adequate care before help arrived? Two weeks later you get a summons for "Failing to render care resulting in injury". You just open yourself up to these things if you do not stop. And, of course, the "standard of care" differs if you are standing by a ditch trying to give someone mouth to mouth or working in a hospital setting. The US Department of Transportation states this standard of care to be...communicate proper information and warnings to help prevent furthur injuries, recognize a person in need of care, attempt to rescue a person needing assistance, and provide emergency care at your level of training. It does not require you to perform miracles like you had an ER at your disposal. That is all I am saying and that is why I quoted part of this chapter. Not trying to get an arguement going. I guess everyone makes up their own mind as to what they will do in this situation. I just hope that if my child is dying on the roadside a person with an ethical conscience passes by. And I would rather have some 20 year LTC nurse (or even a newbie) working on my child than some lay person that barfs at the sight of blood.

Again...not trying to fuel an arguement...just my opinion. Hope I didn't revive this thread trying to express my opinion. And God bless the over zealous newbies! Otherwise who else would pull over? The crusty, bitter, "oldies"?

Im going to disagree here. Typically one unless you are on the job you have no duty to act and stop at an accident scene, unless you are involved in said accdident. How are they going to know your a medical professional if you don't tell them. Hence I dont advertise the fact all over my car like some people do- found this to be mostly newbies in my experence. The standard of care is not ever going to be met unless one is working as most often its illegal to practice as a medic unless one is on the job, as far as nursing goes 90% or better are going to be totally out of their environment. No offense but I dont want a nurse who has worked in a LTC for 20 years who has no idea about trauma caring for me at an accident scene, exeept maybe to stop bleeding- ive seen said nurse put a person from a car because the thought they saw smoke- more often its just strem from the radiator.
You did get the Good Samaritan part right, being that you might get sued but these law should protect you unless you start doing things you know you shouldnt be doing. Rj

mattsmom81 · Jul 20, 2004

I don't necessarily have a 'professional duty' to anyone unless I have accepted that responsibility. Now...at an accident scene, once it is recognized you are a doc or nurse AND if you lay hands on them, THEN you have a professional duty. Putting your hands on a patient in a facility or out can be construed as accepting responsibility and constituting a duty legally. Which is likely why the paramedic in an earlier post chose to give a card to the physician responding to an accident scene...a card saying the doc would need to accompany to the hospital if they chose to stay....not speaking aloud gave the doc the opportunity to decline duty if he hadn't yet announced he was a doc and hadn't touched the patient.

After we've been in this field awhile we tend to get a bit jaded after we've watched goodhearted coworkers screwed for their good deeds. No matter how 'nice' you are at an accident scene...people tend to forget later and become critical if the outcome is not perfect. And there's always an ambulance chaser to help point that out.