Question... are we supposed to help? Good Samaritan.

Nurses General Nursing

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Hi all. I have a question. As nurses or nursing students, if we see an accident say on the side of the road, are we supposed to help and render medical assistance?? How does this tie in with the "Good Samaritan" Act? We are supposed to discuss this in nursing class tomorrow. I found some info. on the net, but it mostly talked about physicians.

Thank you! E

The Good Samaritan Act was put in place so that people would stop to help in an emergency, rather than passing on for fear of getting sued. The rational being, some help (even without much medical training) is much better than no help. Here's the catch. YOU as a licensed health care provider, are held to the standards of your profession, because you know much more than the average joe. So, if you choose to stop at the scene of an accident, you have to be prepared to deal with whatever you find there. Example: I came across a MVA, T-bone mc vs. auto at high rate of speed with massive DSI to the auto, where there was no EMS on scene. The mc rider, obviously really hurt, altered, combative, obvious extremity deformities, bleeding everywhere, the works. Some poor well intentioned woman, was trying to remove his helmet. I just had to stop. I stopped the woman from removing the helmet, and introduced myself as a nurse. By doing this, I had just assumed responsibility for this accident victim and the victims in the car until relieved by EMS. I work trauma, and it's terrifying being there with no equipment, and just the ABCs, because let me tell you, i wasn't about to do open mouthed CPR on this kid's bloody face.

I'm not saying not to stop. I'm simply saying that if you do, be prepared to deal with whatever you find, and see it through. Because if EMS hasn't arrived, you're in charge and responsible. As long as you do everything to the best of your professional knowledge and ability, the Good Samaratin ACt should protect you. If EMS is already on-scene, you shouldn't stop! You are just another source of traffic, and they probably don't want or need your help. And come prepared! My car now comes equipped with a fully stocked emergency pack. Just in case!

Specializes in Med Surg.

I commute to work on a highway that has accidents pretty frequently. Whenever I stop, so far I've found that it's really not too difficult to just keep all of the victims safe until EMS comes. The hardest part is keeping the ones who aren't hurt and want to get out of the car to sit still. I look at each person involved, decide which one needs my attention, and then grab the calmest people out of the inevitable crowd and tell him/her to watch the other victim, keep him calm, and get me if he needs help. I also keep emergency stuff in my car.

By the way, hckyrox, love your name and agree totally :)

My understanding of Good Samaritan law is that you cannot be held legally responsible for not stopping and helping. If you choose to stop and help, you have to perform at the expected level of medical professional, as others mentioned.

Specializes in Emergency room, med/surg, UR/CSR.

In all fairness to krys who said she would glady step over you etc. I kind of took it as a joke, I'm going to give her the benefit of the doubt that she was kidding. That being said, I agree with Trauma, when I was working on the ambulance and I was on the scene, I had no desire to have anyone trying to help that didn't know what they were doing. Working an accident is a lot different than passing meds to stable patients. I didn't want some Ronnie Red light stopping and getting in my way just because "they were a nurse or a nursing student" and had never took care of an accident victim. On a side note, I did have an ER nurse once who stopped to help at an accident scene, I knew her, she knew me, she was closest to the patient so I let her start an IV for me. Talk about getting grief over that!!!! Other EMS personel were on the scene and were mad because I didn't shove her out of the way and ask them to come over and start the IV. Can't win for losing sometimes I guess.

On a side note, I don't stop at accident scenes because I don't have any type of gear in my car to help at all. no gloves, nothing. Oh, I guess if no one was there I probably would stop to see if there was anything anyone needed, but everytime I have come on an accident scene, police are always there, so I don't get in their way, either that or they victims are standing outside their cars already on their cellphones. I will call 911 as I drive by though if needed.

I get mad at my husband because when we come up to an accident scene he will stop and identify us as nurses and himself as an ER nurse. Again, we don't have any type of equipment in our car, so who gives a rip if we are nurses? As someone else said, if you do stop, don't tell them what you are.......I'm too nervous about the sue happy society we live in. It's bad enough to worry about the patients and family members that I take care of for a living suing me for something I did, didn't do or did wrong that caused supposed harm. As far as I'm concerned, if you have no equipment to use to assist the ill or injured then you are just another bystander, not a nurse. If you stop to help great, but if you don't then that's fine too, it's your call. At least call 911 if there is no one there and make sure help is on the way.

I guess to address the OP, I don't think you are under any obligation to stop. And I don't think legally someone could sue you for not stopping unless they happened to know you were in healthcare and caught your license plate number, but the odds of that are slim to none. I don't know if they could even sue you then.

Oh well. Just my two cents.

Pam

Why are people always so afraid of "being held to a higher standard"? Aren't those standards reasonable?

If someone tries to do a field tracheostomy with a pocket knife and a straw like they saw on TV, THAT would be irresponsible. If a nurse did this, even having been trained in the limitations of their practice, it would be worse than if a layperson did it (though dumb for either) and the nurse should be "held to a higher standard." You're not going to do something dumb like that, are you?

Specializes in Oncology, Orthopaedics, Med/Surg.

okay, i guess there's no better time than now for my honesty to flow here.... i have to admit, i've come across a couple accidents since i've been a nurse (two maybe, i live in a really small town), and to be honest.... i froze right up, got scared out of my wits as to what i might find being the first on the scene, and just kept going. they weren't major mva's or anything, but still, twice i was the first one that came up on the accident and didn't stop because of my own fears. now, i work on a med/surg floor, and am completely confident in my abilities as a nurse there, and trust my instincts and judgements completely..... so, could someone tell me why i get so terrified when something happens outside of work that causes me to panic and keep on going?? it's very bothersome to me, this fear....

If it's a conscious adult, you'd probably want to get their consent first. 'Hi, I'm George, I'm a [emt, nurse], I'd like to help, ok?'

The other thing I remember from EMT class is if you do decide to help, don't leave until you're relieved by other EMS.

With all due respect, I'm not at all certain this is right. :uhoh21: f the person is conscious, yes, you should say "Hello, I'd like to help you if that's ok." Do NOT tell them your status. They don't need to know that and you open yourself up to trouble. Tell them you're an angel, tell them you're Mother Teresa (just kidding). But don't tell them you're a nurse or student nurse.

BTW, I have the highest regard for Mom Teresa and wish I could devote my life to others as she did, so please no one take offense. :uhoh3:

However, I'm not sure consent is needed. An emergency exists, therefore, consent might be implied, just as it is implied when someone enters the ER. Your presence there is all the consent needed for staff to treat you, at least if you are unconscious or conscious but dazed, stunned, or somehow otherwise not quite yourself. So I have been taught, anyway.

Again, though, we are not lawyers here and we really need to ask these questions of attorneys in our own states, as the states can differ on these and other issues.

To the OP: we just had a continuing education inservice on a particular topic at my job. The 2 nurses teaching it knew no more about it than I did and my knowledge was limited. I asked a couple of questions that they could not answer and they got aggravated and embarrassed. I knew I had to back off or face their ire. My point is that, so often, those who are teaching us do not have a full command of their subject. I'm not trying to be critical, as I have occasionally taught nursing students and it is very hard to be up in the front of the class. Students chattered, I didn't know the technology for the slide presentation, one student c/o that I was just reading the book to them, others were upset about not being able to hear me because of the chatters, who I had to warn twice then put out, and then worried that I'd be in trouble for putting them out. I was not a master of my topic or of teaching, although I did know more than my students. Still, I felt that I was short-changing them.

Sorry about the aside. Anyway, OP, I suggest you get the full scoop from 2 or 3 attorneys in your state, perhaps those who handle medical and nursing malpractice cases and perhaps those who handle criminal matters. :idea:

Specializes in ICU-Stepdown.
Why are people always so afraid of "being held to a higher standard"? Aren't those standards reasonable?

If someone tries to do a field tracheostomy with a pocket knife and a straw like they saw on TV, THAT would be irresponsible. If a nurse did this, even having been trained in the limitations of their practice, it would be worse than if a layperson did it (though dumb for either) and the nurse should be "held to a higher standard." You're not going to do something dumb like that, are you?

JJJ, The reason that folks are afraid of that 'being held to a higher standard' phrase is because there are too many lawyers who are willing (hell, watch late-night TV, or noon-time TV and you see the ads practically BEGGING you to sue anyone and everyone if you THINK you may have been injured due to no fault of your own etc etc etc). Can you honestly not understand why professionals are afraid to render aid outside of their own settings and facilities?

Lets all keep in mind, however, that this "higher standard" sounds much more impressive than it is. As a nurse on scene, you aren't expected to start IVs, or do some kind of invasive procedures or anything advanced like that. Basically all it REALLY means is that you shouldn't do something stupid -if a regular civilian steps up and removes the helmet or yanks momma from the car and turns the patient into a quad, they weren't acting in a manner contrary to their training (which was none) -if YOU do the same thing, you should have known better and will be held accountable for your pinic-induced stupidity ;)

But the fear to act is directly attributable to the fear of being sued. We live in a time when people will sue because they received a SCAR after surgery, when they thought they would have none, or that it wouldnt be noticeable.

People walk into puddles at the grocery store, slip, fall, and sue sucessfully. No personal accountability.

:eek:

My god....I hope I am never YOUR patient. :uhoh21: WHY are you a nurse and WHO made you so bitter?!?!

I understand why someone might not want to stop due to sue happy people, but to say "I might be nice and call 911".

Are you serious? Calling 911 does not put you at risk of being sued. Why woul dyou only say "might" call them for you? It just seems odd for a nurse to say something like that. Just my opinion....

I totally understand being afraid of being sued for ridiculous things and not wanting to get involved for that reason. I was asking about the fear of "being held to a higher standard." I was involved in another thread that warned against licensed nurses working 'below' their licensure, for example as an nursing assistant, because they'd be "held to a higher standard" and if something went wrong they'd be held liable as an RN. I didn't get any good examples, though, just repetition of "don't do it; you're held to a higher standard; if something goes wrong, you'll be accountable for it even if it's outside the scope of a nursing assistant."

Specializes in Hospice.
With all due respect, I'm not at all certain this is right. :uhoh21: f the person is conscious, yes, you should say "Hello, I'd like to help you if that's ok." Do NOT tell them your status. They don't need to know that and you open yourself up to trouble. Tell them you're an angel, tell them you're Mother Teresa (just kidding). But don't tell them you're a nurse or student nurse.

BTW, I have the highest regard for Mom Teresa and wish I could devote my life to others as she did, so please no one take offense. :uhoh3:

However, I'm not sure consent is needed. An emergency exists, therefore, consent might be implied, just as it is implied when someone enters the ER. Your presence there is all the consent needed for staff to treat you, at least if you are unconscious or conscious but dazed, stunned, or somehow otherwise not quite yourself. So I have been taught, anyway.

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I'm not sure I agree with all of this. It's my understanding that touching someone without their consent is battery (unless it is someone who is unable to provide consent for themselves). Also, part of informed consent is telling that person your training.

I'm wondering though, would it be acceptable (legally) to just state that you have training in first aid?

Specializes in CVICU.

In regards to being held to a higher standard - I can't site any example other than the nurse practice act I had to read last week (yes I'm a student, and yes I plowed through the whole thing and every regulation I could locate). I'm sure this varies by state, but in VA the practice act states specifically that we will be held to the standards of our license regardless of the activity we're engaged in.

In regards to consent on the scene and implied consent, I'm also a released Ambulance AIC/EMT and I can tell you that we are required to obtain written consent from all patients unless they have altered mental status. All alert, oriented and competent adults who are not intoxicated have the right to refuse care even in life threatening situations, and they must be given an opportunity to do so (MI's routinely refuse to go to the hospital and we can't force them even though we know they're going to code any minute). Treating them without consent is technically considered battery and you can be sued for that too!!! If they are unconscious or disoriented or they are an unaccompanied minor (parent is dead in the car...) then implied consent applies. If they are intoxicated and refusing, then we have to call in law enforcement to compel them to go to the hospital.

I do stop at accidents if there is no EMS currently on the scene although I have no legal duty to do so, and I could not be held liable for not doing so. I think only one or two states(Vt and maybe one other) have laws that obligate trained medical personnel to stop and help. There is definitely risk involved though. The Good Sam laws will give you and your lawyer some legs to stand on but they may not keep you from having to defend yourself and your license in court. You may be put under the obligation to prove that you did what a reasonable nurse would have done under the circumstances and that you did not cause any harm. After all, what is the suing pt's lawyer going to assert? ... that you DID something outside your scope of practice or that you FAILED to properly establish the airway and were thus incompetent ........

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