RN responsibility--how far do you go in being a first responder?

Nurses General Nursing

Published

  • Specializes in PACU, presurgical testing.

Two situations occurred today that made me start to wonder exactly what my responsibility is, now that I have my RN license, in the event of an accident, etc.

First, I saw a woman slumped over on a bench in town, but firefighters were already there checking her out (they are typically the first responders in our town and have AEDs and such on their trucks). Then this afternoon, from my home I heard a car collision somewhere outside the neighborhood but not that far away. Within 2 minutes I heard sirens, and it turns out that the accident was on a main road near my house..

I know that states have laws about professional responsibility--i.e., if I had seen the woman on the bench before anyone came to treat her, because of my RN license I would be expected to do so. If that had been the case today, I would have immediately assessed her and called 911 as needed. Similarly, had I been in the vicinity of the car wreck, I would have immediately called 911 and gone to help the people involved in the accident. But where is the line? Should I have gone over to see what I could do for the woman on the bench once the first responders were there? Should I have thrown my kid in the car and driven in search of the accident? Was I wrong to assume (turns out correctly) that at rush hour there would be hundreds of cars going by who could call 911?

I am eager to help and would do so in any case where I was needed. I just wonder what people's experiences are with this sort of thing or if anyone knows how to get info about it. Thanks in advance.

xtxrn, ASN, RN

4,267 Posts

I'd been out of school for almost a year, and was having lunch with my Mom on Easter at a popular restaurant...at the table across from ours, one of the 4-5 people sitting there was slumping over...nobody at her table was doing anything :eek: I kept watching, and her color started to change. Still, nothing from the "friends". So, I went over there and helped her to the ground (the 'friends' didn't miss a bite of their meals). I went to the desk (LONG before cell phones) and asked them to call 911. In the time it took me to do that, the 'friends' had dragged the poor lady off the floor, and propped her back up in the chair. I put her back on the floor (not one of them had any explanation as to what was wrong- blood sugar, TIA, seizure, stroke, fainted, ????). EMS then wants to talk to me so they know what sort of rig to send (BLS or ACLS), and I told them. They got there fairly quickly, and hooked her up to a monitor, (which- even as a new nurse with no cardiac experience outside of school could see - looked BAD), and hauled her off....The friends KEPT EATING :eek:

I was back at that restaurant a few days later, and asked the person at the desk if they'd heard anything about the lady who was taken out by ambulance on Easter- she asked "which one"?? WHAT?? :uhoh3: Someone else had been hauled off.

I've seen a few accidents- and if I actually saw the MVA, or it was obvious it wasn't a scam, I'd stop. Usually, other people would stop as well.

Trekfan

466 Posts

I'd been out of school for almost a year, and was having lunch with my Mom on Easter at a popular restaurant...at the table across from ours, one of the 4-5 people sitting there was slumping over...nobody at her table was doing anything :eek: I kept watching, and her color started to change. Still, nothing from the "friends". So, I went over there and helped her to the ground (the 'friends' didn't miss a bite of their meals). I went to the desk (LONG before cell phones) and asked them to call 911. In the time it took me to do that, the 'friends' had dragged the poor lady off the floor, and propped her back up in the chair. I put her back on the floor (not one of them had any explanation as to what was wrong- blood sugar, TIA, seizure, stroke, fainted, ????). EMS then wants to talk to me so they know what sort of rig to send (BLS or ACLS), and I told them. They got there fairly quickly, and hooked her up to a monitor, (which- even as a new nurse with no cardiac experience outside of school could see - looked BAD), and hauled her off....The friends KEPT EATING :eek:

I was back at that restaurant a few days later, and asked the person at the desk if they'd heard anything about the lady who was taken out by ambulance on Easter- she asked "which one"?? WHAT?? :uhoh3: Someone else had been hauled off.

I've seen a few accidents- and if I actually saw the MVA, or it was obvious it wasn't a scam, I'd stop. Usually, other people would stop as well.

MAN that must have some good food there ? or that poor woman had some real bad freinds :confused:

Ruas61, BSN, RN

1,368 Posts

Specializes in MDS/ UR.

Please don't pack up the kids and go to respond.

I know everything is all new and shines but really discretion is the name of the game.

If something happens in front of you that you can safely intervene, do so. If not, monitor and call it in or get to someplace safe and call it in.

Be helpful but not a hero. Don't get into something you aren't qualfied in and even than be careful.

xtxrn, ASN, RN

4,267 Posts

MAN that must have some good food there ? or that poor woman had some real bad freinds :confused:

I'm inclined to go with the latter :D

FlyingScot, RN

2,016 Posts

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
I know that states have laws about professional responsibility--i.e., if I had seen the woman on the bench before anyone came to treat her, because of my RN license I would be expected to do so.

There are very few states, if any, that have a "duty to act" law for RN's. There is, of course, the moral/ethical issue that you will have to search inside yourself to see how involved you might want to become.Remember sometimes all you can do is hold someone's hand.

Specializes in SICU.
There are very few states, if any, that have a "duty to act" law for RN's. There is, of course, the moral/ethical issue that you will have to search inside yourself to see how involved you might want to become.Remember sometimes all you can do is hold someone's hand.

agreed! You are an RN not an EMT/Paramedic.. you have no 'Duty to respond' and you cannot get in trouble for not responding...

nerdtonurse?, BSN, RN

1 Article; 2,043 Posts

Specializes in ICU, Telemetry.

If I see a wreck occur on a back country road, I stop, and get out with cell phone in hand. If it's sirens 2 blocks away, let the professional first responders do their job. You don't have gloves, scope, intubation tray, auto-pulse. O2, etc. in your trunk. I have a fairly good first aid kit because I live in the middle of nowhere, and there have been times when I was the first on the scene -- called 911, told them everyone was walking but bleeding, or stuporous -- (of course, that might be because the guy was drunk as a skunk...I was worried I'd fail a breathalyzer just from smelling his breath). I didn't pull people from cars if they were breathing and the bleeding was just seeping from bouncing around the inside of the car, I just kept the guy talking until EMS arrived. Had he went out, then I'd have put him on the ground in recovery position in case all that ETOH decided to come back up.

Don't take your kids. I saw a person get eviscerated in a wreck when I was a kid, and have nightmares about it to this day (half his body was in the car, the other half was smeared down the outside of the car). Don't give your kids that kind of memory.

Specializes in FNP.

In 25 years I have never once responded to any situation outside of the unit that employed me, and I doubt I ever would.

Specializes in LTC, Hospice, Case Management.

Came upon a wreck just last night. Live out in the country and the area is generally very very safe. Two mangled cars, everyone appeared out and walking, one cop present only and he seemed calm. As I drove by, rolled my window down, identified myself as a nurse and asked if he needed any help. He thanked me, replied everyone OK and back up on the way - so I drove on home.

My 15 year old son sitting next to me commented that he thought that was nice of me to do but questioned why I did it. As I told him, if it was you sitting along the side of that road I would hope that someone would stop and help you if you needed it. I believe you get what you give in this world. I agree with others - don't be a hero, just offer a hand if needed.

In 25 years I have never once responded to any situation outside of the unit that employed me, and I doubt I ever would.

Has the opportunity to do so ever arisen?

Check with a couple of lawyers in your state, check with your Nursing licensing Board. Follow the law.

As someone else said here, the ethics depend on you.

Never ID yourself as a nurse at an accident scene; just be a doer of good deeds.

Keep safe, keep your kids safe.

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