Good Samaritan Law

Nurses General Nursing

Published

Recently I came upon a horrific car accident. I did not stop since there were already many people at the scene and I could hear the emergency response vehicles in the distance. I could see that the jaws of life would be needed to get the victims out. I later learned that the passenger died on impact and the driver is in critical condition. Last year I witnessed a car go head first into a ravine at about 60mph. I did stop, along with an off duty paramedic. The 2 men in the car crawled out and were bleeding from many facial cuts. The paramedic instructed them both to lay down and not to move, handed them each a towel to hold pressure on their cuts. He called 911. He never touched either of them.

This recent accident has started a big discussion amongst many nurses I know. Several of them said they do not stop at accidents because the Good Samaritan Law is for non-medical people and that a professional could be held liable if they do something considered negligent. The definition of negligent being whether other nurses would have done the same thing under the same circumstances. For most there seems to be a fear that as a nurse, you might be called upon (at your expense) to defend your actions.

I have researched this law and see that it is different state by state. Here is a summary from Wikipedia:

Good Samaritan laws are laws or acts protecting those who choose to serve and tend to others who are injured or ill. They are intended to reduce bystanders' hesitation to assist, for fear of being sued or prosecuted for unintentional injury or wrongful death. In Canada, a good Samaritan doctrine is a legal principle that prevents a rescuer who has voluntarily helped a victim in distress from being successfully sued for 'wrongdoing'. Its purpose is to keep people from being reluctant to help a stranger in need for fear of legal repercussions should they make some mistake in treatment.[1] Good Samaritan laws vary from jurisdiction to jurisdiction, as do their interactions with various other legal principles, such as consent, parental rights and the right to refuse treatment. Such laws generally do not apply to medical professionals' or career emergency responders' on-the-job conduct, but some extend protection to professional rescuers when they are acting in a volunteer capacity.

I am a Home Care Nurse and it's been many years since my ER training and experience in Critical Care in a hospital setting. So critical first aid is not my expertise. Has anyone heard of a nurse having to defend her actions after giving emergency care at the scene of an accident? What are your thoughts on this? Do you stop at every accident? If you have a minute, google the Good Samaritan Law in your state and see what it says about off duty professionals. I'd be interested in what other nurses think and how you interpret the law.

Kyasi

out of curiosity I just looked up Pennsylvania's Good Sam law and it specifically says that -Any physician or any other practitioner of the healing arts or any registered nurse, licensed by any state, who happens by chance upon the scene of an emergency or who arrives on the scene of an emergency by reason of serving on an emergency call panel or similar committee of a county medical society or who is called to the scene of an emergency by the police or other duly constituted officers of a government unit or who is present when an emergency occurs and who, in good faith, renders emergency care at the scene of the emergency, shall not be liable for any civil damages as a result of any acts or omissions by such physician or practitioner or registered nurse in rendering the emergency care, except any acts or omissions intentionally designed to harm or any grossly negligent acts or omissions which result in harm to the person receiving emergency care.

So as a medical professional you cannot be sued unless you do something grossly negligent...

from the link - http://www.concentric.net/~Maxfax/files/law2.htm

Specializes in Med-Surg, Cardiac.

I'm a long time medic and a 3 year RN. I don't usually stop at an accident unless it looks like someone's unconscious (needs airway open) or some sign of profuse external bleeding. In all the accidents I've been to as a medic I can only think of one that needed rapid intervention to maintain airway and none with profuse (i.e. life threatening) bleeding. So if I do stop at a scene, I'm just adding one more body that's in the way of the police and emergency responders.

I do stop at a fresh accident and ask if they need help and call 911 if nobody else has.

Let's not worry about the successful lawsuit - worry about any lawsuit. Even an unsuccessful lawsuit will still costs you more than you would ever think you could lose.

I really appreciate all the dialog on this subject. One concern I have is what I have highlighted above. While you may not have been negligent, if the patient is injured despite your best efforts, proving that you weren't negligent can be costly.

I checked my state and nobody is required to stop and help, off duty medical personnel or civilian. The GSL was written to encourage those to stop and help without retribution.

If I witness an accident, I always stop. I have to say I felt guilty for not stopping at the most recent accident but I could see that I couldn't help. There were so many people around and the people were trapped in the car. The rescue vehicles were in sight so I knew I would only add to the confusion. Plus, I could see the horror on the faces of those who were there. Quite frankly, I didn't want that image implanted in my brain if I couldn't be of help. Still, within most nurses is the instinct to help. (we wouldn't be in the profession if we didn't have the desire to help and care for those in need)

Hearing the thoughts of the nurses who never stopped that I have talked to really got me thinking about this because it never even occurred to me that the GSL may not cover/protect all nurses.

I'd be interested in hearing if anyone knows of a nurse who was prosecuted, charged, etc for either negligence after helping a victim or for not stopping.

Thanks everyone for your input!

Kyasi

Specializes in Flight, ER, Transport, ICU/Critical Care.

Text size increased for your reading comfort! I am finding that my arms are getting too short. :eek:

This comes up frequently here on AN and while everyone has personal standards and rationales for why or why not they act - questions do remain. Although I am in no position to give legal advice (not a lawyer and banned under TOS) I do hope that some of what I share will help someone make a more informed decision.

First, as for lawsuits - I hope we can all agree that anyone can SUE anyone for anything at anytime.

A lawsuit goes something like this -

It is generally the practice of litigation for a plaintiff's attorney to name anyone and everyone (some even use known and unknown - to cover adding folks if during discovery "names" surface that indicate someone not originally named can share in liability). A plaintiff via their lawyer files an action in a court and all named "defendants" are "served" with a copy of this complaint. After service a "defendant" has to file an answer with the court - defendants rarely share lawyers (cause every individual defendant is interested in proving that they are not liable - you must protect yourself, regardless of what the "other" defendants do) and as a rule a lawyer will likely be needed by any/every defendant to help you understand the legal issues that the initial complaint raises and to prepare your answer as a "defendant". Lawyers do not do this for free - just because your "defense" is a Good Sam act. So even before the court "hears" your side - you will be financially impacted. (Some homeowners policies or other insurance may cover an attorney initially - but, don't count on it and the lawyer for your insurance company will be looking for the first out they can take even if that leaves you without a "provided" attorney - and if there is some real question to your liability you can bet that few insurance provided attorneys are going suitable for a involved civil action). So, while the GS act may be your defense - you will still have to explain the details of your actions and the rationale behind them. Things that might look reasonable beside the road in "the heat of the moment" often can look different in the start light of a courtroom to folks that were not there.

Lawsuits generally go on from here - through discovery (questions and answers of anyone, everyone associated in any way), hearings, motions and maybe, just maybe after several years - you might seat a jury (though less than 5% of cases ever do). These are messy expensive affairs and in the end, it is not just about the truth. It is about what can be proved, what the judge will admit and what applicable case laws already exist. I have seen very simple issues look very complex in litigation and find that by the time an issue makes it to a jury - you may not even recognize what it started out as.

So before you act - think over the information as described above. Although there may be no greater love than to sacrifice your self to help your fellow man - I just want all to be fully aware of what may happen next.

Folks that are injured and sue - they just want/need/must to collect from anyone and everyone that can be made to pay. They may be great people and kind and generous and grateful for your "sacrifice" - but, if they have to spend a lifetime in a wheelchair (and all that means - from lost wages to medical bills to pain and suffering) they will have to do what they have to do - it is just the way it is.

Think about this situation -

You stop at an accident scene where several cars are involved - you quickly look it over and see someone profusely bleeding from a head injury & that person is unconscious behind the wheel of a car that has what looks like smoke coming from it and there are "fluids" running onto the ground. It smells like something is burning. In the heat of the moment you conclude that the car will catch fire and explode. So, you unbuckle the "driver" and pull him/her to "safety". You apply pressure to the head wound and the driver "comes to" and tells you "I can't feel my legs". Now what? You did what anyone would do right? You just stopped to help.

Well, consider this. Very, very few cars ever catch fire from an accident, even fewer explode and even though most produce something like "smoke" it is not because anything is directly on fire and often fluids do run out. But, you a nurse likely did not know that - you just presumed that smell of smoke = fire = explosion = death for this person unconscious behind the wheel. Though you may not have ever been trained about scene rescue, you will likely have to answer a question or two about a head injury, unconscious patients, likelihood of spine injury and then you will have your "heat of the moment" actions examined in the harsh light of a courtroom. By moving this person you likely made their bad spine injury worse (the car did not catch fire much less explode - hindsight is not a friend) - so it cannot be determined with 100% accuracy that you caused their paralysis - it can't be determined that you didn't either. Uh-oh. Now what? Major legal bills are in your future as the question about your actions will go to a jury.

Something to think about. There was a case out of CA recently that a friend pulled another "friend" from a vehicle in a situation like the one I described and the Good Samaritan was found at fault and had a six-figure judgement entered against them. The last I heard it was still in some stage of an appeal. Not good - even if the judgement is reversed - this GS is still a big loser and her plaintiff "friend" is still in a wheelchair.

Although in theory GS laws were written to encourage an off-duty/with no duty to act healthcare provider or lay person to help another in a crisis - like all laws they evolve from the decisions made in the courts that effect real people. Case law evolves - and case law is what court decisions are based on.

Questions about this are normal and the most common that appear are -

* Do I have to stop if I am a healthcare professional?

* What if someone knows that I am a nurse and I pass by - will I be punished/held "liable" for not "rendering aid"?

1st - if you witness an accident directly or are involved (whether impact with you happens or not) you are more than a GS - you are either a witness or a party to an accident. Even if you render no aid - you still have some legal duty to give your information and statement. So, you gotta stop. Call 911 - briefly explain and await further instructions.

But, everyone else? Stopping is a deliberate and willful act. Through my research and to the best of my knowledge, I can not find any reference that a healthcare provider suffered any loss from a decision to not get involved in a situation that did not directly involve them. And as choosing to get involved and then for being held "to your highest training" and expecting that you will do all that you know how --- that is not true - think about a CT surgeon that happens on an accident - no one would ever expect that he has the ability to "crack a chest" beside the road - likewise, as long as you do not break any laws and act as any reasonable person would - you have more than met any "duty" you have. Even if you can start IV's and intubate - folks that stuff is used under the direction and prescription of a physician - and if you are carrying it around in your first aid kit (you are possessing with out an RX and already breaking the law even if you never use it!) and ready to use it as a GS - you will most certainly lose your license. This I am certain of - and you may even be criminally charged - for practicing medicine without a license. Just because you know how to do something and are allowed to do it in certain situations DOES NOT mean you have to do it anytime or anywhere - you are NOT ever going to be held to that standard as a GS. However, if you choose to get involved and whip out your super-duper "first aid" kit and go ahead and start the IV, intubate, cut a trach, reduce a fracture or do a field c-section with a swiss army knife ----- you will be accountable and will have some explaining to do - even if everything turns out okey-dokey! Your life will be a changing!!!!

Back to the question --

Think about a "law" that requires (and punishes for non-action) every healthcare provider to stop an every accident scene they happen upon. There could be so many uninvolved, useless folks at an accident that rescue and law enforcement may have a impossible time getting through - it is ridiculous to think that as necessary. It is also not SAFE - I have covered, in detail, the fact that scene operations are dangerous.

Getting involved has consequences - even if it is not an accident scene - think someone collapsing at a ballgame - there are real risks beyond liability that GS laws to not going to protect you from. Think about being killed or injured (even if you don't die, just have medical bills or are unable to work for a period - who will come to your aid - you have a family and responsibilities) the consequences of exposure to an infectious disease or even think about a hysterical/distraught family that might blame you in some way. There are lots of ways it can go wrong - and you (the Good Samaritan that you are) have few resources if it does. If you are injured/exposed to infectious disease - who will pay your medical bills; what if you are left unable to work - how will your family make up your lost wages; if you are assaulted or killed you are now a victim - there are legal and financial issues there too. What if an angry someone files a complaint against you with the BON - even if absurd - make no mistake the BON is not on your side - all BON's exist to protect the public from you - never forget that.

GS laws in theory DO protect against strict liability unless the person acts in a wanton and dangerous manner. Even though you may have the best of intentions and no other nurse in the world will find any fault with what you do - the thing is - a nurse will not preside - a judge will & a jury of nurses that understand why you did what you will not decide - a random jury of the public will. Sure, most everyone would want help if injured and most will understand the desire to help another fellow man that is injured - there will be a flesh and blood plaintiff involved - one that may be suffering a catastrophic future.

I think knowledge is power and informed decisions are the best ones.

Everyone has to do what is right for them and there are no wrong answers - just be prepared for "what if's".

I'd hate to think of all my amazing colleagues finding themselves in a bad situation because they had not thought their options through. I think helping is admirable and I am, in no way, saying that I'd never assist anyone. I have rendered aid before and may again. I am always fully aware of what could happen and admit that I may even be faced with unintended consequences. I just want all to have amazing lives and careers - we do tough work and work very hard. Most all of us know what sacrifice is - and that grief has no rules and tragedy does not discriminate. Just be aware.

Stay SAFE!

:angel:

Specializes in Nephrology, Cardiology, ER, ICU.

I'm a pre-hospital RN and run with a volunteer fire dept.

Would love to see the statute of these states that REQUIRE RNs to stop.

Sorry, but to stop when you don't know basic scene safety could do more harm than good.

Heck, I'm an APN with 20 years of trauma experience and believe me, I don't stop at EVERY accident - that's for the responders.

Specializes in Addiction, Psych, Geri, Hospice, MedSurg.

Interesting. A search and lots of reading, I see a LOT of discussion about this, and the "duty to act."

I see A LOT of people TOLD in nursing school (I was one of them) that as a nurse you are REQUIRED to stop and render aid if no emergency personnel are on duty. I see a lot of people TOLD not to have anything identifying themselves as a nurse on their car (Again, one of them) if they intend NOT to stop...

But, I can't find anything LEGALLY speaking saying we HAVE to or are REQUIRED to stop.

NREMT-P/RN Wow! Good food for thought! And thanks for the font size adjustment.

Kyasi

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.

http://www.rescueriders.org/liability.html

Happy reading!

Drat, they changed the website up. Oh well, the statutes are there. You just have to copy them into a browser and search from there.

Specializes in SICU.

this irks me to no end!!!

as a registered/practical nurse you are not an emt thus you do not have the duty to respond.

driving down a highway, you are not in a hospital/ltc/ltac/assisted living facility where you would have a duty to respond.

if someone calls the board of nursing and says:

' i saw ohiostudent'11 passing and accident on 1-80...she...she didnt stop...you have to punish her':eek:

(or something like that)

no one will take that seriously....

personally, in this age of sue-crazy people, i.will.not.stop!!!!

i will call 9-1-1

i am not trained in emergency medicine and i will most definitely make the situation worse...

my opinion and im sticking to it ;)

Specializes in Spinal Cord injuries, Emergency+EMS.

in answer to those demanding 'proof' of a professional or legal requirement to assist , this is the scenario for anyone with Uk registration

http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Providing-care-in-an-emergency-situation-outside-the-work-environment/

When I was a waitress a man started choking at work. Another waitress ran over and started beating on his back and the steak bone came flying out. Long story short, the man then complains the waiter hit him to hard and called the corporate office. But not before he complained his steak had gone cold during all the commotion and demanded another one.

In summary, Lord please don't let me be the first person on an accident scene.

Specializes in Critical Care, Emergency Medicine, Flight.
this irks me to no end!!!

as a registered/practical nurse you are not an emt thus you do not have the duty to respond.

driving down a highway, you are not in a hospital/ltc/ltac/assisted living facility where you would have a duty to respond.

if someone calls the board of nursing and says:

' i saw ohiostudent'11 passing and accident on 1-80...she...she didnt stop...you have to punish her':eek:

(or something like that)

no one will take that seriously....

personally, in this age of sue-crazy people, i.will.not.stop!!!!

i will call 9-1-1

i am not trained in emergency medicine and i will most definitely make the situation worse...

my opinion and im sticking to it ;)

so what if you are both an emt & rn like myself and witness an accident (just playing devils advocate)

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