Is there a law protecting a nurse doing something they are uncomfortable with?

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In short, local hospital is trying to institute a policy to where if a critical care helicopter or ground unit is unavailable due to weather or other reason causing a prolonged ETA that the primary nurse caring for the patient in the ER is to ride along with a local ambulance service. The local ambulance service is an ALS truck with a EMT-B (driver) and EMT-P (patient care). The nurse would ride along and follow written orders given by the attending ER physician. Some of the circumstances that this would happen is for patients with blood hanging, stroke patients, etc. The hospital added this to the nurses job description seemingly overnight and instituted the policy with no input from anyone. Needless to say most of the nurses are very uncomfortable doing this for many reasons.

My question... are there any laws namely in Ohio regarding nurses refusing to do something that they are uncomfortable doing? I understand in this field of work there are many things that you will do that you are uncomfortable with but most of these nurses fear that if something were to happen with the patient or something were to happen and the ambulance was to crash and injure or kill anyone that the hospital would not back the nurse up legally.

First I want to say this statement is absolutely false. No ACLS class "certifies" you for intubation. In fact, intubation is not even emphasized in ACLS. I would hope that as a nurse you would know there is much more to intubation than what is in an ACLS class.

I did not say it did, and thank you for your chastisement, though I find it unnecessary given that we are generally in agreement on the general belief that this practice (RN on board with EMS) is not without risk or without additional considerations beyond practicing in the ED.

Specifically with regard to ACLS, I am well aware that it does not emphasize intubation above everything else, which again, I did not say it did. I can't speak for you, but every single time I recert, there is certainly emphasis on the 'airway station' in general, including simulated intubations which you must be checked off on in order to pass the course . Beyond the need to be able to anticipate what is needed in an intubation and to assist those personnel who ARE expected to routinely intubate, why do you think they want to see an RN practice simulated intubation and demonstrate at least a minimal level of comfort with the equipment and procedure? Well.....that would be so that the RN can do it in a true emergency; this is stated outright every single time we recert...."Every one of you should be able to do this in an emergency". I'm surprised you haven't come across this in your experiences.

Anyhoo......rather than splitting hairs about something stupid, how about we agree that when the sh*t hits the fan in the back of a rig, the RN is likely not going to come out unscathed. That's all I meant to point out, and I apologize if my example was unsuitable to you.

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Glad to see your on this site bashing paramedics as well.

No bashing here. If you are a Paramedic you must recognize your limitations. If you are an RN you must recognize your limitations.

From your statement you must be a Paramedic or an EMT who wants to get into a ******* match. Take it back to whatever EMS forum you are from.

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Anyhoo......rather than splitting hairs about something stupid, how about we agree that when the sh*t hits the fan in the back of a rig, the RN is likely not going to come out unscathed. That's all I meant to point out, and I apologize if my example was unsuitable to you.

I do agree that the RN will probably take most of the heat if anything goes wrong with the patient.

I just pointed out about ACLS and intubation since too many ask when they take the class if they are now "certified" to intubate. This includes RNs and EMT-Basics. I would not want someone believing ACLS certifies them to perform intubation. That could jeopardize their license or at least their position with the hospital if it does not allow RNs to intubate.

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Specializes in CCT.

To the OP, the hospital is putting y'all in a crappy position. However, there might not be another good choice depending on the local area, EMS services, ect.

Ideally you will embark on some sort of training program with the local EMS service as your nurses don't need to be operating in the transport environment without further training, and the medics don't need to be taking off with meds that they're not familiar with/are out of their scope. Are these transports happening often? If so, the transport company may be able to justify training and hiring supplementary RNs on a part-time basis to bill at an SCT rate.

Most importantly, understand the challenges of the transport environment. The backup is not available meaning you must be MUCH better at both troubleshooting and anticipating potential problems before they happen.

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Specializes in CCT.
No bashing here. If you are a Paramedic you must recognize your limitations. If you are an RN you must recognize your limitations.

From your statement you must be a Paramedic or an EMT who wants to get into a ******* match. Take it back to whatever EMS forum you are from.

If you would keep the bashing away from the EMS sites, then I wouldn't get into ******* matches here.

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Specializes in CCT.
I do agree that the RN will probably take most of the heat if anything goes wrong with the patient.

I just pointed out about ACLS and intubation since too many ask when they take the class if they are now "certified" to intubate. This includes RNs and EMT-Basics. I would not want someone believing ACLS certifies them to perform intubation. That could jeopardize their license or at least their position with the hospital if it does not allow RNs to intubate.

Wrong, in my state, under my guidelines, ect, I AM RESPONSIBLE. Not the RN who tags along for a transport. If it happens in the back of the truck, it's on me.

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Specializes in CCT.

Too the many RNs on here who are interested in transport, and in how this thread develops. Your experience and knowledge is badly needed in the transport environment. Please don't let liability scare you off, get the proper training, develop the policies and put it to use. There are MANY (but not all as some would have you believe) paramedics who are massively under-qualified to do critical transfers. Work with your local companies and identify where help is needed. We should be working together for the best transport team configuration, not bickering over who's responsible, because if something goes wrong, EVERYONE will hang together.

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Wrong, in my state, under my guidelines, ect, I AM RESPONSIBLE. Not the RN who tags along for a transport. If it happens in the back of the truck, it's on me.

Tags along?

It is on you only until something goes wrong. The RN was put on that truck for a reason and if it is for reasons beyond your scope of practice, your responsibility will be limited.

Again, please do not come here just to bash RNs or feel the need to show your superiority because you are a Paramedic.

I presented a few points for nurses to consider and apply for their area. There are 50 different states with 50 different state scope of practices for Paramedics and each agency having their own set of protocols. In no way are you the spokesman for all of them.

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Specializes in Nephrology, Cardiology, ER, ICU.

Okay as someone who is both an RN as well as a pre-hospital RN we should be working as a team not trying to decide who is responsible. This should all be determined prior to loading the pt. And if there are questions, get them answered BEFORE you start the transport.

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Specializes in CCT.
Tags along?

It is on you only until something goes wrong. The RN was put on that truck for a reason and if it is for reasons beyond your scope of practice, your responsibility will be limited.

Outside of something going wrong with the particular function they are there to monitor (which, I can't think of something the local facility with start that I'm a. unfamiliar with and b. can't get orders for) then it is indeed on me. Even if something did go wrong with said intervention, I'm still supposed to be able to come up with an alternative. Disclaimer, this is my particular service. So yes, the RN is just tagging along in my situation.

Again, please do not come here just to bash RNs or feel the need to show your superiority because you are a Paramedic.

Never said anything to bash RNs. Have a lot of good friends who are RNs and will be the first to admit paramedic education and practice is deficient in a large number of areas.

I presented a few points for nurses to consider and apply for their area. There are 50 different states with 50 different state scope of practices for Paramedics and each agency having their own set of protocols. In no way are you the spokesman for all of them.

Absolutely. Neither, are you a spokesman for what an RN can expect liability wise.

Your postings are remarkably consistent in tone and content to a poster on many EMS sites who when they stick to the their area of expertise is incredibly educational. Unfortunately this poster also has a seemingly pathologic need to decry paramedics as cruel, unprofessional, rude and stupid poor excuses for medical professionals who have no business being anywhere near a patient. While I'm sure your not that poster, I'd hate to think they're spreading there vitrol across yet ANOTHER site under yet ANOTHER screen name.

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Specializes in CCT.
Okay as someone who is both an RN as well as a pre-hospital RN we should be working as a team not trying to decide who is responsible. This should all be determined prior to loading the pt. And if there are questions, get them answered BEFORE you start the transport.

Abso-freaking-loutely!!

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Abso-freaking-loutely!!

Are you agreeing only because a staff member made that statement? Before you stated nurses were only tag alongs.

But, if it gets you off the hook for the personal attacks in an attempt to discredit my posts that give RNs another viewpoint to think about as they are discussing this matter with their administrators....

I only post under one screen name and that one is here. One the other site I use my real name.

Enough of your personal attacks.

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