Just curious how other nurses deal with medical emergencies in public when they’re not on-the-clock. For instance if you come across a stranger who has fainted, had a seizure, broken a bone, etc. Do you rush to the scene and help, or call for help? Do you utilize your nursing skills? I’m also curious about car accidents. Do you stop? I’ve luckily never seen one, and have only been in minor accidents myself.
I was on an airplane recently where the flight attendants asked if there were any doctors or nurses on board to aid to a passenger. Luckily a few people including a few doctors were able to help out.
I’m a newer nurse and don’t have any sort of emergency experience. Emergency or critical care is not my strong suit; in fact, it makes me highly anxious. I’ve never experienced any kind of emergencies in public, and am not sure I would know how to handle it. This got me thinking and was wondering what other nurses do when they encounter these situations? Are we legally obligated to let people know that we’re nurses and help out?
Specializes in Psych, Addictions, SOL (Student of Life).
Above being said I did stop at an accident a few years ago that happened literally in front of me. one Ricky rescue almost got hit putting out flares. There were small children in the hit car and mom was frantically trying to pull them out. Kids had airbag burns so I helped to rinse them off and got them to safety handed off to the paramedics when they arrived. Gave my business card to the cops in case they needed a witness statement and took off.
First off, you're a new grad. Enough said there. Not trying to be offensive, but you need to understand that having "RN" after your name doesn't confer immunity to prosecution if you make a mistake---Good Sam laws are not all powerful. You also don't have any more medical experience than a lay bystander has---in reality.
Second. When you get into this job for awhile--you will understand what I'm saying here---people are not as kind and considerate and thankful as you may think.
Third. If you see an MVA--it's on the road. There are so many reasons here that I can state to NOT stop, it's mind boggling.
1. traffic. Do you know how many EMTs and FD get killed every year doing their job with all the right equipment? DO NOT STOP FOR MVAs.
2. EMS and FD are already on their way unless you witnessed the accident seconds prior. They have the equipment, expertise and resources needed to do that job. Let them.
3. Unless you're one of those freaks who carries a "jump bag" in their trunk waiting for that moment of glory that catapults you into saintlike status for saving the baby in the minivan upside-down in a canal---LEAVE IT ALONE, you do not have the training or the equipment to help. You will most likely make the situation worse---see GETTING HIT BY ANOTHER CAR or unknowingly causing death because of something you practiced in nursing school once.
This is coming from ex Prehospital and ED trauma nurse. The chances that you can intervene successfully in an accident on the road are slim to negative 1 million.
Intervening in two cases I can see would be something I would do---and that is witnessed cardiac arrest or stroke (by me. not by anyone else) or bright red blood spurting from someone's body (witnessed by me. not told to me by someone running breathless looking for help). I would do compressions, not rescue breathing. I would call 911 and stay with a stroke victim. I would NOT coach a bystander. I would hold pressure on an arterial bleed.
Nothing else.
Falling off of ladders--tripping on curbs--getting burned at a bbq--especially MVCs---you are not trained nor are you equipped to intervene in any meaningful way.
Call 911. It's 4 minutes for you to stand and wait or just drive by and call. Getting involved is not a smart thing to do. Just because those of you who have done it and escaped legal entanglements or the death/permanent injury of a person--doesn't mean that next time it won't happen.
I've been threatened as a nurse on duty in the ER by a patient's family for breaking her ribs during compressions. PEOPLE ARE CRAZY.
Even doing effective compressions on a witnessed cardiac arrest would make me pause---you do know that you can (if you're doing them right) break the patient's ribs and then possibly puncture their lung, cardiac lining, diaphragm and other internal organs while you're playing super hero?
MVCs are the biggest no-no in my book. I loathed when passersby or drivers would get involved in an accident scene. FFS. Scene safety is the first thing we all learn as prehospital---and here's Dudley DoRight wading right in there with no thoughts for the safety of himself, the victims, or bystanders.
No. Just no.
This is an absolutely horrible take and incorrect all around. If you have been through school and a preceptorship, you know SIGNIFICANTLY more than a layperson. Your ego and detachment from reality is wild.
Who here didn't learn anything that might save someone's life by the time they graduated? Have you never seen a group of people when accidents happen? Nobody knows what to do and they will often do terribly incorrect things that can hurt the person they're trying to help.
To any new nurses, ignore this persons horrible advice. If you see someone who may need your help, the help you have learned and signed up to give to people, do what you can. Do not act as if you know everything. Don't pretend to know more than you do. But, do the things you do know and have learned. Letting a crowd of people know you are a nurse goes a long way in controlling the situation. Most people will step back and listen to you.
Are they bleeding and need you to stop it? Are they not breathing and need CPR? Can you check their vitals and report things accurately to EMS on the phone, ensuring they have a heads up to the situation before arriving? There are MANY things you can do to help, and maybe save someone's life. You being a new graduate does not mean you're stupid or can't help.
This is an absolutely horrible take and incorrect all around.
The person who wrote that (6 years ago) is not incorrect all around. There is some nuance to the answer to questions like the one written in the OP, that's true—for example if someone indicates they are choking right in front of you and you are prepared to perform correct maneuvers or can call for help by all means do those things. There are other scenarios that are not nearly as straightforward. Sometimes the best answer actually is to stay out of it. If someone doesn't know which is which they probably aren't the best one to be worrying about it.
The OP even indicated that these scenarios were not their strong suit, and that's just the beginning of why not every person who has graduated from some type of nursing program needs to feel obligated to intervene. Not every nurse knows more about this *and* can realistically DO more than anyone else who might be there. We are usually talking about BLS procedures here, not emergency surgery. The bottom line is that the answer here includes a lot of "IFs"
Specializes in NICU, PICU, Transport, L&D, Hospice.
You have to just look at the situation and decide if you can help.
I've stabilized fractures and compound joint dislocations in social settings. I've supported injured children in MVAs while trying to make sure someone else was keeping us safe from incoming traffic. I've done CPR on drowned children and old men on the sidewalk. I've held pressure on lacerations and protected a child from having his dad pull the stick out of the kid's shoulder in the sledding accident. At least I knew that guy and he was willing to listen to me. Most of the other incidents involved strangers or people loosely associated with a common activity like skiing, skating, hiking, swimming, etc.
I think that fear of litigation is not really a factor in my personal decision to help someone. Ability to help and personal safety are probably the biggies for me. I'm retired now. Unless it happens close by, I'm a slow responder. Getting onto my knees is impossible and getting back up is problematic. I need people to have their emergencies that require my assistance on a table or bed.
This is an absolutely horrible take and incorrect all around. If you have been through school and a preceptorship, you know SIGNIFICANTLY more than a layperson. Your ego and detachment from reality is wild.
The vast majority of Registered Nurses that are either fresh out of school OR have just completed a new hire preceptorship do NOT know much more about First Aid measures than the lay person. Yes, they might have BLS/ACLS. Great. Without a monitor, airway equipment, and drugs, ACLS is not going to be very helpful. In the instance of an MVA, outside a specific group of nurses, the RN doesn't have any training in what to do, nothing about scene size up or scene safety, nothing about vehicle stabilization, nothing about patient extrication. Doing the wrong thing can have bad outcomes and if you don't know you did wrong, you can be blindsided by the outcome.
I'm not saying one shouldn't get involved. Biggest thing even a new grad can do is call professional rescuers to respond. After that, if you can safely provide care, stick to BLS and First Aid measures. Your first duty is to your own safety. You can't help anyone else if you get hurt too. In terms of prehospital care, most nurses aren't even trained to do the full scope of what a basic EMT can do.
In my case, I'm also a Paramedic. I have an extensive education and experience in prehospital care. I know my limitations. I can advise what resources are needed. When I'm off duty, I don't have access to any of the equipment I would have on hand... but I also I have the training to be able to provide an appropriate level of care with the things I might have on hand.
I'm also a Registered Nurse. In particular I work in an Emergency Department and I've done that for 10 years. None of the education and experience as an RN has adequately prepared me to function in the field. From that end of things, BLS and Basic First Aid is as good as I've gotten. Flight Nurses that do scene calls and Prehospital Registered Nurses know what to do, but their orientation to those roles give them the requisite education to safely function in the prehospital environment.
So, to sum up: If you choose to get involved, do so SAFELY. Do stick to basic First Aid and BLS measures, call for professional rescuers to take over care from you and when they get on scene, tell them what you know, turn over care and leave unless you are specifically asked to stay.
This is an absolutely horrible take and incorrect all around. If you have been through school and a preceptorship, you know SIGNIFICANTLY more than a layperson. Your ego and detachment from reality is wild.
Who here didn't learn anything that might save someone's life by the time they graduated? Have you never seen a group of people when accidents happen? Nobody knows what to do and they will often do terribly incorrect things that can hurt the person they're trying to help.
To any new nurses, ignore this persons horrible advice. If you see someone who may need your help, the help you have learned and signed up to give to people, do what you can. Do not act as if you know everything. Don't pretend to know more than you do. But, do the things you do know and have learned. Letting a crowd of people know you are a nurse goes a long way in controlling the situation. Most people will step back and listen to you.
Are they bleeding and need you to stop it? Are they not breathing and need CPR? Can you check their vitals and report things accurately to EMS on the phone, ensuring they have a heads up to the situation before arriving? There are MANY things you can do to help, and maybe save someone's life. You being a new graduate does not mean you're stupid or can't help.
You who wrote this should be ashamed of yourself.
I see this is your first post, welcome.
Like akula, I've been a medic for a very long time (25 years) and an ED nurse for 3. I think I can authoritatively say from experience that nursing school does nothing to prepare anyone for the prehospital setting, nor does pretty much any nursing position other than flight nursing for companies that do a lot of scene flights - even then it's limited because most HEMS patients are already somewhat stabilized and differentiated prior to their arrival.
On top of that, modern nursing is highly focused on diagnostic tools that aren't available in your personal car. The art of diagnosing, planning, and implementation are not skills that most nurses possess these days, especially a new grad.
I'm going to agree with my colleagues Akula and Mike. Although I work in a cushy clinic job as retirement nears, I am a senior National Ski Patroller, EMT-P and worked decades in CCT, Flight and ED. Without scene safety and management training, without even basic first aid education and certainly without the equipment we are used to having stopping at accident scenes is a risk I would not recommend to take especially for new grads. Answering the call on a plane? Sure. There's only so much you can do. MVC? Not so much. Even with my experience I think twice about stopping. If I can do so safely I'll stop sometimes. If I can't, I make the 911 call. Honestly if any of you want to be helpful in the community I would highly recommend you take a first aid course. You'd be surprised what you didn't learn in nursing school.
Specializes in NICU, PICU, Transport, L&D, Hospice.
I guess I presumed that health professionals would only engage in skills that they've been trained to perform. On the clock or off. It's a different world out there.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
I did CPR on a guy in a convenience store once. That was the most help I ever gave. Other than that I once convinced a guy in afib to go to the hospital. I stayed with a pedestrian who was hit by a car until EMS came. I hung back and watched an asthma attack until EMS came.
I was definitely needed the day I did CPR, and I probably made a difference to the guy with Afib, who thanked me later. Other than that, I feel like I've mostly just helped people feel safer until EMS arrived.
Yes, I've helped three times. The first was post seizure and the crowd was trying to get him to sit up and drink water. (Why do they always do this) I told them to stop and put him in the recovery position till EMS arrived. Second was on a plane to AK a woman fainted and the crew asked me to monitor her till scheduled landing. I did and she was fine. (The crew gave me a bottle of wine) The third was at a public dance where a man suddendly fell and went into cardiac arrest. 3 paramedics and I arrived, I directed someone to call 911 and get a defibrillator. The paramedics took over. Unfortunately he later passed away. There was no defibrillator at the fairgrounds which later resulted in a law that there be one at all events in my state. I don't feel that I did anything major at any of these, but I tried to help.
I do want to add one thing - cardiac arrest is a no brainer.
I'm a huge data-nerd for cardiac arrest survival and no matter what toys, drugs, airways, we throw at these people, the ONLY thing that has shown statistical improvement in survival rate is early bystander CPR and early appropriately performed defibrillation.
I guess I presumed that health professionals would only engage in skills that they've been trained to perform. On the clock or off. It's a different world out there.
Yes, it IS a different (and litigious) world out there than it used to be (or at least than we remember). I wouldn't say a health professional shouldn't stop and render aid, more that a health professional should recognize the LIMITS of their education and training and render aid if it can be done safely. Yes, I would even counsel physicians NOT to stop and render aid if they cannot do so safely.
Remember that EMS personnel are specialists at what they do and work in an arena most other healthcare professionals aren't trained for.
FiremedicMike is 100% correct in that in the prehospital world, early bystander CPR and defibrillation makes a HUGE difference in outcomes. He and I probably could go on and on about this topic for a long time...
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hppygr8ful, ASN, RN, EMT-I
4 Articles; 5,217 Posts
Above being said I did stop at an accident a few years ago that happened literally in front of me. one Ricky rescue almost got hit putting out flares. There were small children in the hit car and mom was frantically trying to pull them out. Kids had airbag burns so I helped to rinse them off and got them to safety handed off to the paramedics when they arrived. Gave my business card to the cops in case they needed a witness statement and took off.
Hppy