Okay... Looking for everyone's input! So in class today we are talking about legal and ethical obligations of an RN.
We were discussing how as an RN you are legally obligated to stop and help if you pass an accident in certain states.
A student brought up what if you were in a bar on the weekend having a few drinks. Someone at the bar has a cardiac arrest. And no one else in the bar has a clue about how to perform CPR or help this person.
Even if you've had a few drinks... Would you feel obligated to help? Or could your license be at jeopardy because you performed healthcare on someone after having a few drinks?
I don't respond to anything outside of work, in any setting, unless it's someone I know (and, y'know, care about). Strangers are on their own, as far as I'm concerned.
I don't respond to anything outside of work, in any setting, unless it's someone I know (and, y'know, care about). Strangers are on their own, as far as I'm concerned.
I saw two accidents on the way home on I-5. Lots of people already standing there; no EMS yet. Didn't stop.
Obviously if someone were choking in a restaurant, and no one else was helping then I'd help. (Made me think of Mrs. Doubtfire - I miss Robin Williams).
Just to add to the conversation - I retired. My CPR cert has expired. Would that stop me from performing CPR? I don't think so! Would a cert expiration stop anybody?
Generally if your in an emergency and not being paid to be there as a healthcare provider you are considered a Good Samaritan. You should provide care as a reasonable person with equal training would. So CPR is ok. Hands only CPR is ok (911 instructs any bustanders to do hands only CPR and you are not required to give mouth to mouth if you don't want to since the 2010 AHA update) doing a trach with a bar knife and a straw not ok.
on a side note PLEASE don't asssit at accident scenes beyond controlling bleeding and opening airways. You are not properly trained or equipped to work in that environment and are often endangering yourself by doing so. Nurses would do well to adopt the EMTs safety priority list
I had no idea hands only cpr was taught. We were given masks to use for mouth to mouth and told we could always get new ones if we ever had to use. I carry it in my car. I also have an ambu bag. I've always been taught mouth to mouth. My very first certification was 1990. Then a couple of years ago I got my cpr/bls for healthcare workers. We pretty much learned the exact same method except we were given the masks. So I had no idea.
Thats why I asked you guys!! You know better than me!!!
Legal and ethical are two different constructs. There are many things a nurse does based on ethics. Care of self is put on the same level of importance as care of others (per ANA); if you think about it, failing to care for yourself (say doing mouth to mouth with no guard), you may later not be able to care for others. Not crossing over into other people's job descriptions (EMT) is important. But ethically, I'd want to do what I could safely do ( safe for me/safe for the person who needs help).
So we are at a bar, I would have to weigh out the potential for poor judgement vs. a person who needs help now. Love this question, because it does have a number of layers, beyond what was apparent from the OP. And yes, I know people get in legal dutch all the time over things they felt ethically compelled to do, that somehow went wrong and ended up causing legal ramifications.
Unfortunately, injuries can and do happen during CPR. I would worry that if an injury did occur during the administration of CPR, I would be legally liable due to being under the influence of alcohol. I don't know. That's a good question.
I mean... if the situation were exactly as described in the OP (literally NO ONE ELSE is able to help for whatever reason), what worse injuries could you cause? The guy's already dead. His heart is not beating. There's no way for that to possibly be any worse, and no possible way for it to get any better unless YOU (because apparently nobody else in the room is capable of helping) intervene. What's the risk here?
In my home state, EMTs, EMRs, nurses, doctors, etc. are not obligated to give any care in a medical emergency if they are off duty, but if you do choose to help, you're legally obligated to stay on scene until EMS shows up, even if the pt refuses care. (and if you're an EMT/paramedic, it has to be someone with equal or higher training).
I am from the United Kingdom and the resuscitation council over here state that if you need to perform CPR and don't want to give breaths because say the person has been sick or your just unsure of their background then we can give CPR by giving compressions alone. Obviously CPR may be more effective with rescue breaths and compressions combined but we can give just compressions as it too has proven to save lives also.
Specializes in Mental Health, Gerontology, Palliative.
If I was needed eg before the ambo's got there and would be looking at the DRs ABCs and stopping anyone else from moving any possible spinal injuries.
But then again we cant be sued, if someone is pissed off that the CPR that kept their blood circulating (until I could get my hands on an AED) breaks some ribs, I dont face the possibility of loosing everything I own
elkpark
14,633 Posts
I don't respond to anything outside of work, in any setting, unless it's someone I know (and, y'know, care about). Strangers are on their own, as far as I'm concerned.