Obligation to respond: what is your take?

Nurses General Nursing

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I've recently been thinking alot about how, as a nurse, one is supposed to handle injuries/medical situations in the public setting that may come up when one is "off the clock". I want to be helpful but I'm also concerned about liability and the appropriateness of it all.

For example, I was at a softball game one evening and a player took a hit to the face. All the other players and the coaches immediately rushed out to the field and seemed to be handling the situation appropriately (ice to injury, asking appropriate questions, assisting to seated position, etc) and ultimately sent him to the ER as a precaution. I just kind of hung out in the background monitoring it all and asked a question or two but, really, had no part it the process. They were doing everything I felt I would've have done anyway and I felt like I would have just be in the way.

What would you do if a situation like this or any medical situation came up in a public setting? Would you feel obligated to respond or give advice on what should be done whether or not you're asked to help?

Thank you for your responses! I definitely considered liability and the "Good Samaritan" law and then realized that this was true only in emergency situations. It's just been something that I've been thinking about alot lately, not necessarily because of this situation...just in general.

Specializes in Geriatrics, Home Health.

I've intervened in a few situations, but I never mention my name, or the fact that I'm a nurse. Even with Good Samaritan laws, people who intervene in accidents can still be sued.

Specializes in Emergency, Telemetry, Transplant.
As long as you stick to what you KNOW, not what you see on TV, you will be ok.

You mean I can't cut open a patient's chest and insert a vodka "sterilized" straw as a chest tube? (:nono: I only bring this up since Carol did this on ER once....ugh)

I think in this day and age, too many nurses freak out unnecessarily over this issue.

Ever wonder how doctors in public, are always willing to help but nurses always claim that it's not a good idea because we'll get sued?

Ever wonder how it's doctors that always end up getting sued and never nurses...thus, why you can get for us for under $200 and theirs is thousands?

I never, EVER worry about it.

#1 I'm not going to try to be the hero...if I am not 100% sure how to handle a situation, I don't touch it.

#2 You also don't have to announce yourself as a nurse, if you help, unless you see someone doing something harmful.

I was the first at the scene of a major car accident once...a woman broke her leg so bad it was sticking out the side of her calf. I went over and held her hand, asked her questions to assess her consciousness. I screamed for two people to call 911 instead of standing their gawking. Someone tried to give her water, I told them not to in case they had to get airway access...then I had to tell them I was a nurse and they didn't pursue it.

I told the woman not to move, she asked me to get her out of the car and I told her, "The best thing you can do is sit where you are...when help arrives they'll have all kinds of equipment to get you out...if I do it, I may make your leg worse."

She was ok with this.

Turned out the woman had also broken her ribs and had internal bleeding. I found out she later died.

Do you think I sweated that ? Nope..not at all.

I acted within my scope of practice and I have never been trained to handle trauma.

I've intervened in a few situations, but I never mention my name, or the fact that I'm a nurse. Even with Good Samaritan laws, people who intervene in accidents can still be sued.

They get sued because they do things they are not trained to do or they make stupid decisions.

I don't even know if I live in state that has a Good Samaritan law, because to me, it doesn't matter.

Do what you know, stay away from what you don't, and it shouldn't matter to you either.

Specializes in ER.

If you choose to help, be aware that your IQ will drop about 20 points because of stress and an unfamiliar situation. Start with the basics and keep it simple. No spectator will know you're a nurse, so the high school kid who took first aid will have the same clout with his suggestions as you will with xx years of experience. The inexperienced yahoos will be the ones who butt right in, and take over, are you ready to deal with that somehow?

I keep going if I see an ambulance, they know what they're doing.

I'd have to see people trapped, unconcious, or severe bleeding with no EMS around, then I'd stop.

If you choose to help, be aware that your IQ will drop about 20 points because of stress and an unfamiliar situation. Start with the basics and keep it simple. No spectator will know you're a nurse, so the high school kid who took first aid will have the same clout with his suggestions as you will with xx years of experience. The inexperienced yahoos will be the ones who butt right in, and take over, are you ready to deal with that somehow?

I keep going if I see an ambulance, they know what they're doing.

I'd have to see people trapped, unconcious, or severe bleeding with no EMS around, then I'd stop.

I agree, no reason to stop if EMS is around. I wouldn't either. The only things that I have helped with is when there wasn't anyone around to help.

Specializes in LTAC, ICU, ER, Informatics.

As a former paramedic, I've stopped on my share of car accidents if there were no first responders there. I'll stop at an accident scene every time if there's no one else there yet.

As for other types of public settings, I'll leave it alone if it's being handled well. And will step in (and have) if the person is being or about to be harmed.

Ex #1 - my daughter was in a Jr. High basketball tourney and another girl took a bad hit and went down with a tibial fracture I could see from the stands. I waited for the trainers to deal, only to find out Jr. High here has no trainers, and the coaches have no first aid training, just CPR. When some helpful adults started waving the leg around in an attempt to elevate it and put a heavy bag of ice directly on the break, I intervened and basically did nothing but keep people from causing further injury until EMS got there.

Ex #2 - last week I was at dinner with friends and there was a full-blown choking at a nearby table. It was behind me so I only realized it when the victim started gasping and crying out while his rescuer was still doing the heimlich. I went over and it took me several firm and loud commands to get the rescuer to stop because the guy was making noise and so it wasn't indicated anymore and they needed to leave him alone. The wife got really upset with me, and informed me that "he wasn't breathing". Well, ma'am, he might not have been when it started, but at the point he's making noise you're supposed to stop. She got P.O.'d with me and as the patient was by then sitting and talking (albeit with a wheeze) I left it alone.

I don't lead with "I'm a nurse" I just say I'm trained and start giving instructions to people. I'll answer honestly if asked about my credentials, but most of the time I just step in and direct until official help arrives.

I have also found that people who know you're a nurse (family, friends, etc.) just expect you to jump right in and do something...even if the situation is being handled.

Eh, as the previous posters have said, I would just observe. Especially with kids, too many people around in "hero" mode spikes the tension level up a notch or two or ten, so I am hesitant to add to the mix. If I knew the child, and the child knew me, I would perhaps just offer some comfort--as in most of these situations until an ambulance arrives there's little one can do. Never the less, if it is a true emergency (life and/or limb) and is appears that the patient is suffering needlessly, then I would step in to offer assistance in a supportive role as opposed to calling the shots--If it were a CPR situation, then without question I would help--people tire quickly doing compressions.

Many fields and organizations or schools have EMT's on staff that are present at each game. Might be a thought for the powers that be as a suggestion for the future (as part of the athletic training department or the nurse's office).

If you frequent the games, I would certainly put a call into your carrier and just ask them about the scenario. Never hurts to be informed.

I won't go any further than performing a tracheotomy....... :nailbiting:

I won't go any further than performing a tracheotomy....... :nailbiting:

LOL from the pen you pull out of your pocket and Mc Guyver?!?!?!?!

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