I recently went on vacation & was on an airplane. A person on the plane had a seizure & then went into full arrest. There was another RN on the plane with me. We are both ER nurses & ALCS certified. We used a BVM & an AED. We started an IV and gave epi. All supplies were from the plane. My license is in California. We Diverted to Nevada.
Looking back I wonder if I was covered under the good Samaritans law or did I practice outside my state & scope of practice. Technically, although we left California we landed in Nevada so I wasn't in my state. Also, there was no doctor on the flight who gave the epi order.
You can't compare the two. A flight falls under federal, not state guidelines regardless of what state the plane is flying over.
I cannot work as a nurse outside of my state without obtaining a license in the state in which I wish to practice. The exception to that was when I was transporting and we could practice nursing in our neighboring states because the patient was technically admitted to our hospital upon our arrival (we were literally designated as a hospital without walls). My question is when we are flying as civillians and outside of the auspices of our state regulations are we federally recognized as nurses? In that case what scope of practice do we fall under?
Specializes in Adult and Pediatric Vascular Access, Paramedic.
Hi,
My two cents is that I would rather take my chances and help someone than refuse and watch them die, especially in a serious emergency such as anaphylaxis or cardiac arrest. My niece has a severe peanut allergy and I would want someone to help her providing they had the proper knowledge, especially since according to the article I read they carry Benadryl IV as well as Epi. I do think they should have you show proof of licensure though.
I will ink the article which actually highlights available medications and equipment on a plane. I would probably hesitate to put a line in someone who does not have a life threatening illness (they just feel nauseou etc.)
Just a thought that Lay people give epi all the time - I have had an epi pen for my allergic asthmatic son since he was two. Because he goes to a private school any number or teachers, coaches and Scout leaders have been trained - by me and authorized by me to give it when needed.
The prescription functions as the order. A doctor has given the instruction for that patient to have an epi pen under a certain set of circumstances.
I think this is one of the sad things about nursing. Would a doctor wonder if they were "allowed" to try to save a person? Would a paramedic or EMT? No, only a nurse seems to be stuck in this area where they have enough knowledge to do something like follow ACLS protocols and yet they might be in trouble if they actually do it.
Also, I wonder what kind of documentation is required? It just wouldn't feel right not to chart a head to toe assessment and then fill out 3 or 4 different forms that all say the same thing. And who I gave report to once the airplane landed.
I cannot work as a nurse outside of my state without obtaining a license in the state in which I wish to practice. The exception to that was when I was transporting and we could practice nursing in our neighboring states because the patient was technically admitted to our hospital upon our arrival (we were literally designated as a hospital without walls). My question is when we are flying as civillians and outside of the auspices of our state regulations are we federally recognized as nurses? In that case what scope of practice do we fall under?
You can't compare transport nursing to commercial flights. Although air transport service is regulated by the FAA, rules on commercial airplanes are still federally regulated.
Use common sense and think about how silly it would be if it wasn't. You have a passenger that goes down and let's say you are in the only medically trained person on that flight as an RN. You don't ask the pilot, "Hey, can you let me know what state we are flying over...this guy on the floor doesn't look so good but I can't push any meds because I'm licensed in a compact state and if we are not flying over one I can't do anything for him except CPR."
Seriously....think about that for a moment. You have a passenger in full cardiac arrest...would you really and truly just let him lay there and die if you knew what to do, had the equipment to do it, and just ...well, didn't.
Physicians have to be licensed as well in individual states. If federal regulations state you can, then you can. The scope of practice is going to default to your highest level of training...the same as it would in the state you are licensed in.
Also, I wonder what kind of documentation is required? It just wouldn't feel right not to chart a head to toe assessment and then fill out 3 or 4 different forms that all say the same thing. And who I gave report to once the airplane landed.
You are not going to perform a head-to-toe assessment because even a physician doesn't perform a head to toe assessment if someone is in full cardiac arrest.
You are not going to be charting on the plane at all. You are going to stay with that passenger.
You give report to the medics when they arrive at the airport and ask them if you need to write anything down...many times it's not needed, they do it for you.
You can't compare transport nursing to commercial flights. Although air transport service is regulated by the FAA, rules on commercial airplanes are still federally regulated.
Use common sense and think about how silly it would be if it wasn't. You have a passenger that goes down and let's say you are in the only medically trained person on that flight as an RN. You don't ask the pilot, "Hey, can you let me know what state we are flying over...this guy on the floor doesn't look so good but I can't push any meds because I'm licensed in a compact state and if we are not flying over one I can't do anything for him except CPR."
Seriously....think about that for a moment. You have a passenger in full cardiac arrest...would you really and truly just let him lay there and die if you knew what to do, had the equipment to do it, and just ...well, didn't.
Physicians have to be licensed as well in individual states. If federal regulations state you can, then you can. The scope of practice is going to default to your highest level of training...the same as it would in the state you are licensed in.
I wasn't comparing this situation to transport I was simply outlining how I can practice in another state without actually having a license in that state and I have plenty of common sense thank you but all I've seen here are people's opinions about we legally can and cannot do. I have seen nothing in writing that definitively states what the federal government says our scope of practice as nurses is and that is all I was asking.
The scenario you posted was ridiculous and frankly insulting. I'm not an idiot. Of course I would do what I can in an emergency situation and I'm well qualified to run codes without a physician however I am also prudent and I don't have a ton of extra cash lying around to defend myself in a lawsuit because I inadvertently went outside my SOP based on what strangers on the internet said.
You are not going to perform a head-to-toe assessment because even a physician doesn't perform a head to toe assessment if someone is in full cardiac arrest.
You are not going to be charting on the plane at all. You are going to stay with that passenger.
You give report to the medics when they arrive at the airport and ask them if you need to write anything down...many times it's not needed, they do it for you.
psssttt.....I really think SubSippi was being sarcastic, using tongue-in-cheek humor.
Also, I wonder what kind of documentation is required? It just wouldn't feel right not to chart a head to toe assessment and then fill out 3 or 4 different forms that all say the same thing. And who I gave report to once the airplane landed.
Jory, can you post a link to what the federal government says our scope of practice is as nurses responding to in-flight emergencies during our civilian air travel?
I wasn't comparing this situation to transport I was simply outlining how I can practice in another state without actually having a license in that state and I have plenty of common sense thank you but all I've seen here are people's opinions about we legally can and cannot do. I have seen nothing in writing that definitively states what the federal government says our scope of practice as nurses is and that is all I was asking.
Links to information about the federal Aviation Medical Assistance Act have been posted in this thread twice. Both mention that it applies to physicians, nurses, PAs, and EMTs. I'll link it again:
FlyingScot, RN
2,016 Posts
I cannot work as a nurse outside of my state without obtaining a license in the state in which I wish to practice. The exception to that was when I was transporting and we could practice nursing in our neighboring states because the patient was technically admitted to our hospital upon our arrival (we were literally designated as a hospital without walls). My question is when we are flying as civillians and outside of the auspices of our state regulations are we federally recognized as nurses? In that case what scope of practice do we fall under?