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.
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:
I read the article. It mentions nurses in passing and focuses on EMTs and Medics. And it doesn't speak to the issue of scope of practice only the protection it provides. It might keep us from being liable but that does not guarantee that it would keep somebody from attempting to sue us and as I said before I don't have any extra money available to hire a lawyer for such nonsense. The AHA's stance is that they are not the ones who are certifying medical professionals to provide ACLS they simply give a certificate that states you passed the class. In my current role I am not allowed to independently give Epi. Is it stupid? Of course, but their house their rules. Even when I ran codes myself I was working off of a protocol. I was not allowed to stray from the PALS algorhythms without explicit MD orders. In my research I have found that most airlines have standing orders, signed by a physician, that state any responding medical personel should follow ACLS guidelines which would cover us but I would just like to see something specific in writing. Especially in this day of rampant litigation and nursing boards that seem to be more and more punitive. Pretty much every article I've found focuses on physicians and medics but not other types of health care providers. If I was hauled into court and asked if I was allowed to give medications without an order I'd just like to be able to answer "yes under certain circumstances" with a more concrete basis to that answer than "I read it on the internet". The FAMMA isn't all that clear.
Really people, I'm not that obtuse and I would never let another human being die without rendering the highest level of care that I can provide I just think it would be nice to know without a doubt that I'm not going to get skinned in the process. But not knowing would not stop me from doing the right thing.
I read the article. It mentions nurses in passing and focuses on EMTs and Medics. And it doesn't speak to the issue of scope of practice only the protection it provides. It might keep us from being liable but that does not guarantee that it would keep somebody from attempting to sue us and as I said before I don't have any extra money available to hire a lawyer for such nonsense. The AHA's stance is that they are not the ones who are certifying medical professionals to provide ACLS they simply give a certificate that states you passed the class. In my current role I am not allowed to independently give Epi. Is it stupid? Of course, but their house their rules. Even when I ran codes myself I was working off of a protocol. I was not allowed to stray from the PALS algorhythms without explicit MD orders. In my research I have found that most airlines have standing orders, signed by a physician, that state any responding medical personel should follow ACLS guidelines which would cover us but I would just like to see something specific in writing. Especially in this day of rampant litigation and nursing boards that seem to be more and more punitive. Pretty much every article I've found focuses on physicians and medics but not other types of health care providers. If I was hauled into court and asked if I was allowed to give medications without an order I'd just like to be able to answer "yes under certain circumstances" with a more concrete basis to that answer than "I read it on the internet". The FAMMA isn't all that clear.
Really people, I'm not that obtuse and I would never let another human being die without rendering the highest level of care that I can provide I just think it would be nice to know without a doubt that I'm not going to get skinned in the process. But not knowing would not stop me from doing the right thing.
I'm confused on what part of the following you don't understand...
In 1998, these protections were expanded to medical professionals in the sky providing in-flight emergency care, with the enactment of the Aviation Medical Assistance Act by Congress. The act specifically protects state-qualified EMTs and paramedics, along with physicians, nurses and physician assistants.
EMS...Emergency Medical Services...that means everyone that is licensed, nurse, physician, NP, EMT, paramedic, etc. It is NOT the same as an EMT.
So yes, the article addressed and it addressed it thoroughly.
I gave my students a challenge..I told them that I would give someone $50 that could find any nurse in our state that was sanctioned by the BON for attempting to render aid to a patient in an emergency situation that ended up getting in trouble for it.
Not a single student could find one.
In fact, they couldn't even find where one had ever been disciplined for a medical error...everything was drugs, false charting, abuse, etc.
It's time we stopped spreading these nursing myths as if they are common occurrences when they are not. Yes, you'll always be able to dig up a couple of stories on the internet. People have had meteorites hit their houses too but it sure doesn't happen every day.
There is a reason why I can carry $2 million in malpractice insurance for around $200 a year. It's because nurses are rarely sued.
It's not a matter of my misunderstanding. I'm not an idiot. I'm talking scope of practice, you're talking legal protection. So I think I will just bow out of this discussion before there are any more posts implying that I am intellectually challenged.
I'm not getting the premise for arguing that ACLS is not within a nurse's scope. Generally, scope of practice is defined as a broad description of potential scope with exclusions specifically listed, is there anything that says ACLS, which falls under all state's broad scope definition, is excluded from nurse's scope?
I'm also not sure why people think an MD must be present, that's the whole point of ACLS is that a physician does not need to be physically or otherwise present.
I had a coworker (ICU Nurse) respond during a plane medical situation (vagal/brady situation with LOC in an elderly patient), he communicated with a doc on ground via radio in the cockpit and did interventions accordingly.
Lung sounds, heart rhythm, last BM, INR, geez.... Good thing the Feds just linked up with Cerner. It's the only charting system I'm proficient in.
Not all Feds. VA uses a cryptic system that causes pain to the user. Sometimes, actual PAIN, if it's a particularly bad day and one part of the system doesn't feel like chatting with another part of the system or want to share its updates....
Not all Feds. VA uses a cryptic system that causes pain to the user. Sometimes, actual PAIN, if it's a particularly bad day and one part of the system doesn't feel like chatting with another part of the system or want to share its updates....
Oh, well, brace yourself, my love, for it seems you've missed the big news.
Which basically translates to "more pain and lack of communication", but in pretty color schemes.
Awesome. I've used three charting systems, and they picked the one I like least. It's the most cumbersome and awkward of the ones I've used (Epic, Centricity). Should fit in with the VA.
Okay people, in a dire circumstance without orders on a plane in the middle of the ocean I am going to push drugs. I am sure airlines/Feds/States have a protocol to cover licensed medical folks as well as ACLS having standing protocols in the absence of a physician. With the example listed above, airlines can get you in contact with a physician if you need help but even that takes time you can not afford to lose.
"Sorry bro you are crashing faster than my third grade paper air plane but I am not going to do anything because I am scared of losing my license when there are a myriad of protocols and Good Samaritan laws in place to protect me."
They put the kit on a plane for a reason, are you going to keep your hand down when they ask for medical personnel? What kind of person does that make you.
If you really deem you are that incompetent in ACLS situations or have little experience in that arena then BLS is better than nothing....
FlyingScot, RN
2,016 Posts
I read the article. It mentions nurses in passing and focuses on EMTs and Medics. And it doesn't speak to the issue of scope of practice only the protection it provides. It might keep us from being liable but that does not guarantee that it would keep somebody from attempting to sue us and as I said before I don't have any extra money available to hire a lawyer for such nonsense. The AHA's stance is that they are not the ones who are certifying medical professionals to provide ACLS they simply give a certificate that states you passed the class. In my current role I am not allowed to independently give Epi. Is it stupid? Of course, but their house their rules. Even when I ran codes myself I was working off of a protocol. I was not allowed to stray from the PALS algorhythms without explicit MD orders. In my research I have found that most airlines have standing orders, signed by a physician, that state any responding medical personel should follow ACLS guidelines which would cover us but I would just like to see something specific in writing. Especially in this day of rampant litigation and nursing boards that seem to be more and more punitive. Pretty much every article I've found focuses on physicians and medics but not other types of health care providers. If I was hauled into court and asked if I was allowed to give medications without an order I'd just like to be able to answer "yes under certain circumstances" with a more concrete basis to that answer than "I read it on the internet". The FAMMA isn't all that clear.
Really people, I'm not that obtuse and I would never let another human being die without rendering the highest level of care that I can provide I just think it would be nice to know without a doubt that I'm not going to get skinned in the process. But not knowing would not stop me from doing the right thing.