Old Women Hit by Car...What Would You Do?

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So the other day I am driving along and come upon an old women laying in the street as she has just been hit by a car while walking across a cross walk. I pull over to see if there is anything I can do. There is an old man kneeling next to her. I tell him I am a nurse and ask if there is anything I can do to help. He tells me, "I'm a physician, she's just out of it, I mean I'm out of it too, but not that out of it and I'm not in the mood for your help right now." The woman is breathing, talking etc. However, she is confused. The police arrive on the scene and an ambulance is coming in the distance. At this moment before the ambulance arrives the old man/physician instructs the women to get up and helps her walk to the sidewalk. As a new grad nurse who hasn't started working yet I realize that I do not have much training in this area of nursing. However, my thoughts were ABC's and do not move the women until the medical team arrives is able to stabilize the spine. If I would have been the only one on the scene I then would have moved on to assess as much as I could while waiting for more help to arrive. I mean it's an older women, which makes me think fragile bones, combined with a hard fall etc etc. What do you all think?? What would you have done in this situation??

I wonder if the doctor was the one who hit her?

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I wonder if the doctor was the one who hit her?

That's what I was thinking.

Like some of the others have said, I would definately not move her unless she was unsafe and then do my ABC's.

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Thank you all so much for your responses. The input you have all provided was exactly what I was looking for. I will also give you a little more information. A young girl was the one who hit the woman with her car. After the physician took over care of the old lady. I went over to comfort the girl who had hit her. She was taking a left hand turn, had waited for others to cross, but did not see the lady d/t snow/ice on her car window. There was a younger couple also on the scene who had called for help and were controlling the traffic. Again, thank you all for your responses! :)

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Specializes in ER, ICU.

If a physician is directing care they are responsible for that care. If they are doing the wrong thing, and you feel like it, you can make suggestions like "I'm a trauma nurse and I think we should take spinal precautions". But you can't take over and shove them to the side (unfortunately). If I felt I needed to I personally would get pretty assertive, but still, they are responsible.

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Specializes in NICU, Post-partum.
So the other day I am driving along and come upon an old women laying in the street as she has just been hit by a car while walking across a cross walk. I pull over to see if there is anything I can do. There is an old man kneeling next to her. I tell him I am a nurse and ask if there is anything I can do to help. He tells me, "I'm a physician, she's just out of it, I mean I'm out of it too, but not that out of it and I'm not in the mood for your help right now." The woman is breathing, talking etc. However, she is confused. The police arrive on the scene and an ambulance is coming in the distance. At this moment before the ambulance arrives the old man/physician instructs the women to get up and helps her walk to the sidewalk. As a new grad nurse who hasn't started working yet I realize that I do not have much training in this area of nursing. However, my thoughts were ABC's and do not move the women until the medical team arrives is able to stabilize the spine. If I would have been the only one on the scene I then would have moved on to assess as much as I could while waiting for more help to arrive. I mean it's an older women, which makes me think fragile bones, combined with a hard fall etc etc. What do you all think?? What would you have done in this situation??

My guess?

The guy may not have even been a physician but more along the lines of a physician wannabe.

I think you were right...the fact he even asked her to move, was rude when you asked to help...tells me he was not who he said he was.

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The paramedics should have taken control of the scene. It's their expertise. If you stumble across an accident scene, you check for safety first, only move victims if it's absolutely necessary and hold c-spine or preform CPR until the paramedics arrive. At that point I defer to them. I don't know much about scene management, extrication, and transport.

I feel it's as safe bet to assume this "physician" was not a doctor at all.

(P.S. - It's womAN, unless there were several women lying in the road.)

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Specializes in Med/Surg - E.R. - Pediatrics.

You did fine... you did exactly what your teaching told you .... ABC's Dont move the patient unless their life depended on it (IE. the car was about to catch fire). The problem here is your dealing with uneducated people who under stress do stupid things. A Doctor knows not to move the patient but you can only suggest... some doctors think they know it all (most do)

I wouldnt worry about it... you did what you could.

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You did fine... you did exactly what your teaching told you .... ABC's Dont move the patient unless their life depended on it (IE. the car was about to catch fire). The problem here is your dealing with uneducated people who under stress do stupid things. A Doctor knows not to move the patient but you can only suggest... some doctors think they know it all (most do)

I wouldnt worry about it... you did what you could.

Unless he can prove his credentials, I'm not deferring to any Tom, Dick or Harry on the street who claims they are a doctor and putting a person at risk. And, even if he can prove his credentials, I'm still not deferring to bad judgement.

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Maybe he has the latest Readers Digest 1st Aide Manual and fancied himself as a bit of a legend??

Did you ever find out if the woman was okay?

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Specializes in Spinal Cord injuries, Emergency+EMS.
If a physician is directing care they are responsible for that care. If they are doing the wrong thing, and you feel like it, you can make suggestions like "I'm a trauma nurse and I think we should take spinal precautions". But you can't take over and shove them to the side (unfortunately). If I felt I needed to I personally would get pretty assertive, but still, they are responsible.

you have a professional responsibility once you assumed that duty of care.

'just following orders' didn't work in Nuremburg and it won't work in a modern courtroom.

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Specializes in ER.

This didn't happen in a small town in central california did it?? I saw a very similar scene unfolding last week I believe on my way home. Old lady on the ground but she was at the curb and PD was on scene when I came by.

Anyway, street medicine is always complicated. Everybody that has seen an episode of COPS or Trauma life in the ER or HOUSE or any number of elaborate medical entertainment shows on, wants to be the hero and rush in to save a life. If the guy was a doctor then how does he know your a nurse? I've happened upon a few MVA's and such in my travels and always somebody id's themselves as fire/rescue, volunteer, lifeguard or whatever but you do what you can. People are strange animals and it's difficult to say how they will respond if you try to assert yourself and you have to ask yourself is it worth endangering my safety? Good Samaritan laws are in place to protect you and as long as YOU don't act grossly negligent then you are not at fault. He ID'd himself as a physician, he moved the lady to the curb, therefore he is responsible for his own actions. In reality are you going to stand there and argue with some stranger about how to treat this lady? He's getting her up are you going to hold her down? You can suggest not moving her but in his 1st response to you he already dismissed you as a credible voice and would most likely become even more dismissive if you questioned his actions. You can't make people do what you want and honestly if you had attempted to stop him by either restraining him or the pt then your actions could be considered assault.

With all that said, you did the right thing. You identified yourself and offered assistance. There really isn't much more you can do when someone is there and feels they are in control of the scene.

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Specializes in Med/Surg - E.R. - Pediatrics.
Unless he can prove his credentials, I'm not deferring to any Tom, Dick or Harry on the street who claims they are a doctor and putting a person at risk. And, even if he can prove his credentials, I'm still not deferring to bad judgement.

I really get tired of know it all's. You dont know that mans credentials any more than he knows yours, All you can do is ask... I would never stop in an Emergency situation and ask anyone to Prove to me they are who they say they are while there is a life to be saved. Its just not common since.

You do what you can,..... You are not responsible for what some other idiot does... your only responsible for what you do.

And, even if he can prove his credentials, I'm still not deferring to bad judgement.

Oh Please what are you going to do Tackle the guy? If someone wants to be an Idiot off your duty there is nothing short of violence that will stop them. Are y ou going to stand in the middle of the street Yelling and screaming to get this guy to stop moving the patient?

Ask 800 people and you will get 800 ways to spin it...

Use common since... Do ABC's, insure the patient is in a safe location, keep patient stable... if some fool tries to move the patient then you try to explain its not the tight to do. If they pick the patient up and move them its their problem not yours.... just try to stabilize the patient once the patient is moved. And like everything Document Document Document even if your not on the clock. Because as you can see by the answers posted here ... their is always someone looking for a Lotto Ticket Win and will sue. That is whats nice about the good samaritan laws

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