responding outside of hospital

[pinky22786]

There has been 2 times that I have felt bad about not responding to a accident outside of the hospital. Both were minor and want the opinon of other Nurses if I should have done something. I am one year out of school and have worked in a urgent care clinic as LPN and now on med/surg as RN.

First was one year into nursing school and I think that I had just passed my LPN test. My husband and I were at a hockey game when a puck came into the crowd and hit a elderly man in the face. He stood up on his own without any problem and sat back in his seat. There was minimal blood that I could see from my seat and with in 2-3 minutes First Aid Staff was on site. This one I dont feel bad about as he just had a laceration and what was I supose to do hold pressure on his nose as he was doing already. He came back to his seat with in 10 minutes of leaving to be checked out by First Aid Staff. My husband just does not let me live this down.

Then today I was at my brothers wedding and 2 children were jumping on a trampoline and bumped heads. The mom went over and pulled the little boy off and was carring him to a chair. You could see a small bloody nose but he was acting as a kid would when injured. The mom was holding pressure and checking his mouth out. I did not respond as she was doing everything I would have. Then my sister-inlaw called her mom over to check him out as she is a nurse too with much more experiance then I. She went over and checked his mouth out and then let the mom continue as she was.

If the situation does require more I have steped up and said something and assessed more indepth. Dirt bike accident, rider went over handle bars and landed flat on back, said to call ambulance to transport but they dissagreed and took rider in by private car. Turns out rider had multipul compresion fractures and was place in cspine once they arived at the ER.

I just feel like I have done something wrong when I do not respond. Yet when its something simple and I have assessed from a far and do not feel like it requires additional attention then what the people are doing already, I should not interfere just because I'm a RN. What are your opinons?

[loricatus]

I agree with you.

[TruNurse86]

You must be in my head because I was just thinking about the same thing. I recently just got accepted into a hospital LVN program and I am worried about all of the incidents I'll encounter off the job. Just my but I do not feel that you were wrong. I would have done the same things that you did in those situations.

[diane227, LPN, RN]

Does not sound like anything serious. You did the right thing. If you come on a situation and you don't know what to do, don't do anything. Unless you have had some specific training in emergency care I would advise you to stay clear of these situations. Most states have laws that protect people who render aid in an emergency but those who are in health care are held to a different standard. I have responded to many accidents because I was an ER nurse for decades and have a lot of experience with pre hospital care and first aid but if you don't, then don't try to do it. You may cause more harm and you might end up in court.

[NewGradRN09]

Also, in a lot of situations, what good are you without equipment? I am an EMT (and a new ER nurse) and I HATE when people show up to scenes and say, 'I'm a nurse!'... well that's a great accomplishment, but you really are not going to help me much by saying that. If you see someone having chest pain, the best thing to do is call 911. Without a bp cuff or any other equipment, you're just going to stand there awkwardly while the patient expects you to do something.

Obviously, if it's within your means to help (choking, CPR, etc.), help! But a lot of minor situations don't need the aid of a nurse, or anyone other than the patient's mom.

You've got a great heart though! Thank you for thinking of others :)

[nerdtonurse?, BSN, RN]

My guidelines are: if you're crying or screaming, you've got a)airway, b)breathing and c)circulation, and if I don't see jets of blood, compound fractures, or avulsion of tissue, I don't get involved -- sometimes, coming up and saying, "I'm a nurse" and trying to get involved just scares everyone into thinking the situation's worse than it is.

If you're having a CVA or MI, I can't do much for you without a EKG/drug box and gear, unless you need CPR, and if you need CPR in the field, I'll do my best until EMS shows. I do carry a mouthshield in my purse, and have a nice emergency bag in my trunk an EMS friend helped me set up -- basically a "keep them from bleeding out until EMS shows" kit. But that's because I live in a rural area, 30 miles each way to the hospital.

[Cyn2school]

Wow! What great advice here. Definitely wouldn't go beyond my scope of practice.

[sissiesmama, ASN, RN]

I agree with Newgrad and dianne, without equipment, there's not a lot you can do without the proper equipment. You don't want to end up libel for anything. Really the only type things I have assisted like that have been

an MVC with traumatic injuries (I am an ER RN and keep an extensive first aid pack in my car)

a driver who lost consciousness actually sitting in the vehicle in the parking lot of our hospital

Anne, RNC

I try to balance it with would I want someone to help me or my family if the need arose and "can I do more good than harm in this case". I have been thinking about going to EMT school for a change, and a lot of my buddies are firefighters and EMS.