RN responsibility--how far do you go in being a first responder?

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by wannabecnl wannabecnl Member Nurse

Specializes in PACU, presurgical testing. Has 4 years experience.

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traumaRUs

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 30 years experience. 164 Articles; 21,186 Posts

As an RN you have no duty to respond. Heck even as an APN, I have no duty to respond. Since you don't know what is going on, no action on your part is needed except to call 911.

I will then add that I'm also a pre-hospital RN with my rural rescue squad. I drive about 100-200 miles/day for my job, all in rural areas. When I'm outside my fire dept district, I would stop ONLY if I was obviously the first person on the scene.

You can easily get yourself into trouble, both liability-wise as well as health-wise when you don't have pre-hospital experience.

xtxrn

xtxrn, ASN, RN

4,266 Posts

As an RN you have no duty to respond. Heck even as an APN, I have no duty to respond. Since you don't know what is going on, no action on your part is needed except to call 911.

I will then add that I'm also a pre-hospital RN with my rural rescue squad. I drive about 100-200 miles/day for my job, all in rural areas. When I'm outside my fire dept district, I would stop ONLY if I was obviously the first person on the scene.

You can easily get yourself into trouble, both liability-wise as well as health-wise when you don't have pre-hospital experience.

Good point :) I saw an accident that had obviously happened very shortly before I came upon it (a very small car became one with a very large RV at the end of an on ramp on I-10)....and it was gruesome. There were people all over the place (moving and otherwise), most trying to help. I have no clue if any of them were medically trained (no emergency personnel there yet)- but what I saw was a situation that could only get worse with more people running around- not to mention cars lined up along the shoulder. And the person left in the small car was pretty obviously beyond help- or didn't need anybody moving them- even if "only" for crime scene/accident investigation purposes.

Double-Helix, BSN, RN

Specializes in PICU, Sedation/Radiology, PACU. Has 11 years experience. 1 Article; 3,377 Posts

I'm not sure where you learned that you are obligated to respond to an emergecy, or potential emergency, because you have an RN license. If someone, God forbid, is shot on the street right in front of me, I have no obligation to get involved because I'm an RN. That's extreme, but likewise, I don't have any legal obligation to assist anyone outside of my place of employment. The only thing you need to do in this situation is call 911.

The only way anyone would know you were a nurse at the scene is if you identified yourself as such, so how would you be brought up on discipline for this sort of thing?

Finally, I would never put my kids in the car to drive to the scene of an accident. In fact, I would never stop at an accident scene if I were alone in the car with kids. Not only does it risk (as another post stated) traumatizing them, but who is going to keep an eye on my children while I am assisting the accident victims. My kids come first.

hecallsmeDuchess

hecallsmeDuchess

Specializes in LTC, Acute care. Has 6 years experience. 346 Posts

I've always wondered what my responsibility was in these cases.

The last time I saw someone down in Walmart, I was just a few months into having my license. It happened right in front of the pharmacy and I didn't know what to do but a few people who I suspected were family members were around her. I knew the pharmacy had called somebody because I could hear them talking on the phone as I stood in line. I was so uncomfortable not knowing what I should do, if anything so I just wandered around checking my watch and hoping EMS arrived fast. It took them quite a while (well, 20 minutes) but it felt like forever. I was so disturbed by that scene and the fact I felt so helpless but I guess it makes sense not to jump blindly into things as others have so wisely said.:nurse:

That Guy, BSN, RN, EMT-B

Specializes in Emergency/Cath Lab. Has 6 years experience. 3,421 Posts

Only time I ever have done anything was when I had a pretty good accident that shut I-70 down. Once I assessed myself and my passenger, I went from car to car to make sure there were no serious injuries. EMS was already alerted as I had the fortune of hitting a police car ( Bonus points? ).

Should the situation arise where I can help out, I bet I would do it. I would never do anything to put myself or my life on the line though....to a certain degree.

traumaRUs

traumaRUs, MSN, APRN, CNS

Specializes in Nephrology, Cardiology, ER, ICU. Has 30 years experience. 164 Articles; 21,186 Posts

But why make yourself a potential victim?

When I go on a call (as a volunteer ff), I have 12 yrs experience/training to do this, I have taken several defensive driving courses to insure you don't hit ME while trying to render aid, I have the equipment (including extrication equipment), and I have enough similarly trained folks (whom I would and do trust with my life) at my side.

Please don't interfere.

linearthinker

linearthinker, DNP, RN

Specializes in FNP. Has 25 years experience. 1,688 Posts

Has the opportunity to do so ever arisen?

Of course.

wannabecnl

wannabecnl

Specializes in PACU, presurgical testing. Has 4 years experience. 2 Articles; 341 Posts

Interesting points. I was told by a professor early on (I believe it was in prereqs, not in the nursing program) that we had a professional responsibility law that meant we did need to act within our scope of practice. I do know (from looking it up on the BON website) that we have a Good Samaritan law that protects us from liability in a case where we try to help. I'll check the first part with the BON.

One reason that I want to volunteer with the Red Cross is to learn the right way to respond to incidents, both large and small scale. I'm not looking to "interfere," but I can't see myself sitting by while someone gets hurt or sick and not offering something to help if there's no one else there and if it is safe to do so. For example, I'm certified in BLS and ACLS; it would be unethical for me to sit by and watch someone have a heart attack on the street and not do what I've been trained to do in that situation.

Don't worry, folks; I'm not some nutball ambulance chaser; I just wanted to know where the line is between non-interference and negligence. It's clear from people's posts that apart from personal/family safety, that line is pretty fuzzy.

xtxrn

xtxrn, ASN, RN

4,266 Posts

Interesting points. I was told by a professor early on (I believe it was in prereqs, not in the nursing program) that we had a professional responsibility law that meant we did need to act within our scope of practice. I do know (from looking it up on the BON website) that we have a Good Samaritan law that protects us from liability in a case where we try to help. I'll check the first part with the BON.

One reason that I want to volunteer with the Red Cross is to learn the right way to respond to incidents, both large and small scale. I'm not looking to "interfere," but I can't see myself sitting by while someone gets hurt or sick and not offering something to help if there's no one else there and if it is safe to do so. For example, I'm certified in BLS and ACLS; it would be unethical for me to sit by and watch someone have a heart attack on the street and not do what I've been trained to do in that situation.

Don't worry, folks; I'm not some nutball ambulance chaser; I just wanted to know where the line is between non-interference and negligence. It's clear from people's posts that apart from personal/family safety, that line is pretty fuzzy.

Your scope of practice isn't to run to accidents :D That's for the paramedics and EMTs :) Your scope starts when they're admitted to your floor.... Check the first part as you'd planned- states do have different requirements. My experience is that we are not obligated -- and there was something about not having vanity license plates w/anything 'nursey' on them, to avoid any problems like witness statements, etc. It's sad that in this day and age, we have to protect ourselves against the creeps who set up scenarios to lure victims to them.

If you see an MVA, or other incident, and want to help- and have the skills to do so (be careful with that one- even stabilizing a neck without someone else there with a collar/board can be risky).

As far as unethical- that's a personal decision. You can't be negligent for something you don't do (on the street)....and yet, I do understand how hard it would be to not help. But for your state, best to look at the BON requirements. :)

danh3190

danh3190

Specializes in Med-Surg, Cardiac. Has 4 years experience. 510 Posts

One reason that I want to volunteer with the Red Cross is to learn the right way to respond to incidents, both large and small scale. I'm not looking to "interfere," but I can't see myself sitting by while someone gets hurt or sick and not offering something to help if there's no one else there and if it is safe to do so. For example, I'm certified in BLS and ACLS; it would be unethical for me to sit by and watch someone have a heart attack on the street and not do what I've been trained to do in that situation.

But, unless the person's in cardiac or respiratory arrest, what can you do with your BLS or ACLS? I don't carry O2, IV supplies, or drugs in my car. The most important thing is to call 911 and clear any obstacles that would interfere with their ability to access and treat the patient. I've been a paramedic 27 years and have only stopped to help at 3 or 4 scenes. If everybody's awake and I don't see lots of blood flowing there's not much I can do except call 911.

SummitRN, BSN, RN

Specializes in ICU + Infection Prevention. Has 10 years experience. 2 Articles; 1,567 Posts

If the EMS professionals aren't there, "hi I'm *first name* and I know first aid. Can I help you?" act reasonably at the first responder level, and when the professionals show up, offer your help, but be prepared to get out of the way.

If EMS is there, leave them alone... unless it is one ambulance and a school bus hit a van full of nuns.

SNIXRN

SNIXRN

Specializes in Critical Care. CVICU. Adult and Peds PACU.. Has 8 years experience. 269 Posts

But, unless the person's in cardiac or respiratory arrest, what can you do with your BLS or ACLS?.

They could be seizing, choking, cyanotic, vasovagal... All things that we can help with (without supplies), at least until EMS arrives. If not anything else, call 911 and make sure they are out of harms way.