Should I Have Stepped In??

MadisonMonroe · Mar 23, 2007

Trust your instincts. You assessed the situation and that is the first step.

New2ER · Mar 23, 2007

I'm going to address your post only because I have taught CPR for 7 years and address the very same issues you dealt with.

It's great that you're CPR certified but there are 3 reasons most people do not get involved in an emergency of the type you describe: 1. Fear of doing something wrong 2. Fear of disease 3. Fear of litigation. You pretty much covered all three. I tell you this so you'll know that your hesitation is not at all uncommon and you shouldn't feel guilty about it.

You should not get involved in caring for an unknown bystander unless you are willing to do EVERYTHING you have been trained to do. Doing anything less or leaving the patient if you became "grossed-out" for example, could lead to you being sued to negligence. So in that case, your hesitation was a good thing if you weren't fully prepared to act.

The Good Samaritan act covers layman citizens attempting to help within the scope of their training. That does not mean you can't get sued, it just means that a lawyer or judge would have grounds to dismiss the suit if you acted properly and within your scope as any prudent person would have done.

You should not feel bad about getting involved. Unless you are experienced at dealing with emergencies, this is one emergency that might have been over your head. Even as an experienced EMT and ER nurse for a year now, my adrenaline would have been rushing...I can't imagine how you felt not having been faced with a situation like this before. Being as you were not there under a professional capacity your only legal responsibility would have been to contact police/ambulance but as they were already on their way, there was obviously no need. Morally, others might have wanted you to act because you had some training; however, as cruel as it might seem, I tell my classes that if you wouldn't normally kiss the person and you have no protective gear - do not get involved in care. The situation sounded quite bloody posed several very real dangers for you.

Treating people in the field, i.e. outside a hospital setting, is quite different than what you learn in nursing school. The rescuer/partner and other personnel on scene take priority over the patient. If the rescuers get hurt, who is left to help? As an EMT/paramedic, you have to be prepared to leave that patient behind if say, the guy/girl with the showed up again until the situation was contained by police.

Police officers are usually trained EMTs in most states so they, of all people initially on scene, would have been responsible to act.

Flare, ASN, BSN · Mar 23, 2007

As I read the scenario there the only thing i could think was "scene safety". Given the fact that there was a shooting there, a crime scene and the whole bit, i can't say i blame you for not running out there. It may not have been safe for you.

Police are by and large cpr trained and if there was a true concern i am positive that they would have been administering cpr instead of processing the scene.

You have no duty (legally) to act unless you have been delegated /assigned that patient or scene. You may ethically feel like you need to do something, but that is a different situation.

creature · Mar 23, 2007

That would have scared my half to death and I'm not sure I would have jumped right in the middle of all that either. Like the others have said police are trained in CPR and I would assume would have initiated it if was needed. Don't be too hard on yourself, but I can understand how you must feel.

leesespieces · Mar 23, 2007

Thanks everyone for your replies and assurances. I feel much better. It was a pretty scary situation and something I've never seen before; thanks for helping me realize I did the right thing!

jill48, ASN, RN · Mar 23, 2007

You should be ashamed of yourself; and so should all of the posters that supported your cowardness. That was someone's child, brother, or father. And you said you are sure the amulance was only "minutes away"? Well alot can happen in those "minutes". Like you could have helped. It's really sad when someone who can save a life doesn't just because they are afraid of legal ramifications. If anything, there should be legal ramifications for people who can help but refuse to. And to all of you who are going to post now and say that I am being to rough on the OP, this was a life or death situation, and she could have saved a life.

Flare, ASN, BSN · Mar 23, 2007

You should be ashamed of yourself; and so should all of the posters that supported your cowardness. That was someone's child, brother, or father. And you said you are sure the amulance was only "minutes away"? Well alot can happen in those "minutes". Like you could have helped. It's really sad when someone who can save a life doesn't just because they are afraid of legal ramifications. If anything, there should be legal ramifications for people who can help but refuse to. And to all of you who are going to post now and say that I am being to rough on the OP, this was a life or death situation, and she could have saved a life.

So based on your answer - if given the same situation where someone was shot in the street before you, you would put your own life and safety on the line and rush out into what can very easily be a very unsafe scenario? What if the person was just reloading?

In the same manner of thinking, would you attempt to pull someone getting electrocuted off of a downed power line?

I am not saying liability - i am saying personal safety. The issue of legally responsible vs. ethically responsible to me is rather minor compared to personal safety.

queenjean · Mar 23, 2007

Whoa, Jill, it's hard to assess what was going on; those are some strong words from someone who wasn't there.

If the police were there and were not doing anything for the person, I would assume that person was dead. Plus, if they are securing an area, they aren't going to let anyone in. Running up to help might get you tackled, maced, or tazered if you aren't okayed to even be in the area.

One thing about nursing (or life in general) is to learn from situations. Take a look at what happened. What did you do right? I'd say: concern for your own safety. In a situation with unknown shooters, where police are on hand securing the scene, I'd say that safety is an issue.

What could you have done differently? Well, not having been there, it's hard for me to say. but here's a suggestion if you come across a similar situation again. Try to identify a person in charge, tell him/her your qualifications, and offer your assistance. If they need you, they'll put you somewhere. So I guess you could have gone up to a cop, said something like, "Hey, I'm a nursing student, I am CPR certified, that fellow appears in need of assistance. Is there anything I can do to help?"

Learn from the situation, critically analyze it, and then move on. Nearly every day in nursing you will screw up, or potentially screw up. Not too long ago I mis-set a PCA. I gave someone 10x the amount of pain medication they were supposed to have. For 2 hours. Despite me having checked it, and another nurse double checking my work. Luckily the patient wasn't injured (as a matter of fact, she complained that the PCA only worked for the first two hours--lucky me that the day I screw that up, it's on a person who is a chronic drug user and was probably looking for a fix, as we were her third hospital in two days for three different complaints of pain...).

Did I beat myself up about it? Well, yeah, some. I could have killed her. Will it every happen again? I dont' think so. I am FASTIDIOUS about checking my PCAs, as well as when I double check others. I ALWAYS now recheck my settings 30 minutes into a dose. I examined what I did wrong, and improved my practice because of it. I didn't quit nursing, I don't lose sleep over the error (well, maybe that first night or two I did), and I got over it. I won't ever forget it, but I won't let it happen again. It's called learning from your experience.

This sounds like it was a scary but valuable experience. Nursing work is filled with such experiences. You can always take away something positive out of it, you can always learn and grow from it.

jill48, ASN, RN · Mar 23, 2007

So based on your answer - if given the same situation where someone was shot in the street before you, you would put your own life and safety on the line and rush out into what can very easily be a very unsafe scenario? What if the person was just reloading?
In the same manner of thinking, would you attempt to pull someone getting electrocuted off of a downed power line?
I am not saying liability - i am saying personal safety. The issue of legally responsible vs. ethically responsible to me is rather minor compared to personal safety.

She said the police were there. Is that not safe enough for you all?

jill48, ASN, RN · Mar 23, 2007

Whoa, Jill, it's hard to assess what was going on; those are some strong words from someone who wasn't there.
If the police were there and were not doing anything for the person, I would assume that person was dead. Plus, if they are securing an area, they aren't going to let anyone in. Running up to help might get you tackled, maced, or tazered if you aren't okayed to even be in the area.
One thing about nursing (or life in general) is to learn from situations. Take a look at what happened. What did you do right? I'd say: concern for your own safety. In a situation with unknown shooters, where police are on hand securing the scene, I'd say that safety is an issue.
What could you have done differently? Well, not having been there, it's hard for me to say. but here's a suggestion if you come across a similar situation again. Try to identify a person in charge, tell him/her your qualifications, and offer your assistance. If they need you, they'll put you somewhere. So I guess you could have gone up to a cop, said something like, "Hey, I'm a nursing student, I am CPR certified, that fellow appears in need of assistance. Is there anything I can do to help?"
Learn from the situation, critically analyze it, and then move on. Nearly every day in nursing you will screw up, or potentially screw up. Not too long ago I mis-set a PCA. I gave someone 10x the amount of pain medication they were supposed to have. For 2 hours. Despite me having checked it, and another nurse double checking my work. Luckily the patient wasn't injured (as a matter of fact, she complained that the PCA only worked for the first two hours--lucky me that the day I screw that up, it's on a person who is a chronic drug user and was probably looking for a fix, as we were her third hospital in two days for three different complaints of pain...).
Did I beat myself up about it? Well, yeah, some. I could have killed her. Will it every happen again? I dont' think so. I am FASTIDIOUS about checking my PCAs, as well as when I double check others. I ALWAYS now recheck my settings 30 minutes into a dose. I examined what I did wrong, and improved my practice because of it. I didn't quit nursing, I don't lose sleep over the error (well, maybe that first night or two I did), and I got over it. I won't ever forget it, but I won't let it happen again. It's called learning from your experience.
This sounds like it was a scary but valuable experience. Nursing work is filled with such experiences. You can always take away something positive out of it, you can always learn and grow from it.

Yes. I HAVE come upon situations and pulled over my car and got out and walked up to the police and offered my help. I WOULD lose sleep if I could have helped, but didn't. And there is no comparing this situation to a med error. Gimme a break!

scallisto · Mar 23, 2007

jill48,

I think you should be ashamed of yourself!! Yes everyone is entitled to their opinion but you could have been a little more compassionate in your post. You were really harsh. Also, you cannot say for certain what you would have done, as a NURSING STUDENT, in that situation b/c you were not in the situation as a NURSING STUDENT!

Steph