Should I Have Stepped In??

PANurseRN1 · Mar 24, 2007

Well, good for you. That's what works for you. But there was no reason to bully the OP, which is what you did. She was obviously conflicted. There would have been much better ways to offer a differring POV without trying to make her feel like a terrible person.
FWIW, do you even work in the EMS system? Do you get to work with the police, ambulance crews, etc? Maybe things are just different in your area, because where I live I can tell you it would not be appreciated if you went busting into a scene where crime scene tape had gone up. (Which, BTW, when there's a body, usually means the person is dead, obviating the need for CPR.)

Never mind. I looked at your profile. My questions are answered.

jill48, ASN, RN · Mar 24, 2007

The OP also said she actually NEVER had to do CPR. This scene was NOT a good time for her to do her first one. Not at all.
I as a seasoned nurse, having done many rounds of CPR wouldn't have gone into this scene. It's too unsafe. She's too green. That's just common sense.

OMG I cannot even believe you just said that. She's too green? So when would it be a good time and environment for her "first one"? You say "first one" like it's some performance. IT WAS A LIFE. No one is going to care how nervous you are (even experienced nurses still get nervous) or if you miscount on your compressions.

PANurseRN1 · Mar 24, 2007

So last night right as we were about to fall asleep we heard what sounded like fireworks outside our apt. Then we heard people screaming. We thought it may have been gunfire since we also saw the lights of a police car a minute later. So we go outside to see what happened and find that 2 people were shot like 100 feet from our building!!! There was a young man lying on the ground, bleeding and someone said he was not breathing. ( The other guy I think was shot in the arm but was walking around and talking) The police were there but no one was doing compressions on this guy. It looked like there was a family member sitting next to him and I though I saw him give rescue breaths once. Then I heard him say he might have been breathing.
Now I am not a nurse yet (7 weeks to go) but I am CPR certified. I didn't step in and offer to do CPR for a few reasons. They had started to put up the crime scene tape and it was only a matter of a minute before the ambulance arrived. I never got real close but it looked bloody and I didn't have any gloves or anything and I don't know this guy from Adam. I've never had to actually do CPR. I guess I was just plain scared! Plus I don't know the possible ramifications if something went wrong. Would the Good Samaritan Act protect me? Was I obligated by law being healthcare provider CPR certified and a CNA to do something? I know the ambulance got there right away but now that I am thinking about it today I am getting upset and thinking no matter what I should have done SOMETHING or at least told the police I could try to help if they wanted me to. What do you think" I really feel terrible

Let me share something with you that happened to me when I was a student.

I was on summer break after my first year and was going to visit a friend. I was driving across a major bridge that connected one state to another. All of a sudden, there was a terrible accident right in front of me. Several cars involved. One slid on its roof and headed straight for me; I was sure I was going to get pushed straight off the bridge as I was in the outermost lane.

Traffic came to a standstill. I knew there had to be victims because of how bad the accident was. I was torn as to what to do. On one hand, I thought I should get out and see if I could help; on the other, because I had nothing with me and because of how bad the accident was, I didn't think there was really much I could do til EMS got there. I was also afraid of getting hit by cars trying to get around the pileup. (Philly/NJ drivers aren't exactly the most patient people in the world.)

EMS got there, and eventually traffic got moving. When I got to my friend's house, we watched the news, and I was horrified to hear that there were several fatalities. I sat there shaking and crying, thinking that maybe I could have done "something." That haunted me for a long, long time.

In retrospect, I now know that there was probably little I could have done. The scene was not secure, I did not have appropriate equipment to help them like c-collars (never thought about gloves and masks since this was back in the pre-HIV days) and I did not at that time have the knowledge to care for their level of injuries.

Don't let this get to you. You did what was right for you in that situation. In another place and another time, you might react differently.

jill48, ASN, RN · Mar 24, 2007

Actually no. As I said earlier I've run EMS for 7 years or so and have been in some very similar situations. I know of at least 2 cases where the police felt they has secured the scene after a shooting only to have the shooter return.
In one case the shooter jumped out of the closet of the apartment and shot the EMT on scene dead. He was the only person in the room because the police had already "secured" the scene. In the other, a shooting victim was being loaded into the back of an ambulance when the original shooter walked up to the stretcher and shot the victim in the head. These are rare but not unheard of instances. For a different kind of personal danger, a nurse I worked had contracted Hep C after doing mouth to mouth on a 12 year old that had hit his head on the side (open wound) of a pool and nearly drowned, his parents hadn't told anybody that he was infected.
I understand your anger over leaving a patient that could theoretically be saved and I applaud your courage and pulling over at accident scenes to help, however, in my opinion, personal safety is first and foremost. Can you honestly tell me that you'd be OK with being shot or contracting, say, HIV just so you can say you were being a hero? As nurses we're always thinking 2 steps ahead. EMS is no different, but safety for ourselves and other rescuers is always most important.

I'm not a hero. I never said I was one, and I don't want to be one. I'm just somebody who would help if it was needed. It has nothing to do with my skills. It has everything to do with me dedicating my life to people who cannot help themselves. And yes, I would take the chances you mentioned above. That is just who I am and I'm proud of it. So think what you want of me, but I guarantee if it was your brother or mother lying on the ground, you would be quite happy that someone like me was there.

flashpoint · Mar 24, 2007

One of the first things taught in just about any EMT class is scene safety...even the most seasoned professionals don't jump into potentially violent scenes until they are ASSURED that the scene is safe. The ASSURANCE that the scene is safe has to come from the LEO in charge once they are sure the bad guys are not going to come out of the shadows. People who are not a "part of the team" have NO business intervening on crime scenes...even just identifying yourself as a nurse and offering to help is a distraction to the LEOs who are trying to investigate, clear the scene, render aid, etc. I can't believe that anyone without proper training (training way more than CPR) would even think about trying to render aid at a CRIME scene...that seems more like bravado than compassion to me.

One of my instructors in paramedic school wore a t-shirt that said..."Compassion kills...don't dive into incidents." He is a very smart guy...

TazziRN, RN · Mar 24, 2007

Jill:

A) The poor dying soul on the ground was, in all likelihood, already dead if the cops were doing nothing and the relative was allowed to sit next to the body. Cops do not just stand around stringing up crime scene tape if the body on the ground is still breathing. Have you ever worked ER? In my entire career I have never seen a gunshot wound to the chest survive if the pulse and respirations have stopped, generally because the heart has either been shot to pieces or there's blood pooling in the chest.

B) Just because the cops were there does not mean the scene is secure. Medics can't even render aid until the scene has been secured, so ya know what? It's very possible the guy could have been breathing and yelling for help, but the medics would not have been allowed near him right away.

C) You are entitled to your opinions, and this board is all about allowing us to express opinions, but that does not give you the right to kick the (*&$! out of someone who didn't know what to do. It would be one thing if she stood by and deliberately yelled to the rafters "I don't want to get involved!" but that ain't what happened.....she didn't know if she should have gotten involved. The mods are probably going to ask me to edit this one but I've gotta say it: I feel sorry for any students or new nurses who have to come to you for questions. You're jumping all over the OP about her supposed lack of compassion but you don't seem to know the meaning of the word yourself.

LovebugLPN · Mar 24, 2007

Tazzi,

I love your responses, especially this one. You managed to say it all and in the most thorough way I could imagine. The OP did the right thing and she needs to know that.

PANurseRN1 · Mar 24, 2007

I'm not a hero. I never said I was one, and I don't want to be one. I'm just somebody who would help if it was needed. It has nothing to do with my skills. It has everything to do with me dedicating my life to people who cannot help themselves. And yes, I would take the chances you mentioned above. That is just who I am and I'm proud of it. So think what you want of me, but I guarantee if it was your brother or mother lying on the ground, you would be quite happy that someone like me was there.

I don't think anyone has accused you of being a hero; quite the opposite.

flashpoint · Mar 24, 2007

I love you Tazzi...

BJLynn · Mar 25, 2007

OP: You did the right thing. You listened to your instincts.

Rule #1 of Search and Rescue, Lifegaurding, EMS, or whatever: Never create two victims. A dead or injured rescue person is no use to anybody, especially the original victim.

I'm one of those people who will dive in and help (aka: adrenaline junkie), if I'm needed and it is reasonably safe to do so of course. But I will not endanger my life senselessly. Yes, I have put my self in danger for total strangers, but not without extreme thought put into it first. I've perched on a cliff helping to get a trauma victim out of an isolated ravine in the dead of night, but I will NOT stick my hands into the blood of a stranger without protective gear on or do rescue breaths without a barrier. It may not create a 2nd victim right there and then, but it may down the road.

(During the whole ravine incident, I was tied off and secured with ropes and other equipment. Some danger to myself, but it was mitigated danger.)

sissiesmama, ASN, RN · Mar 25, 2007

When I signed in to the site, this post was the first one I read. It has taken me a while to reply without sounding harsh.

First to Tazzi, YOU GO GIRL!! You read my mind, and voiced your opinion without being insulting, which was something that jill couldn't do.

I am an ER nurse, with 16 years experience. My husband is also an RN, with experience in ER, hospital spervision, and also critical care and ER transport. I did pick his brain to get his opinion on the subject. My ex husband is a police officer and I also gathered his opinion and the opinion of my neighbor who is a EMT-P with 15 plus years experience.

My points have already been covered, so I will not linger and beat a dead horse.

1. The OP is a NURSING STUDENT, and if I'm not mistaken, she was asleep. I don't know how I would have reacted being awakened by GUNSHOTS that close to my residence, even with my 16 years of experience.

2. If the police were already there, if they are trained like they are in my state(Louisiana), they have some first responders amongst the crowd. Some of them, if not all of them would have have some training in CPR/first aid. Cops do not like bystanders messing up their crime scene. Sure, she could have offered, but I do not blame her for not. I don't know that I would have in her place. I do, however, stop at all wrecks and offer assistance, but I have a well stocked first aid kit in my car. Please note, jill, that I have the kit in my car, not BESIDE MY BED. And in that situation, I would not have gone to my car to retrieve it, which brings me to my next point.

3. I would not gone to my car to get my kit, because SOMEONE ELSE may have gun, a knife, or some other weapon that could cause bodily injury. This is alo my next point.

4. In EMT school, you learn quickly to make sure that the scene has been secured before you just jump in there to be a hero and become a second victim, or in this case, a third victim.

5. If the police were already there, I would think that the injured person is not just injured, but probably a BODY at that time. ER doctors do not appreciate a bystander that attempt to revive someone who would have been pronounced at the scene.

Jill - I hope you did not mean to sound as insulting as you did, but it is that kind of comment that runs off good inexperienced nurses. The OP should not feel ashamed, you should for berating her for asking for assistance on the forum.

Anne, RNC:uhoh3:

TazziRN, RN · Mar 25, 2007

5. If the police were already there, I would think that the injured person is not just injured, but probably a BODY at that time. ER doctors do not appreciate a bystander that attempt to revive someone who would have been pronounced at the scene.

I didn't know how to say that about bystanders reviving a body....thanks!