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Affleck-Gadd is far from alone in using her nursing
skills while off duty. In 2001, according to the CDC,
more than 4.5 million nonfatal injuries were reported
due to car accidents in America, 3.5 million cases of
overexertion, 369,000 injuries due to dog bites and
63,000 injuries from gunshot wounds. More than 45,000
people nearly choked or suffocated and 5,800 nearly
drowned. A whopping 7.8 million people sustained an
injury due to a fall. And more than 15 million Americans
suffer from heart disease-the nation's No.1 cause of
death.
With Americans ill and injured every minute of every
day, it's no surprise then that many nurses find themselves
running a trauma code while they are on vacation, shopping
for groceries, on their way home or even at church.
"Nurses will respond when they see a need and
they have the ability to deal with the need. That's
why they went into the profession," said Barbara
Zittel, Ph.D., RN, executive secretary of the New York
State Board of Nursing.
In the summer of 2001, Zittel was having dinner at
a fancy New York inn when she noticed another restaurant
patron in distress.
"It was an elderly man who looked like he was
having a heart attack. I had him put on the floor and
started CPR and mouth-to-mouth [resuscitation],"
she said. A physician-while flatly refusing to do mouth-to-mouth-offered
assistance, and started performing chest compressions
alongside her. Their efforts were not enough, however,
to save the man.
"Afterward, for a quick instant I wondered if
I should have responded as I did," she said. "If
I had to do it over again, I would, and I would come
to the rescue of others. That's what nurses are about."
Many nurses, like Zittel, seem to jump into the fray
with barely a second thought.
But if there's a little voice inside your head telling
you not to get involved, listen to it, said Kathleen
Lambert, JD, a clinical supervisor and lawyer in Tucson,
Ariz. Some accident scenes are unsafe. Some nurses don't
have the training or stomach to respond to a trauma
situation. And there can be an issue of liability.
All states now have good Samaritan laws that protect
medical and nonmedical personnel who volunteer to help
those in need of emergency medical treatment, even when
something goes wrong. Each state's Nursing Practice
Act has a section outlining protection specifically
for nurses who respond to emergencies outside of their
workplace.
But the laws differ from state to state-and may be
affected by the new federal Homeland Security Act, which,
according to Lambert, likely will offer more protection
for medical practitioners responding in emergency situations.
"There are a great deal of changes coming related
to emergent care and what is supposed to be done,"
she said. "If you limit health care professionals
so much that they don't want to practice, you will be
hurting society as a whole."
In general, Lambert advised, the laws and codes will
not cover practitioners who step outside the boundaries
of their licensed skills. In addition, she cautioned,
nurses are not covered by their employers' malpractice
insurance when they are off duty.
Responding to an accident or treating someone who is
ill is "very much a personal choice," Lambert
said. "You need to consider so many things: 'Is
this something I can handle? Are there dangerous things
about the situation?' You need to weigh and balance."
"I'm not saying don't give aid," Lambert
continued. "But do look at what your skills are
and where you would be most useful. It may be using
your phone and calling 911, or saying, 'Don't move this
patient right now, it looks like a neck injury.' "
Standing guard is exactly what Richard Bowen, RN, did
early one foggy morning on a rural stretch of highway
near the Arkansas-Missouri border. The 36-year-old OR
nurse and Desert Storm veteran was on a bus with 40
U.S. Marines on their way home to Springfield, Mo.,
from a reservist's training weekend in April 2000. Almost
everyone on the bus was asleep, camouflage paint still
covering their faces, Bowen said.
About 1:30 a.m., the bus driver pulled to a stop, and
Bowen awoke to someone calling for his help outside.
"I thought we were back at the reserve center
and maybe someone had sprained their ankle getting out
of the bus. I got out and found a car tipped over. It
was shocking," he said.
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