The emergency nurse as a first responder.

Abstract

am also a certified emergency medical technician (EMT). Although I am not a member of our local volunteer first aid squad, I often ride and assist squad members who are trained to render basic life support. The ambulances are equipped with cardiac monitoring and defibrillator equipment. If advanced cardiac life support is required, the first aid squad is required to call the paramedics. I have assisted paramedics in establishing venous access and in administering intravenous medications. I have also defibrillated patients in monitored situations where the paramedics were not yet on the scene. Have I acted beyond the scope of my legal responsibilities? If there is a lawsuit against me and the squad, how will I be judged? Answer The reader’s interesting question raises several interesting legal issues that must be addressed to answer the question. In the scenario presented, the emergency nurse is volunteering her efforts in assisting a volunteer first aid squad. In many jurisdictions, volunteer rescuers are provided immunity from civil liability under legislation generally known as “good Samaritan” laws. Raising the affirmative protection of any potentially applicable good Samaritan law may be the nurse’s first line of defense. If the court rules that the immunity provision applies to the facts and circumstances of the case, the suit against the volunteer nurse will be dismissed. If the nurse is not a volunteer or if for some other reasons immunity is not provided, the conduct of the nurse will be judged according to principles governing the law of torts (civil negligence). Generally, the law requires a person who provides professional care to exercise that degree of knowledge, care, and skill ordinarily possessed and exercised by a reasonably prudent average health care provider in the same or similar circumstances. In the scenario presented in the question, the emergency nurse would be expected to exercise that degree of knowlege, skill, and care possessed by the prudent average certified emergency nurse who is also a certified ACLS instructor and certified EMT as would be expected under the same or similar factual circumstances. Even though the nurse is also a licensed EMT, she will be held to the higher standards of a registered nurse working under the same or similar conditions. If the nurse has the knowledge, skills, and ability to provide care that exceeds that of an EMT, the law requires that the nurse do so, provided circumstances permit. Clearly, if equipment and medication is not available in the ambulance, the law will require only the level of care that is feasible under the circumstances. On the other hand, the nurse may not refrain from using his or her nursing skills and training because he or she is “wearing the hat” of an EMT. In lawsuits alleging professional negligence, the standard of care by which the conduct of the defendant is measured is generally presented to the jury through the testimony of expert witnesses. The courts have reasoned that lay persons should not be permitted to guess or speculate about what the professional conduct of the defendant should have been. When a case reaches trial, it is the job of the expert witness who testifies on behalf of the plaintiff and the expert witness who testifies on behalf of the defendant, to tell the jury what level of care should have been provided. The expert for the plaintiff will state his or her opinion that the defendant nurses’ conduct did not meet acceptable levels of care. The plaintiff’s expert can be expected to establish a high standard of care. The expert for the defendant will most likely disagree with the plaintiff’s expert opinion