A correspondent writes:
I recently read with interest your following article, Nurses as ‘good Samaritans’ – can I be liable if I do stop? (March 2014) retrieved from the following link:
As a registered nurse I consider that our regulatory body, the Nursing and Midwifery Board of Australia (NMBA) needs to consider publishing a position statement or professional guideline on this topic. From my experience many licensed nurses and midwives do lack knowledge in this area and since the Queensland Nursing Council became defunct in 2010 there are no contemporary professional guidelines on this subject other then the NMBA Decision Making Framework. This framework can be accessed from the following link, titles Codes & Guidelines with the sub title of Decision Making Framework (DMF):
This framework is excellent for when a licensed nurse is working within an organisational work context (on duty) but based on personal and anecdotal evidence I don’t consider it guides nurses when they are off duty and faced with decisions about care in an emergency situation within a community setting such as for example a shopping mall.
In reference to the previous regulatory body, The Qld Nursing Council (QNC), their framework included statements such as:
Exclusions – when the Framework does not apply
A nurse or midwife can use the relevant principles to determine what activities or tasks they can delegate or accept. But, in the following circumstances the Framework should not be used:
1.0 Actions in an emergency
Nothing in this document can be construed as preventing a nurse, midwife or other person from taking appropriate action in an emergency.
In relation to the above QNC Framework please refer to: p. 4/18 http://www.health.qld.gov.au/parrot/html/documents/nursingscprac.pdf
Broadly speaking I think most licensed nurses would prefer a regulatory guideline/position statement on this matter rather then interpreting Good Samaritan Laws.
Your opinion on this matter would be personally appreciated.
It’s certainly a concern if nurses or other health practitioners believed that they could not render assistance as some complex procedure had been involved. As my correspondent notes the Decision Making Framework requires a nurse to
• Identify client need/benefit
• Reflect on scope of practice and nursing practice standards
• Consider context of practice/organisational support
• Select appropriate, competent person to perform the activity
In any nursing practice this will often be automatic as nurses go about their daily work they know what is in their scope of practice and what their organization expects and whether it is their task or someone else. Equally even in a roadside emergency a nurse may quickly identify what action is required and that action may be non controversial (eg the patient has stopped breathing and needs CPR) and know that in the context they are competent and appropriate to do that.
It is hard to see how this sort of framework would actually stop anyone doing what they can at an emergency or accident but if there is that fear, a comment such as ‘Nothing in this document can be construed as preventing a nurse, midwife or other person from taking appropriate action in an emergency’ could be helpful.
The Medical Board of Australia, Good Medical Practice: A Code Of Conduct For Doctors In Australia (March 2014) says:
2.5 Treatment in emergencies
Treating patients in emergencies requires doctors to consider a range of issues, in addition to the patient’s best care. Good medical practice involves offering assistance in an emergency that takes account of your own safety, your skills, the availability of other options and the impact on any other patients under your care; and continuing to provide that assistance until your services are no longer required.
That seems like a perfectly reasonable statement of what might be expected by anyone in an emergency.
What has to be reiterated is that people DO NOT get sued for stopping and helping at accidents. Courts have bent over backwards to ensure that people who go to help are not denied compensation for their own, even foolishly caused injuries and that the original wrongdoer is liable for any extra damage done by a rescuer. No court or tribunal would ever accept that some statement on nursing ethics or practice is intended to, or does, stop a nurse providing assistance at an emergency. But remember Dr Lowns was liable for not attending an accident (Lowns v Woods (1996) Aust Torts Reports 81-376) and Dr Dekker was guilty of improper professional conduct for not rendering assistance (Medical Board Of Australia v Dekker  WASAT 182).