Analysis

A Good Samaritan nurse can be a lifesaver – literally, but before stepping in, make sure to weigh the risks

The legal and professional implications for nurses who go to the aid of people away from their workplace
The Ibrahim family (L-R) April, Isaac and Magdi Ibrahim, with baby Eliana. This article looksw at the legal and professional implications of nurses going to the aid of people in trouble outside their workplace.

The legal and professional implications for nurses who go to the aid of people away from their workplace

  • Nurses have a duty to help under the NMC code but theres no legal obligation
  • Even so, you must act within the limits of your knowledge and competence only
  • Always take account of the safety of others and never put yourself in danger

Delivering a baby in a hospital car park, tending to a man having a cardiac arrest at the roadside, the first-year nursing student saving a childs life while on holiday just some examples of off-duty nurses springing into action in emergency situations covered by Nursing Standard over the past year.

Here we look back at some of

...

The legal and professional implications for nurses who go to the aid of people away from their workplace

  • Nurses have a duty to help under the NMC code but there’s no legal obligation
  • Even so, you must act within the limits of your knowledge and competence only
  • Always take account of the safety of others – and never put yourself in danger
Therapeutic liaison worker Apexa Patel, deputy ward sister Kerry Barnacle and staff nurse Katie Abram Deputy. The article looks at the legal and professional implications of nurses going to the aid of people in trouble outside their workplace.
Left to right: therapeutic liaison worker Apexa Patel, deputy ward sister Kerry Barnacle
and staff nurse Katie Abram

Delivering a baby in a hospital car park, tending to a man having a cardiac arrest at the roadside, the first-year nursing student saving a child’s life while on holiday – just some examples of off-duty nurses springing into action in emergency situations covered by Nursing Standard over the past year.

Here we look back at some of these inspiring stories and also ask nursing experts about the legal, professional and ethical implications for nurses who provide first aid outside of the work environment.

‘Things came together to save my life’

It was a case of right place, right time in April for two off-duty mental health nurses who helped save the life of a cyclist.

Deputy ward sister Kerry Barnacle and staff nurse Katie Abram from the Bradgate mental health unit of Leicestershire Partnership NHS Trust were on their way to take part in a fundraising event with therapeutic liaison worker Apexa Patel when they spotted a man who had collapsed by the roadside.

The 54-year-old man, who was just 6km into a 60km cycle ride, was in cardiac arrest.

Ms Barnacle started CPR and Ms Abram used a defibrillator that was located near the scene.

And in another stroke of luck, two other nurses arrived on the scene to help out.

The cyclist, who has no memory of the drama that unfolded, said afterwards: ‘I can’t believe how things came together to save my life – the chances of these people just being there on the day are unbelievable.’

Picture of ED sister Sally Barley, who helped a fellow nurse trapped in a vehicle following a car crash. The article looks at the legal and professional implications of nurses going to the aid of people in trouble outside their workplace.
Emergency department sister Sally Barley

Also this year, emergency department sister Sally Barley won praise for helping a fellow nurse who was trapped in her vehicle following a car crash.

Ms Barley, who was on her way home from a night shift at Scunthorpe General Hospital in March, was one of the first on the scene.

She carried out initial assessments on trapped practice nurse Caroline Fox, who sustained five fractured ribs, cracked vertebrae and three dislocated toes.

When paramedics arrived, Ms Barley helped break the window of a car door so it could be opened from the inside, and comforted Ms Fox until fire crews arrived to cut her free.

‘I cannot praise Sally enough,’ Ms Fox later said. ‘She was absolutely brilliant and really calming.’

Baby delivered in hospital car park

In April, the emergency was a little closer to home for emergency nurses Sasha Ronson and Alix Green, and nursing student Chloe Doherty.

The trio were on a shift break at Blackpool Victoria Hospital when they heard the cries of a woman in labour.

The Ibrahim family (L-R) April, Isaac and Magdi Ibrahim, with baby Eliana. This article looksw at the legal and professional implications of nurses going to the aid of people in trouble outside their workplace.
The Ibrahim family (L-R) April, Isaac and Magdi Ibrahim, with baby Eliana

Joined by a midwife, the group delivered the baby in the hospital car park.

New father Magdi Ibrahim, himself a doctor at the hospital, admitted: ‘I was very scared... it was as if all of my medical experience had gone.’

UK does not have a Good Samaritan law

Providing first aid outside of your work situation can be seen as the act of a Good Samaritan, according to Marc Cornock, a qualified nurse, academic lawyer and senior lecturer at the Open University who writes expert advice columns for Nursing Standard.

But unlike some other countries such as Germany, the UK does not have a Good Samaritan law that requires someone to come to the aid of another, unless there is a pre-existing duty or they created the situation.

This means that as a nurse you have no legal duty to provide first aid to a member of the public outside the work situation and environment.

However, there is a professional and ethical duty for nurses to assist under the Nursing and Midwifery Council (NMC) code.

ED nurse would be held to a different standard

The code states registered nurses should ‘always offer help’ – as long as it is within the confines of their competence.

This means a nurse working in an emergency department (ED) who is used to dealing with emergencies every day would be held to a different standard than a nurse whose role does not involve front-line care, according to Iwan Dowie, a senior lecturer in healthcare law at the University of South Wales.

An emergency nurse would be expected to have more knowledge, he says.

‘Training tells us to keep going, so that’s what I did’

How a first-year nursing student saved a child’s life

Picture of Rachel Rose, a nursing student who revived a child who became unconscious.  The article looks at the legal and professional implications of nurses going to the aid of people in trouble outside their workplace.
Rachel Rose

A nursing student who saved a child’s life while holidaying in Majorca was hailed as ‘an inspiration’ after she put into practice cardiopulmonary resuscitation (CPR) skills she had learned only weeks earlier.

Rachel Rose, a first-year adult nursing student at the University of Sunderland, acted quickly to carry out CPR on five-year-old Kylie Ann Stewart after hearing the girl’s mother calling for help.

The child had lost consciousness. ‘For four minutes I kept going but there was nothing, no signs of life at all,’ Ms Rose said. ‘But all the training had told us to keep going, so that’s what I did. She was just about breathing, then she started moving her eyes a little.’

‘She did what no one else was able to do’

Kylie Ann was taken to a nearby hospital, where she remained for nearly two weeks. She was found to have contracted E. coli, which had caused her kidneys to shut down and resulted in her losing consciousness.

The child was flown home to the Republic of Ireland for dialysis, and Ms Rose did not know if she had survived until she discovered that the mother had been searching for her on Facebook.

Catherine Stewart said she wanted Ms Rose to know how grateful she and her family were. ‘She did what no one else was able to do and because of that she saved Kylie Ann.’

Catherine Stewart with her daughter Kylie Ann, who was revived by a nursing student after becoming unconscious. The article looks at the legal and professional implications of nurses going to the aid of people in trouble outside their workplace.
Catherine Stewart with her daughter Kylie Ann

 

RCN guidance on Good Samaritan acts uses the example that if a registered general nurse with no midwifery training or knowledge came across a woman in labour, their professional duty of care ‘may be limited to reassuring the woman, making her comfortable and then calling an ambulance, acting within their competence’.

But while helping those in need may be instinctive, the NMC code says that when offering assistance in an emergency, registrants should take account of their own safety, the safety of others and the availability of other options for providing care.

Mr Dowie says the key consideration is whether it would be dangerous or unsafe personally to intervene. Before helping, nurses should check that it is safe to do so, he says.

In the wake of the terrorist attacks in the UK over recent years, nursing staff have been praised for their courage, but the advice from the government is clear – you should never put yourself in danger to help others.

Unions usually provide members with liability cover for Good Samaritan acts

RCN guidance on responding to unexpected incidents states that if it is not safe you should move to a place of safety.

‘You should then ensure that you or someone close to you has contacted the emergency services. Only then should you consider providing care if it is safe to do so,’ it says.

Another issue for those doing Good Samaritan acts is the chance of being sued for negligence for providing inappropriate care.

Most employers have vicarious liability, which means they can be liable for the acts or omissions of their employees, provided it can be shown that they took place in the course of their employment.

However, there is no vicarious liability for acts or omissions by nurses that occur outside of work.

Yet some professional unions, including the RCN and Unison, provide cover for Good Samaritan acts to their members.

Picture of RCN head of legal services (regulatory) Rosalind Hooper. The article looks at the legal and professional implications of nurses going to the aid of people in trouble outside their workplace.
Rosalind Hooper
Picture: John Houlihan

RCN head of legal services (regulatory) Rosalind Hooper explains that the college’s members are covered against the financial consequences of a claim for clinical negligence when they act in a Good Samaritan capacity carrying out unplanned first aid to an injured person in an emergency situation.

Members should familiarise themselves with the exclusions

‘The RCN generally covers members carrying out Good Samaritan activity in these circumstances, provided they are acting within their sphere of competence,’ she says.

‘There’s no need to pay anything extra, RCN indemnity is included in your membership fee, provided you meet the eligibility criteria.’

But she says members should familiarise themselves with the exclusions outlined in the terms and conditions before a situation arises where they might need to offer first aid.

There are no reported cases in the UK of anyone successfully bringing a claim against a Good Samaritan, and there is legal protection for those who perform such acts in England and Wales under the Social Action, Responsibility and Heroism Act 2015.

Mr Dowie says: ‘If you do assist someone, it is very unlikely you will have any liability for anything you do. If you go and help in the street, generally the law is quite kind.’

‘I was petrified I would lose my pin’

Coverage of the issue in Nursing Standard has also prompted readers to share their own stories on social media of stepping in to offer first aid – on planes and trains and at sporting events.

‘Newly qualified, stopped at the side of the road to help a guy who had blacked out and come off his push bike,’ one nurse recalled.

‘I was petrified I would lose my pin before I even started. Looked after him til ambulance arrived.’

One nurse stepped in to help at the hairdressers and on a train, while another described being on the sidelines at an amateur rugby game when a young player had a heart attack. ‘Good outcome as well, he is now home recovering,’ the nurse wrote.

What the NMC says about assisting in an emergency

The NMC code says nurses should always offer help if an emergency arises in their practice setting or anywhere else. However, you must:

  • Only act in an emergency within the limits of your knowledge and competence
  • Arrange, wherever possible, for emergency care to be accessed and provided promptly
  • Take account of your own safety, the safety of others and the availability of other options for providing care

NMC director of education and standards Geraldine Walters says the key issue is that in every situation professionals should practise within the limits of their knowledge and competence.

Dr Walters says: ‘Professionals on our register show both a clinical excellence and a commitment to kindness, compassion and respect, and we’re proud of the contribution they make every day, including in emergency situations.’

Adapted from the NMC code


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