Yes, as a registered nurse and as a human being, I am obliged to stop and perform first aid should I see an automobile collision with serious injury. According to the Bureau of Labor Statistics, registered nurses (RNs), regardless of specialty or work setting, perform basic duties that include treating patients, educating patients and the public about various medical conditions, and providing advice and emotional support to patients’ family members. This definition shows that there is also the public included among the responsibilities of registered nurses. Nurses have for many years been awarded the top ranking in opinion polls about which occupations are most trusted by the general public.
Some people might opine that nursing duties only relate to clinical settings and they tend to focus only nurse-patient relationship. Duties of the nurse exist only within the parameters of the hospital. Some might even argue that such intervention in roadside emergencies can get a nurse into legal complications. But then, nursing is a profession that the public depend on for support and care especially in emergency situations.
Historically, nurses have been associated with emergency responses. In early times, even though nurses were not as much educated and trained as the nurses of today, they offered their nursing services with great dedication and motivation. They were known for their self-sacrificing nature and offering a human touch that says “I care.” Nursing history is replete with examples of nurses who have knowingly incurred great risk in order to care for those in need of nursing or to contribute to the advancement of health science. In the United States, the Civil War is cited regularly for the role of volunteer nurses and for the stimulus it gave Clara Barton to organize the American Red Cross, which she eventually accomplished in 1881 (Williams, 2003). That humane touch has been characteristic of the nursing profession.
The first plank of the Code for Nurses states “The nurse provides services with respect for human dignity and the uniqueness of the client, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.” This central axiom of respect for persons directs the profession (ANA, 1994). The nurse is not at liberty to abandon those in need of nursing care. According to Gebbie and Qureshi (2006), “The fundamental goal of nursing, to assist individuals to their highest possible level of functioning in the face of health and illness challenges, is never more needed than under emergency conditions”. This means, a registered nurse is obligated to attend to the wounded person in a roadside emergency.
According to the Code for Nurses, nurses may morally refuse to participate in care, but only on the grounds of either client advocacy or moral objection to a specific type of intervention. As applied to nursing, a moral obligation exists for the nurse if the following four criteria are present: The client is at significant risk of harm, loss, or damage if the nurse does not assist; The nurse’s intervention or care is directly relevant to preventing harm; The nurse’s care will probably prevent harm, loss, or damage to the client; The benefit the client will gain outweighs any harm the nurse might incur and does not present more than an acceptable risk to the nurse (ANA, 2006). In the case of the roadside accident, the victims need to be attended to by a healthcare professional. Prompt medical attention by the RN can make a difference between life and death. Moreover, there is no personal risk. Hence there is a moral obligation on the part of the nurse to attend to the victims.
Society has come to rely on nursing and to expect that it will rise to the health demands of virtually any occasion. The only problem registered nurses encounter during such roadside interventions is that they may be forced to take decisions beyond those they are qualified for. But then, they can be protected by the Good Samaritan Doctrine which is a legal principle that prevents a rescuer who has voluntarily helped a victim in distress from being successfully sued for ‘wrongdoing.’ The purpose of this doctrine is to prevent people from refusing to help for fear of legal repercussions if they make mistakes in treatment (Neumann, 2005).
The practice of the professional nurse extends beyond the confines of the immediate setting where the nurse practices to the broader environment (AU, 2006). According to a survey of many nurses all respondents claimed to have medical assistance and would do so again, but about half of them would not do so unconditionally. However, no respondent has experienced legal complications from providing medical help though they had “heard” or “read” of such cases. Thus, it is the moral obligation of a registered nurse to help any accident victim in an emergency situation.
Critique of Journal Article:
Gebbie, K., Qureshi, K. in the article titled “A Historical Challenge: Nurses and Emergencies” (September 30, 2006) reviews the beginning of emergency nursing as a specialty. The authors also discuss the 21st century expectations about nursing during unexpected disaster situations and various nursing roles related to emergency care. The article is detailed and has many links to related articles.
The article says that both paid and volunteer nurses have played a huge role historically in fighting epidemics, HIV and AIDS. Later, nurses became known for their wartime services. By the middle 20th century, emergency rooms came into being. Today, emergency care has become a nursing specialty. The authors then point to the growth of the International Committee of the Red Cross and the International Rescue Committee. The role of the nurses in local public health emergencies is highlighted. The authors conclude that nurses have been key players during various emergency situations in the past. In the future, any kind of emergency in the community can impact the public’s health and nurses are needed for prevention, surveillance and response of every type.
At the end of the 20th century, national thinking about emergency preparedness led to two important developments: identification of the key competencies needed for effective emergency response, and increased attention to planning for and practicing emergency response. The authors point out that it was necessary for nursing to identify the core abilities needed to become a part of an emergency response team and perform well. Therefore the UG nursing curriculum was adapted by the International Nursing Coalition for Mass Casualty Education (INCMCE) to assure communities that their professional nurses were competent to respond when needed.
The article includes tables that list the competencies for public health workers, and the currently available emergency response competency sets applicable to nursing and the sources from which these data can be accessed in their entirety. Today, it has been recognized that there needs to be an inter-agency, interdisciplinary response, and that nearly all emergencies have potential health consequences. The authors conclude that nurses will continue to be key players in the local and national level emergency response as we move through the 21st century and that the fundamental goal of nursing, to assist individuals to their highest possible level of functioning in the face of health and illness challenges, is never more needed than under emergency conditions.
The article is written in chronological sequence and is highly informative. The authors discuss present day trends in detail in the context of the terrorists attack on the World Trade Center and Hurricane Katrina. The included tables and references prove to be very useful in understanding the competency sets needed for emergency responses. This article underlines the need for competency in emergency response. This means nurses should be given better basic and continuing education and should be trained to meet such emergency situations through hospitals, public health centers, and community drills.
U.S. Department of Labor. Bureau of Labor Statistics: Registered Nurses. Occupational Handbook. http://www.bls.gov/oco/ocos083.htm
AU (2006). School of Nursing: Our Philosophy. http://www.nursing.auburn.edu/about-us/our-philosophy.html
Williams, Robyn (2003). ABC Radio National Broadcast: The Ethics of Nursing in the Third Reich. Adelaide Institute. http://www.adelaideinstitute.org/Holocaust/nursing.htm
Print and Journal Sources:
Gebbie, K., Qureshi, K. (September 30, 2006) “A Historical Challenge: Nurses and Emergencies”OJIN: The Online Journal of Issues in Nursing. Vol. #11 No. #3, Manuscript 1. Available: www.nursingworld.org/ojin/topic31/tpc31_1.htm
ANA (1994). Ethics and Human Rights Position Statements. Risk versus Responsibility in Providing Nursing Care. http://www.nursingworld.org/readroom/position/ethics/etrisk.htm
ANA (2005). Code of Ethics for Nurses with Interpretive Statements. The Center for Ethics and Human Rights. http://www.ana.org/ethics/code/protected_nwcoe303.htm
Neumann, Karl (2005). Are you a Good Samaritan. News Share. Nov/Dec 2005. http://www.istm.org/publications/news_share/200512/samaritan.aspx