I Saved A Life At The Airport - here's what to do if you respond to an emergency while off-duty

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[00:00:29] You're listening to Ask Nurse Alice presented by nurse.org where Alice Benjamin combines no nonsense advice with thought-provoking interviews. Hi friends! Welcome to the Ask Nurse Alice podcast, the show where we talk about anything and everything nursing and

[00:00:55] healthcare related. I'm your host Alice Benjamin, clinical nurse specialist, family nurse practitioner, and chief nursing officer at nurse.org. And on today's episode, I want to talk about good Samiritan laws. Now as a healthcare provider, some of you are nursing students,

[00:01:14] aspiring nurses, nurses, APRNs, physicians, PT, EMTs, like, listen, certified nursing assistants, whoever you are that's listening, who might be in a healthcare professional role. We take care of patients. That's what we do. That's what we go to school for. That's what we're trained to do.

[00:01:32] And once we become licensed or certified and we're in our role, that's what we're doing every day, taking care of patients. In our clinic, our hospital setting, or perhaps it's telehealth, maybe it's in a school, whatever your setting is you have your setting

[00:01:47] and you're operating within your scope of practice. Taking care of people. Very clear. Now how many of you have had to render care to someone while you are off duty, outside your clinical

[00:02:01] setting? Not currently working in the role. That is a little bit interesting and scary if I can say at the same time. And I had a recent experience. I went to New Orleans traveling for

[00:02:18] the Essence Festival where I was a speaker. Had a great time all of the time, talked about health and wellness at the festival, met a lot of great people, talked to a lot of people who had health

[00:02:29] questions. It was awesome. It was great and networked. Also, it was the power, the nurse power brunch network was out there and had a fabulous time at that event as well. But on my

[00:02:38] travel back, which by the way was very exhausting, had a full weekend where I really didn't sleep, I was go, go, go, go. Got on a plane, flight was delayed, crying baby's uncomfortable seat sitting

[00:02:50] in the middle and it's like, oh, just so ready to get home. So I finally landed LAX, which is my airport here in Los Angeles. Well after midnight later than I expected, I had checked bags and I

[00:03:01] was like, I just want to get home. So as I get off the plane, I'm walking to baggage claim and I can hear overhead an announcement that says if there is a healthcare professional in the baggage claim, please walk towards baggage claim carousel 23 and wave your hand.

[00:03:20] I'm just approaching on the scene. I'm like, oh surely thousands of people are here in LAX. Somebody's obviously responding right? I'm getting off the plane. I'm still far away. I go to my carousel and went for my bags and I still hear this announcement again.

[00:03:34] I'm like, hey, nobody come? Y'all call 911? Like what's happening? Why are you having to call this again? Anyways, I'm getting, I get my bags and I hear it again. Like okay.

[00:03:46] And I literally have to walk past carousel 23 to exit the building to go to, to catch my Uber. So I'm walking but in my head, I'm like, surely somebody's arrived. Somebody's gonna do it.

[00:04:00] I'm not thinking like, oh, let me go. Right? It's almost like being in the hospital. You hear a code overhead. You hear it and you see people already running there. And so you're

[00:04:11] like, oh surely they got enough people. I don't need to come. And so you just get to do about your duties because there's enough people there responding. We know how it is when there's too

[00:04:18] many people in the room when there's code. So I'm thinking to my head, although I'm not seen anyone. I'm like, oh surely somebody's there. I'm getting closer and closer. And I see a whole

[00:04:27] bunch of police officers kind of this almost like in a huddle and I see a lady on the ground. Looks like an elderly lady. And then I see blood. So for a moment, y'all, for a moment,

[00:04:38] I love people. I love taking care of people. But I was dog tired. Okay. And for a moment, I'm like, I'm not responding. I don't need to. I don't have to. I'm not on duty. I legit did.

[00:04:51] And many people would have just kept walking at the door. Some people would have maybe even wanted to respond but like, no, I'm not going to respond because of the legalities. I don't know what I'm getting myself into setting myself up for legal troubles,

[00:05:05] even if they wanted to really, really help. So I think there's a lot of reasons why people like us healthcare professionals in our regular everyday lives off duty, don't necessarily respond to emergencies. Now, if I decided to keep walking at the door and

[00:05:18] someone had known, oh my gosh, that's nurse Alice emergency room nurse practitioner critical care and I just kept on walking. They would have known that they probably would have thought

[00:05:26] very badly of me. But here's the thing, I'm off duty and I'm not obligated to stop and take care of anyone when I'm off duty. There's not feel like a moral obligation but not there's no legal

[00:05:38] thing that says, Hey, you have to stop and you have to do this. Right. So it becomes an issue of ethics and morals of whether you're going to strong and some again want to but because

[00:05:48] of fear of legal issues of getting on me to get sued. That might be something that is a barrier to prevent someone from responding. That's all been identified, which is why there is something

[00:05:58] called the Good Samaritan law. Okay. This, the whole premise of the Good Samaritan law is so that to protect an individual who intervenes to assist another person without any prior notion or responsibility or promise for compensation. That's really the whole premise of it. Right.

[00:06:17] I'm off duty not expecting a paid didn't plan for it and but I'm here to help you. Okay. So it is a law that is meant to protect people like that, like us and to remove some of those

[00:06:29] fears of liability and getting sued and all those things if I decide to help someone. But it's for public interest and public good that we do do that, which is why the Good Samaritan

[00:06:39] logs this. So I'm getting close. I'm walking up on the baggage claim 23 and I see the huddle of the police officer. I see an elderly woman lying down. I see someone kind of kneeling

[00:06:49] in her head and I see blood, but I don't see any action and movement. So me, the Yardner's practitioner, I just couldn't help it as tired as I was. It was already like maybe close to one o'clock in the morning,

[00:07:00] but I'm like, oh, let's do gotta go help because I would want someone to help me. I would want someone to help my family, my friends if that were me. And I know that I have the skill set

[00:07:11] to do that at least until emergency services arise. So I go there. There is a home health registered nurse that's kneeling by her head. She identified herself as a nurse. I said, hi, I'm Alice. I'm an emergency room nurse practitioner. Can I be of assistance? And so

[00:07:26] I didn't know who the folks were there, but then the person at the head, she said, hi, I forget what her name was, but she's like, I'm a home health RN. I'm so glad you're here.

[00:07:34] And I'm like, okay. And then I'm looking at the police officers and I'm like, so what happened? And as they're talking, not that what they were saying wasn't important, basically like my eyes are scanning head to toe, like looking at this little old lady on the

[00:07:47] ground head to toe, head to toe. So as they're talking, which seems like walk, walk, walk, because it's like they're telling me this long story. I'm like, to me, it's like, get to the point. Give me a quick S bar, but they're not health professionals. So they can't

[00:08:00] do that. And so anyways, as they're talking, I'm looking head to toe. The woman is her eyes are opening and closing. She's tracking. She's looking at me. There's a bloody towel on the back of her head, which one of the police officers with gloves is holding on

[00:08:19] bright red. I see that there is vomit on the ground. I see that she is urinated on herself. And she seems very well kept. Okay, so I kind of scan, you know, she's breathing, she's tracking didn't look pale, diaphoretic or anything like that. She just seemed like,

[00:08:38] oh, I fell and my head's bleeding type of thing. And so the police officer said, passengers said that she was standing there and she fell back and hit her head. And so I

[00:08:47] introduced myself to the patient. I'm just going to make up her name to Hi Gladys. My name's Alice. I'm a nurse practitioner. I'm here to help until the paramedics get here. Are you okay? He says, I'm okay. I feel really silly about everything that's happened. I said, well,

[00:09:03] what happened? She's like, I don't know. I got off the plane. I was traveling by myself, going home. And next thing I know, I'm on the ground. And so I politely asked her, I said,

[00:09:13] well, I'd like to ask you a couple questions just to kind of see where things are going. Is it okay if I look in your purse and we look at your ID because it's very important that we

[00:09:23] know who you are? So, and a friend of hers got her purse, got her driver's license. So I verified, I said, can you tell me your full name? Can you tell me your date of birth? Do

[00:09:31] you know where we are? You know, I already asked her sort of what happened. I said, you know what's going on now? And she was alert and oriented times four. She could tell me everything. I asked her if she had any medical conditions. High blood pressure, diabetes, cholesterol,

[00:09:43] osteoarthritis just had a cabbage earlier in the year, January. I guess I'm saying where she had this surgery, but she had it locally in the Los Angeles area. And she said, oh yeah,

[00:09:54] my granddaughter is a nurse. I said, okay, well, can we call your daughter or your granddaughter family member? So we called her daughter, no answer. Called the granddaughter who was a nurse,

[00:10:06] called her and she was a newer nurse who was working in med-surge and was not aware of her grandma's medical history other than she had surgery in January. So didn't really get much information there but did say, you know, can you call? I tried to verify medical information,

[00:10:22] but I said, can you call your mom to let her know what's going on? I'm here. I identified myself as I'm here with your grandmother and we are waiting for paramedics to arrive and she will

[00:10:32] likely, she's going to the emergency room and she's likely going to be admitted considering her medical history. She is on blood thinners and her head is bleeding. I said, I'm not her direct provider but based on my assessment I gather that's probably what's going to happen.

[00:10:49] She said okay, thank you. And then that was the end of that conversation. So in the interim we're waiting. So the police officers are there and then it's me, I turn around and the

[00:10:58] the home health R.A. is gone. She's out of there. And so I just said okay in my head although I was not at work, I thought, how long would you do at work? Obviously I wanted to get her to head CT

[00:11:07] right? Can't do that. We're waiting for paramedics and I asked like what's what's the delay? What's going on? So apparently at LAX they have five rigs that respond to emergency calls and the

[00:11:18] fifth rig had just recently left for with someone else and they were all like I mean dispersed. So they were waiting and then when we you know I was literally there with the lady for about an hour

[00:11:28] almost and the reason why it took so long is because once one of those rigs was cleared the traffic with getting back to the terminal where we were was like crazy. LAX was not

[00:11:41] but the in they couldn't get through so they were trying to but anyways in the during the time I continued to assess and reassess didn't have any blood pressure machine did anything like

[00:11:50] that. I asked one of the first aid kit whether I said we probably should get the AED interesting enough they didn't want to go get the AED because they didn't think that was warranted. I said

[00:11:58] you know we really should have it or at least where is it? So no one went and broke it and got it however I knew where it was close enough because although this woman was alert oriented

[00:12:07] talking to me at any given moment she could have stopped breathing become unconscious or things like that and I would have need to have quickly placed the AED but at least I knew where it was and by this time we also have Delta employees around and everything

[00:12:19] and I continued to talk to the woman. I do a whole neuro assessment test I you know to see if she could follow my commands I assessed her muscle strength you know didn't

[00:12:29] have her get up we just had her continue to lay on her side in a rescue position because she hadn't previously bought it so I didn't want anything to happen so we kept her on her side

[00:12:38] good pulses skin was nice and warm so I wasn't concerned for any compromise with circulation but I did look at her head so like her head there was just like this bloody town I said you know

[00:12:49] can I have a set of gloves I just want to take a look at what's going on to see if the blood was pulsating to see determine if it was arterial or not there was no

[00:12:57] pulsation and it was just like a slow ooze it wasn't a pulsating ooze so obviously there was lots of blood her hair started to become matted I don't have like cat scan MRI radar eyes

[00:13:08] or anything but from what I saw it didn't look like it was arterial because it wasn't like pulsating blood out but and it it definitely slowed down but because she was on Xeralto and I think she was

[00:13:19] also taking aspirin some other things be concerned right she fell and there was so much blood on the floor I was trying to you know it's hard to estimate the blood but definitely enough blood

[00:13:30] I'm pretty sure she's going to stay overnight at least overnight in the emergency room if not admitted because here's the thing we want to secure the bleeding right first off make sure there's no internal head bleed stabilize the external bleeding make sure there's no internal bleeding

[00:13:45] in the head and then also it's like well why'd you pass out so getting to that underlying cause was it and she was elderly traveling by herself oh and she also said she hadn't taken

[00:13:53] her medication in three days because she ran out because she was traveling so it could be a combination of things remember diabetic high blood pressure so could have been blood pressure could have been blood sugar issues could have been dehydration um she had some cabbage done I

[00:14:07] don't know what other things she has going on for her but could have been something cardiac related an arrhythmia I don't know what her carotids are doing like there's so much although as a nurse practitioner and even as a nurse you start thinking these things but again

[00:14:20] I'm off duty I'm a good Samaritan I ain't supposed to be there I'm volunteering and I'm helping because I see a person in me that was the situation with that long and eventually the paramedics came I gave a quick s bar provided them the phone number for the

[00:14:37] daughter and the granddaughter and called the granddaughter again on the patient's phone washers there to let them know what was happening and so then I was kind of washed my hands of that

[00:14:47] and I was getting ready to go police officers took a report for me asked me who I was my name contact me needed and then the Delta lady was like oh my gosh thank you so much we'd like to

[00:14:57] offer you some some Delta sky miles for your service thank you so much and this I would totally without expecting that so she got my contact information it was by the way Delta

[00:15:05] was so kind enough to give me sky my point I was not expecting it didn't ask for it and it was just gifted to me for my time now what would have happened if she started

[00:15:15] vomiting or stopped breathing and we needed to initiate CPR like that's when things get a little you know a lot more complicated but still I'm off duty I wasn't in a patient provider role I wasn't expecting payment I was you know this told completely

[00:15:33] off the clock just assisting and so as a good Samaritan even if something had gone needed more in depth like she needed CPR and let's say I did CPR and during the process of doing CPR I cracked one of her ribs that's happened before especially in elderly frail

[00:15:49] people I've it happened one time patients still survive but you know he was very frail and had osteoporosis and all the whole bunch of things anyways someone might be afraid like oh my gosh

[00:15:58] I cracked a rib they consume me or that rib could puncture those long they can get a new model they could sue me like in the people that's why people don't respond and they act but

[00:16:08] people survive those things and I think not I think I know that there's community and public benefit when healthcare professionals with our knowledge and our training do respond in emergency situations now again moral ethical issue if you want to you don't have to

[00:16:25] but if you decide to this good Samaritan law supposed to protect us and all 50 seats and the district of Columbia have good Samaritan laws and there are even additional federal laws that can protect us one of those including the 1998 aviation medical assistance act which

[00:16:41] this law provides coverage to good Samaritans while in fight in air and protects doctors and other healthcare professionals acting in good Samaritan roles on airlines I've never had to respond in that situation because I remember there wasn't an incident one time but there was a

[00:16:57] y'all they went with the doctor whatever go ahead go with the doctor you know I'm just America's favorite nurse family nurse practitioner with critical care ER experience go ahead and go with the family practice doctor who rarely touch patients but that's not

[00:17:12] here nor there that's ego that was my ego talking but anyways a healthcare professional responded so my services weren't needed but I say this to say there are laws out there

[00:17:22] that are intended to protect us but there are some caveats to that I think that we should be also aware of so let's first be aware that we are protected by good Samaritan laws

[00:17:31] when we were acting with certain conditions in place first off if the patient is awake alert oriented able to consent we must ask for permission from the ill or injured person when

[00:17:47] possible so this lady was talking to me she was amicable and happy that I was there to help her she told me thank you so much for being here I'm so glad you're here so she was happy to have me

[00:17:57] there also we have to ensure that the care given is appropriate and it's not reckless so like for example if someone stopped breathing heart heart stopped obviously initially CPR is appropriate if someone stopped breathing and I decided I want to take my pocket knife out

[00:18:17] put a little slit in the trachea area take a straw and make a homemade trachea no that's gross negligence that's we're not doing that I saw that at ER episode on television where that is

[00:18:29] something that is well beyond the scope of a good Samaritan law and especially if something goes wrong with that that's would be considered reckless also a person covered by the good Samaritan law

[00:18:44] is not the person who caused the accident like if there is a an accident someone's doing respond if you cause the accident you can't also be the good Samaritan because you cause the accident

[00:18:53] which even why you need to respond and try to provide the care and then also this is care that is only being given in emergency situation while waiting for trained on duty help to arrive okay

[00:19:07] so those are some conditions that need to exist to be covered by the good Samaritan law it's important to know that in your duty of caring for someone outside of hospital walls

[00:19:19] outside of clinical laws while you're off duty and you're doing this out of the kindness of your heart that yes there are good Samaritan laws meant to protect you I gave you some examples of what

[00:19:31] is appropriate and what could be considered gross negligence but also I want to also specify this because this is I'm not a lawyer don't bring my name up in court if you ever go

[00:19:43] but so this is just kind of a general broad brush conversation that yes there are good Samaritan laws that exist but you must also recognize what if there are anything specific to your states

[00:19:54] because in rare cases and depending on the exact location and conditions and circumstances of what happened you may be held liable there is a case an example of something that happened in California

[00:20:07] while it was two nurses who just got off work I think they were in hospital parking lot still there was some I don't know the exact accent that something that happened but one of the nurses cars the car caught on fire she's inside the other nurse

[00:20:22] it does something to and drag and pulls the oh no she was driving she hit like a light pole something happened car caught on fire so the other nurse is trying to drag her out of the car

[00:20:34] and cause a spinal cord injury and unfortunately that nurse was held liable for something I mean that's a little unusual weird maybe maybe it was because of it was on hospital grounds

[00:20:44] maybe it's because they were just coming off of duty I'm not exactly sure of the incidents but I and it's sad that I have to tell that story because I don't want to discourage you from

[00:20:52] responding but that is a case so you that has happened so you know you have to be very careful of what is specific to your state and even traveling outside of the country outside of the country

[00:21:05] many countries still have good Samir to laws but how they the details of them what's covered what's not covered still something that is specific to their area so if you're traveling somewhere and you'd like to know it's real important that you look that information up but again general

[00:21:21] like things like CPR listen we try and regular everyday people to do CPR because we know the value of that again it's about public interest public benefit there's some research that shows when we can raise awareness with physicians nurses and other health care providers that

[00:21:37] good Samir to laws exist that the likelihood for them to help increases so that's why I wanted to talk about this because it happened and I didn't really talk about it I was exhausted I was just

[00:21:47] trying to recoup from the trip and I was like you know what I should probably talk about this because even myself first but second I wouldn't go respond then I felt kind of like this

[00:21:57] the strings on my heart get told and I'm like Alice you should respond but I've you know I'm aware of good Samir to laws and want to make sure that you everyone who's listening students nursing students nurses advanced practice nurses doctors whoever's listening that these exist and so

[00:22:15] there is some there is coverage again don't go trying to do mini surgery in the grocery store around when the person passes out again no self-made tricks but CPR if you want to do

[00:22:27] some of the basic things that you can do to help sustain a person until advanced health care services arrive right something that's very important to do something else I wanted to jump

[00:22:40] back real quick to the story about I we were on the ground we were already at LAX so I wasn't necessarily in the air and I spoke to their good Samir to laws while we're in the air

[00:22:49] if you are someone who ever has to respond to an emergency on the air by the way which some of the most common in-flight emergencies include syncope or near syncope that's like number one

[00:23:00] I think I've been syncopal on a plane but I hadn't eaten so I just need to orange I just asked the do it isn't give me several cups of foreign shoes and water and I was fine gastrointestinal

[00:23:09] issues respiratory is next then cardiovascular next ones and usually so people do know that on a plane even if you've not seen it so minimum requirements for onboard emergency medical kit equipment on us domestic flights include an aed an automated external defibrillator

[00:23:31] equipment to obtain a basic assessment equipment for hemorrhage control initiation of an iv line and medications to treat basic conditions so planes have that if you didn't know now you know now if you're traveling over to other countries their kits may be a little bit

[00:23:50] different for the most part there's some type of medical kit so because I recognize that airline stewardess are not healthcare professionals they could probably be very good at CPR there's going to be some limited scope of their ability so again if I was traveling my friends were traveling

[00:24:04] I would want somebody to respond so now I've taken it upon myself that every time I travel and I get on a plane not for not to brag or boast or anything but usually when you come on like hi

[00:24:13] welcome aboard I said hi thank you so much I'm hopeful that my services won't be needed because I am off duty but just want you to know I'm an emergency room nurse practitioner

[00:24:24] so if anything's needed you know where I'm sitting and so usually that's where you know they keep you in mind and actually after essence I've had three other flights that I've taken on one

[00:24:36] occasion someone one of the stewardess did come by me she said I don't know that we're going to need you know but there's someone who's not feeling well up at the rear of the plane so just

[00:24:46] just let you know and so she just said that but she never came back so it actually kind of filled my cup a little bit to be needed and considered in those situations because again

[00:24:58] when emergencies go down people just want help they're not asking you for medical miracles but they just want help and if you are the person on the plane who is the best trained most

[00:25:08] knowledgeable best skills to provide basic care things to people that may seem like medical emergencies some of them are like really that's it here you got some itchy takes a bit of drill you have

[00:25:21] like your upset stomach here try some alox first oh you're you know like some basic things that we can do or someone cuts themselves and maybe they're bleeding a little bit we can clean the wound

[00:25:30] and look okay superficial the supply some pressure put a bandage okay until we get to unless it truly is a situation where you can in your clinical experience say hey we need to we need to land wherever we gotta go this is an emergency situation and you could

[00:25:44] actually save someone's life in that sense so like you might need to do CPR or based on your clinical expertise they let we don't have two hours to wait till we land in LAX we need to

[00:25:53] we need to go somewhere now this person is bleeding out and need something now like or this person is having a stroke we need to land now it's closest stroke center like those are

[00:26:03] the things that you can say your clinical advice your good Samaritan law like you're protected like for me to say to someone to an airline stewardess or quite like patients actually having a stroke

[00:26:14] their medical history is that our recommendation is that they get to the nearest stroke center immediately we need to reroute do you know how much of an impact that can make up someone's life

[00:26:23] time is tissue and we know that right so rather a flight try to continue for the next three hours to get to its end destination versus they make a pit stop and they land in the next 30 minutes

[00:26:36] to get someone to the closest stroke center you can make a difference in saving someone's life I know you're off duty you're on vacay you're ready to do this type of things and you're not

[00:26:46] obligated to be a good Samaritan but I would strongly encourage you to consider the gift the skill the knowledge the gift that you have to help change the trajectory of someone's life under the protection of the good Samaritan law I hope that that encourages you to speak up

[00:27:04] even if you're not completely physically involved to at least share your clinical expertise verbally to say what should happen what should be done I would hope that you would consider that and make that contribution to the community because we need you nurses doctors

[00:27:20] healthcare professionals extremely needed in the workplace but just imagine and just know not everyone makes it to the hospital not everyone's going to make it to your ER not everybody's going to make it to your med surgery or ICU bed because they're going to die

[00:27:32] before they get there so if you can make a difference by just helping to direct general lay people in emergency situations at least until advanced healthcare and first responders arrive that would be so much appreciated so that's my story wanted to share I hope that

[00:27:52] empowers you to better understand what good Samaritan laws are and empowered you to act on them and to share your gift we've got to get a little mushy and soft there guys because

[00:28:02] you know it really means a lot so people don't make it to the hospital so if we can help let's do it let's do it make sure to share this podcast episode with a friend classmate

[00:28:11] coworker sharing of caring and it means so much to me nurse.org and the podcast as we grow and try to get so many more listeners and this information out there so if you found it

[00:28:20] helpful just know someone else will too so please leave a rating review a comment leave five stars for your review on your favorite podcast streaming platform make sure to share and guys I would

[00:28:33] love to hear from you I'd love to hear what you thought about this episode and hey if you have an idea for the next episode please email me at nurse Alice at nurse.org it's all

[00:28:41] with my pleasure chatting with you and shout out to nurse.org for hosting podcasts until next time make good choices be kind to one another and live with my friends thanks for listening to Ask Nurse Alice visit nurse.org for nursing career education and community resources