1. Mackay, Taralynn R. JD, RN
  2. Starr, Kristopher T. JD, MSN, RN, FNP-C, CEN, CPEN

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IMAGINE YOU ARE DRIVING in heavy traffic when you see a motor vehicle crash (MVC) ahead. A bloodied motorist is waving for help. What should you do? Your conscience and compassion compel you to help but your common sense prompts you to weigh the legal risks. You have three options:

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* help the MVC victim(s) at the scene


* drive past the scene but call 911 for help


* drive past the scene and make no call for help.



In most states you have the legal right to choose any of these options, although a few states require specific actions in the case of someone injured in an MVC or during a crime. But even if you have no legal duty to act, it is generally thought that a nurse has an ethical and moral duty to provide assistance.


Good Samaritan laws were enacted to encourage people to voluntarily help someone in need without the fear of being sued for any reasonable care rendered-even if some mistake in treatment occurs. Every state has enacted a Good Samaritan law, but the specifics differ from state to state.


Your legal duty

As long as you pass an accident scene-whether or not you stop down the road to call 911-you have no affirmative legal obligation to an injured victim in most states (the exceptions are discussed below). However, depending on state law, you may incur a legal duty to the victim just by stopping your car at the scene. From that point on, you must intervene appropriately and, unless the scene becomes unsafe for you (or police order you away from the scene), you cannot leave the victim until he or she is being cared for by another healthcare professional with as much or more expertise as you in a prehospital setting.


At this point, you establish a nurse-patient relationship for that particular event. You now owe the patient the normal duty you owe any patient: nursing care that meets the standard of care of a reasonably prudent nurse in a similar situation.


Affirmative duty to render aid

A few states require licensed healthcare professionals to stop and render aid at the scene of an emergency if they can do so without endangering themselves. This is an affirmative legal duty, not an optional one. These statutes are decidedly different from Good Samaritan laws, which provide a liability shield for voluntary aid given or actions undertaken voluntarily and in good faith at an emergency scene that do not rise to the level of gross negligence.


Good Samaritan laws do not prevent a victim from filing a malpractice lawsuit for any service you render at the scene, but they are intended to limit your liability-unless your behavior was grossly negligent or intentionally harmful, or you were the person who initiated the emergency situation (for example, by striking the victim with your car).


Bottom line: Don't wait. Make sure you know how your state's Good Samaritan law applies to never know when you will encounter an off-duty emergency.


Source: Adapted from Mackay TR. Legal risks while off duty. In: Ferrell KG, ed. Nurse's Legal Handbook. 6th ed. Philadelphia, PA: Wolters Kluwer; 2016.