|
provide
care in an emergency. Second, care must match existing knowledge
and competence and will be judged using the Bolam test – the
rule that a professional is negligent if he or she does not adhere
to accepted practice. Third, nurses and midwives must be prepared
to give account to the courts or professional peers for any actions.
First aid training is more than the ability to provide emergency
care at the scene of an accident.
Applied judiciously, such knowledge underpins many of the fundamental
skills essential for clinical nursing practice. This encompasses
management of emergency incidents and ensuring a safe environment.
The first aid model of incident, casualty and time management, risk
assessment and prioritising emergency treatment are all-transferable
to the clinical environment. For example, first aid skills may include
effective airway management, plus recognition and appropriate management
of acute cardiac and neurological events. Ability to recognise and
minimise signs of shock, haemorrhage, and major metabolic crises,
such as diabetic coma, are also in the first aider’s repertoire.
Transferred to the clinical environment,
these may be summarised as the three principles of preserving life,
promoting recovery and preventing the condition from worsening.
All nurses and midwives should have the opportunity to acquire first
aid competencies and these should be a compulsory component of all
preregistration courses and continuing professional development.
The benefits to nurses and their work would be greater than the
costs of training or potential litigation.
An RCN group examining the issue recommended that the minimum outcomes
in the occupational standards for first aid (http://www.firstaidcafe.
co.uk/Reference/NVQ1.asp) would address nurses’ need to respond
to people with minor injuries, people with major injuries, and to
perform cardiopulmonary
resuscitation and use automatic external
defibrillation.
As a St John Ambulance cadet, I received my basic first aid certificate.
The knowledge I acquired at that time led to my development as a
registered nurse. The fundamental principles I learned then have
since been applied to many aspects of my clinical practice.
Rick Dean is assistant chief nursing
officer, St John Ambulance national
headquarters, London
|
THERE
WAS a time when first aid skills were taught to nurses as
a compulsory component of the pre-registration curriculum, and people
assumed that nurses were experts. But growing anecdotal evidence
suggests first aid training for nurses has become almost extinct,
apparently having disappeared from the curriculum without professional
debate or consent. Recent calls for the restoration of first aid
training in nurse education were taken up at RCN congress. First
aid skills and competence appear to vary
considerably among registered nurses. Some possess extensive skills
having probably undertaken
training on a voluntary basis outside their
|
employment
through organisations such as St John Ambulance or the British Red
Cross. Information from RCN congress 2003 suggests that many nurses
are eager to learn these skills.
Fundamental to this debate is the Nursing and Midwifery Council’s
Code of Professional Conduct. Clause 8.5 of the code states: ‘In
an emergency, in or outside the work setting, you have a professional
duty to provide care. The care provided would be judged against
what could reasonably be expected from someone with your knowledge,
skills and abilities when placed in those particular circumstances.’
Three key principles are contained in the NMC statement. First,
there is a professional duty to |
