[GarethForster1]

Markus UK makes some very valid points in his last post which as a registered healthcare professional I very much share, hence for me in that situation it was an ethical decision I made to assess the patient. Indeed I gained informed verbal consent from Patient and ensured that this was witnessed by a member of the cabin crew. You have to weigh up all options, though ultimately any Nurse or Dr is trained to save lives and that is what we do, so long as we are working safely within our own scope of practice. I strongly dispute the comments on here that suggest payment should be made to the patient. Becoming unwell at any time could happen to any of us. If a Dr or Nurse was not on board an airline would probably have little alternative but to divert. causing them delay, disruption and severe financial implications. As a healthcare professional I expect to be reimbursed for my time and services in the same way as you would be for yours, whatever they may be,

[HarryMonk]

GarethForster
As I said in my 20.46 post, how does one value the reward? Already from your comments and those of David Gordon to the value of any reward are different.
I am not saying you don’t deserve anything, I know if you helped myself or my family I would seek you out after the event and offer thanks and a suitable gratuity, I just don’t think any reward needs to come from the airline just because the event occurs on their aircraft through no fault of their own

[sweetcandy12]

DavidGordon10 – this is a very interesting post! I think all airlines should have a doctor and engineer as part of their crew to deal with some serious emergencies especially on intercontinental flights.

[SimonS1]

Many of the incidents highlighted above are literally life and death issues, so a little thanks and gratitude doesn’t seem too much to ask. You could take the narrow view about it not being the airline’s issue etc but saying thanks is surely better than a death on board.

[MartynSinclair]

There are 2 issues here:

1. Payment (recompense) for effectively being on duty

2. Authority for the Dr/Nurse to treat based on the legal jurisdiction & position of the aircraft.

I admire Dr’s & Nurses for putting their hands up to offer help, but unless they are protected i.e. the airline confirm they are authorizing them to treat the patient, I think they must be crazy to help.

There is a recent case of a Dr who was arrested in UAE whilst in transit and charged with manslaughter….

http://www.nytimes.com/2013/04/12/world/middleeast/united-arab-emirates-laws-ensnare-a-doctor.html?pagewanted=all&_r=0

OK – he was not treating a patient in an aeroplane, but this does highlight the perils…

The airlines should SUPPORT a volunteer medic, working on one of their airlines BEFORE the medic agrees to treat.

[JasmineBear]

@DavidGordon10

I too have had the pleasure (?) of being the Dr. on board, and until my last call up, had always answered the crew request. However, last one (now several years ago) was to attend the Captain, who was feeling dizzy, on a transatlantic flight ex-LHR and advice was needed prior to reaching point of no return to LHR.

To provide confidentiality to those involved and to cut a long story short, yes a medical issue which was ongoing, but no not something we needed to turn back for, and yes, very polite grateful CSD and flight crew including the 2 x 1st officers who took over, no not a single F/U from BAEC or the airline, despite my GC status. To be fair, I was not expecting anything as getting safely there (and on time) was recompense enough. However, what has stopped me from answering the calls since, was advice from my medical practice insurers of the risk of medical malpractice lawsuits, especially for flights to and from USA…. It seems it is just not worth the risk.

Of course, you will have a duty of care morally, and in some countries (France, so presume French airspace or French carriers?) a legal duty of care as well to respond. Have been lucky never to have had to test that dilemma as another medic has always piped up early!

[Chardie]

I’m very surprised no one has mentioned the good samaritan law.
I believe this originated in the States.

Also surprised that it seems to be the pilot who decides whether to divert a flight and not a Dr dealing with a patient.

I work in remote locations and it is always the Dr or Medic on site who decides when to evacuate a patient, never the pilots.

Sounds like some posters on here are looking for an excuse not to help which I find very sad.

[rferguson]

OK…just to add my two pence worth from a cabin crew perspective.

Over the past near 20 years working onboard i’ve seen my fair share of in-flight medical emergencies. No offense what so ever to those amazing doctors out there, but given the choice between a GP/consultant and say a nurse or paramedic the nurse of paramedic would win with me (and I think I probably speak for most crew) every time.

Firstly, an aircraft is not a hospital. It is a unique environment that offers a limited scope in terms of medical facilities. Most of the doctors don’t seem to grasp that. Also, cabin crew are only trained to a certain level medically. This is another issue that doctors don’t seem to grasp. My last medical emergency a doctor asked me to ‘draw up’ a syringe with blah blah blah in it!

Secondly, I know in a hospital situation the doctor is god. In the air, the situation is a little different. The captain is in charge and there are certain procedures we need to follow. The first of these is to initiate contact with the air-to-ground service Medlink. I recently had a scenario where after establishing contact with Medlink they asked some general questions regarding pulse rate etc of the patient. When I asked the doctor for these details I had the most condescending reply ever. They were not interested in passing on any information to Medlink or co-operating with our procedures. After administering some drugs, the same doctor suggested we move the very overweight lady to one of the crew rest bunks (there were no empty seats) – so move someone that has just suffered a suspected angina attack up a steep narrow ladder to an overhead crew rest area???

Of course nothing can replace a ‘real life’ medical professional. But the involvement of medlink is essential. Firstly, they are aviation medicine specialists. Secondly, they know every item of medical equipment and every drug we carry on board. Thirdly, they know what medical facilities are available on the ground at potential diversion airports (which is an important factor when flying over africa etc). And finally they act as a liason between us in the air and those on the ground at a diversion airport.

Doctor/Nurse + Medlink involvement = ideal situation.

Nurses and paramedics seem more open to being asked questions, taking advise, cooperating than doctors. I guess maybe it is a reflection of their day to day life in a hospital environment where as doctors ive encountered do not want to be questioned.

Anyway, thats my experience. Nurses and paramedics, 10 out of 10 in onboard emergencies. Doctors, amazing stuff you do but you’d always be my second choice. Sorry!

[MarcusUK]

Sadly, gone are the days when the an Airline cabin crew always had a Trained Nurse as one of its team on board!
I think with globalisation, it became a much more sought after qualification, to speak several languages, and look a certain body shape, than it did to have relevant experience in the air for emergency situations.

With several hundred passengers, on very large aircraft, travelling up to 15 hrs these days, it should really carry more relevance to have a trained Nurse on board.
I suppose it is too much of a combo to have an Air Martial that is also a registered Nurse! I can think of some very burly Matrons that could do both though! No nonsense Matrons on Board would solve all issues.

Most of us Nuses are trained to be stroppy, assertive, at times prescriptive, and certainly confident to take things in a cool, levelled manner, whatever happens. This was one of the great elements of Nurse training in the UK, though I consider this sadly gone from most newcomers.

Many more experienced Nurses have a natural vocation, and we shall always respond on board when asked or when we see help is needed. Many times i have observed and volunteered without calls going out, as I am sure others have.

But please all be aware as Martyn points out, there are complications and issues that need to be carefully considered.

An Airline cannot take liability or authorise you to “practice”, in an ethical or legal sense. Few would be licensed to practice in several countries.
You would still be legally culpable for your actions, in whatever country, and who says if this is the Airline base, origin or destination of the flight.

There may well be situations where we can do little, or events surpass equipment or competence of any Dr, Nurse or paramedic.
Our actions then become subject to investigation, and interpretation.

Remember, there are Dr’s and Nurses who are imprisoned in the UAE for assisting so called “sides” in conflicts or disturbances…

The UAE also has over 300 medications sold over the counter legally in the UK, that are banned there. Administration of the flyers own drug by you, even in assistance, could in fact be an offence, as could the carrying of that without documentation as required there!

Many issues, but an interesting debate.

I wonder if BT is aware of Airline Policies in this regard, in asking or idemnifying their staff of professionals on Board, in such situations?

[SimonS1]

“Chardie – 26/05/2013 06:04 GMT

I’m very surprised no one has mentioned the good samaritan law.
I believe this originated in the States

Sounds like some posters on here are looking for an excuse not to help which I find very sad.”

Indeed very sad. Just like the rush these days to sue for every minor grievance, which I believe also originated in the States.

[DavidGordon10]

Chardie @ 06.04 – the captain must decide. The captain of an aeroplane, like the captain of a ship, must be in command. He (or she!) will take the advice of the doctor or nurse – and the captain of the ship will take the advice of the navigation officer or the master at arms or whatever – but in the end the captain is in command and must take the correct decision for the good of the plane/ship and its passengers.

RFerguson @ 10.38 – I can absolutely understand that a nurse in general is more use than a doctor, and the arrogance of some of my medical brethren makes me cringe. The best combination for something difficult, in my experience, is one of each. I have had some really excellent working in mid-air with colleagues from nursing. We spend a lot of time these days trying to educate medical students that we must work in teams. Doesn’t always penetrate the medical student skull….

[Chardie]

SimonS1 – 26/05/2013 13:40 GMT

“Indeed very sad. Just like the rush these days to sue for every minor grievance, which I believe also originated in the States.”

This is exactly why the Good Samaritan law was introduced. So that people could help and assist without the fear of being sued.

http://en.wikipedia.org/wiki/Good_Samaritan_law

[lloydah]

and in that Wiki explanation it seems that the US interpretation of that law is the most complicated and various. It could therefore depend upon the destination State could it not?

[Chardie]

No idea lloydah, I’m not from the States and I’m not a Lawyer.

[SimonS1]

Chardie – 26/05/2013 14:22 GMT

This is exactly why the Good Samaritan law was introduced. So that people could help and assist without the fear of being sued.

http://en.wikipedia.org/wiki/Good_Samaritan_law

Did you read the link that you quoted? Reading the bit under United States doesn’t exactly support your point….

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