Document 4Qw6vE2Ep4y5bz4BB9a4OJNjj

OCCUPATIONAL HEALTH SERVICES aod ethical codes She may not divulge in formation contained in individual employee health records unless the employee gives his signed permission The files are only ac cessible to medical personnel, hence the nurse usually maintains them She should not, however, accept employment that re quires her to assume responsibility for serv ice outside the sphere of her professional training and experience According to The Legal Scope of Indus trial Nursing Practice, a statement pub lished by the American Medical Associa tion in 1959 "Courts have held that professional nurses have a legal duty to interpret evidence pre sented by the patient possibly indicating the need for medical attention, and to proceed in the light of that interpretation to do what is required for the patient, as for ex ample the need to call a physician, to dis continue a treatment where there is evi dence of its harmful effect, eg, on an unoonscious patient, or to determine the patient's need for special medication, eg, sedatives There can be little doubt that by custom and usage the relationship between doctor, patient, and nurse is one in which the parties recognize that the nurse as well as the physician has the function and re sponsibility to observe and interpret the patient's reactions "In emergency cases, industrial nurses have a duty to determine the need for prompt medical attention, to make a tenta tive diagnosis of the patient's condition, and to employ necessary resuscitative and firstaid measures " First Aid Definition and limitations In many small organizations and in field operations, it is neither practical nor justifiable to have qualified professional medical personnel available In such cases, the best arrange ment is a suitable first-aid kit or a statlbn administered by trained lay first-aid attend ants who follow procedures and treatments outlined by a doctor The doctor should be available on an on-call or referral basis to take care of injuries not of a minor nature It should be noted that m some jurisdic tions injured employees have their choice of a physician In such cases, the employer should comply with this request, if possible At this point it is well to recognize that Fig 38-4. Combination emergency shower and eye-wash fixture Courtesy Speakmen Company there are really two kinds of first aid One is emergency treatment--according to the American Red Cross first-aid textbook, "First aid is the immediate, temporary treat ment given in the case of accident or sudden illness before the services of a physician can be secured " Proper first-aid measures reduce suffering and place the injured per son in a physician's hands m a better condi tion to receive subsequent treatment The duty of a person giving first aid ends where that of the physician begins The other land of first aid is the prompt attention given to injuries, such as cuts, scratches, bruises, and burns, which are usually so minor that the injured person would not ordinarily seek medical attention Whether these wounds heal satisfactorily depends on proper care immediately after injury and subsequently This is probably the appropriate place to point out that lay treatment is too frequently ooertreatment, which can have results as bad as careless ness or neglect The requirement that all employees re- 38-5