Not ACLS certified pulled to Tele floor... - page 2

by Jess_Missouri_RN

3,614 Views | 18 Comments

I'm just curious about an issue that to me seems important. I work a med-surg floor and on occasion I'm pulled to a med-surg Tele floor to which the regular Tele floor staff are ACLS certified. I am given Tele patients on this... Read More


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    At My Hospital you have to be acls certified to work in IMC (Tele) if Your not You will be by the time your off orientation. They have tried to float people down there and they tell them "it's ok somebody will be watching your monitors." Ummm No I don't think so! How can someone watch their monitors and yours?! That's 10 monitors! And how can You trust a nurse you don't even work w/ regularly to do that? You can't! And god forbid something happens and You get pulled into court what are you going to say? "Umm someone else was watching my monitors, because I don't know how to read them." I mean come on, You need to protect your patients, your self and your license!
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    We have medical nurses pulled to our floors all the time. We tend to give them medical patients that for whatever reason, docs decided they need tele monitoring. Our charge nurse reads their required strips every 4 hours, and we watch for the major rhythm changes, the alarms etc. All us tele nurses watch for the patients. We have 14 monitors to watch, and we do a pretty good job. There is no reason for the ACLS cert for everyone. If there are any problems we encourage pull nurses to ask for help, or call a response code if help is needed. The last time I had a pull nurse, the patient was very sob and having some flash pulmonary edema, so I yelled out for a code help. The pull nurse was able to help with direction, and report off to the team and to ICU. It's just like being a nurse.
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    My unit requires ACLS within 6 months I think, but we often get floats from the gen MS floor. I don't think the floats need ACLS - between us regulars and the code team, there will be plenty of certified folks. I do believe we have to have at least two ACLS RNs on the floor - we may not always have a doc available for a code.

    Further, we give the float nurses the most stable patients without drips. Even if it is one of the float nurse's patients that codes no one will be looking to him or her to run the code - only answer history questions and follow directions.
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    Quote from LilBoo
    At My Hospital you have to be acls certified to work in IMC (Tele) if Your not You will be by the time your off orientation. They have tried to float people down there and they tell them "it's ok somebody will be watching your monitors." Ummm No I don't think so! How can someone watch their monitors and yours?! That's 10 monitors! And how can You trust a nurse you don't even work w/ regularly to do that? You can't! And god forbid something happens and You get pulled into court what are you going to say? "Umm someone else was watching my monitors, because I don't know how to read them." I mean come on, You need to protect your patients, your self and your license!
    *** Uh, what does having ACLS have to do with compentcy to wach monitors? Neither I nor my hospital considers a ACLS trained nurse to be qualified to monitor tele patients if they have not also passed the basic EKG class. ACLS does not teach rhythem identification. Only those nurses who have been to basic EKG class are qualified to monitor tele patients. ACLS is different and more or less unrelated. I don't see how having ACLS certification is going to protect an nurse in court if s/he hasn't also been trained in EKG. There could be lots of changes in a tele patient that a nurse who has been trained only in ACLS would not be able to indentify. ST segment elivation for example.
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    Quote from PMFB-RN
    *** Uh, what does having ACLS have to do with compentcy to wach monitors? Neither I nor my hospital considers a ACLS trained nurse to be qualified to monitor tele patients if they have not also passed the basic EKG class. ACLS does not teach rhythem identification. Only those nurses who have been to basic EKG class are qualified to monitor tele patients. ACLS is different and more or less unrelated. I don't see how having ACLS certification is going to protect an nurse in court if s/he hasn't also been trained in EKG. There could be lots of changes in a tele patient that a nurse who has been trained only in ACLS would not be able to indentify. ST segment elivation for example.
    ACLS does teach some recognition of ST elevation. ACLS is not, however, a comprehensive course in reading all of the subtleties of the EKG. ACLS is also not a course that teaches anyone how to prevent a code, rather it teaches a systematic way to deal with a code. Nothing more, nothing less.
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    On my floor they will usually assign a nurse to cover/watch a pulled nurse's patients on monitor. Also I am sure most hospitals have Monitor Techs (my current job ) that will call you about any changes in condition or arrhythmias.

    Also consider buying an EKG pocket reference book. It will help you on any floor you work even if just to look up the definitions and acronyms. It gets old having to constantly explain what a PAC/PVC is.
    Last edit by ChaseZ on Jan 16, '12
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    ACLS does teach some recognition of ST elevation. ACLS is not, however, a comprehensive course in reading all of the subtleties of the EKG.

    *** I am an ACLS instructor and we do not teach people to recognize ST elivation or relly much of anything else. We expect them to have passed a basic EKG course prior to attending ACLS. Doesn't alwasy happen though.

    ACLS is also not a course that teaches anyone how to prevent a code, rather it teaches a systematic way to deal with a code. Nothing more, nothing less.

    *** Good point.
    wooh likes this.
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    Not all nurses need to be ACLS certified. New Grads starting out in ICU don't even need to be ACLS certified. They typically have a year to obtain their ACLS. As long as there is ACLS certified nurses in the hospital, I.E., code team, ICU nurses, your fine. You can initiate CPR with BLS if needed.
    HazelLPN and wooh like this.
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    Quote from MomRN0913
    Not all nurses need to be ACLS certified. New Grads starting out in ICU don't even need to be ACLS certified. They typically have a year to obtain their ACLS. As long as there is ACLS certified nurses in the hospital, I.E., code team, ICU nurses, your fine. You can initiate CPR with BLS if needed.
    *** In our hospital's Critical Care Nurse Residency program the (nurse) residents are put through ACLS during the first month of class room instruction. After that each one takes turns carrying the code pager and responds to all codes that day. They are usually used to do compressions or maybe run the defib. By the time the 7 month program is over each resident has been to 3-10 codes and will (hopefully) have rotated between all the code jobs except code team leader. Their behavior during the codes is noted and is counted when the decision is made wether they graduate and go to SICU, MICU, PICU, ER, or PACU or if it is discovered they panic or act inappropiate during codes they may be offered a job on med-surg instead of one of the critical care areas.


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