VAD and the Nurse Practice Act

rninme · Jul 18, 2006

Since the "common complications" from a VAD (ventricular assist device) are bleeding; infection; device problems/failure; low cardiac output; stroke; hypoxia........I wouldn't touch one without proper orientation and would have NO problem saying NO!

nedanurse · Jul 18, 2006

Yeah, That is what I thought. It is amazing what Nurses will push nurses to do knowing it is not safe and that they would not do it themselves. It is a crazy world out there. Thanks for the response.

TennRN2004 · Jul 21, 2006

How many people work with VAD's out there??? How in the world does an institution hire a new grad and give them VAD's with no training on them. Doent the nures practice act say we have to be proficient at something before we can be responsible for it???

I would say that's a malpractice suit waiting to happen. A new grad needs to be trained on a fresh stable heart population, understand in depth the hemodynamics of heart surgery, and the normal recovery before they are ready to even think about taking a patient with a VAD. That is horribly unsafe.

dorimar, BSN, RN · Jul 22, 2006

Oh my gosh!!!! I wouldn't go near one!!! I have losts of icu experience but NO experience with the VAD. I know lots of nurses with years in CVICU, that have never had a VAD, and wouldn't touch one for that very reason.

Interesting discussion, as someone on another thread recently stated that "Everyone gets the orientation they need". I commented that many new grads are set up for failure by being placed in unsafe situations they have not been trained for and/ or are not ready for. Guess it takes a sentinal event to stop that practice at the facility. The sad thing is, that the new grads accepting that assignment have no idea what risk they are placing themselves or the patient in, or I'm sure they wouldn't accept said assignment.

chaosRN, ASN, RN · Jul 22, 2006

Wow! My unit would not even think about putting a RN with a VAD if he/she wasn't familiar with it! Sometimes that mean changing up assignments at the last minute if the nurse assigned has had no training, or isn't familiar and the charge nurse of the previous shift didn't know. I have experience with and love VADS, & will volunteer to be the nurse any day! :wink2:

ALCCRN · Jul 25, 2006

My unit would never give a new grad a VAD. Usually these patients are in surgery soooo long that we have time to prepare staffing. But when you get a patient with a VAD, I've never seen one person be able to take care of it initially. Several days out when the coags, hct, etc have stabilized one person can handle it.

chaosRN, ASN, RN · Jul 25, 2006

Our VAD's are 2:1 or even 3:1 if necessary immediate post-op

TennRN2004 · Jul 26, 2006

Our VAD's are 2:1 or even 3:1 if necessary immediate post-op

Same here, we have a primary RN that does the charting/paperwork, secondary RN does all the running, hanging bloods/meds, whatever is needed in addition to help the primary.

augigi, CNS · Aug 2, 2006

Well thankfully VADs are getting better, as is patient selection so hopefully the days of 3:1 for a new VAD patient postoperatively are reducing!

In my previous unit, which did a lot of VADs (relatively, for Australia; 10-15/year) we had a VAD program which you had to complete to be able to care for them. It was always a big thing of mine that when a patient on say Thoratec pVAD had been there and stable for a long time, awaiting a bed on the stepdown, it annoyed the hell out of me when agency nurses were given the VAD patient to look after. Just because they sit there and go along ok most of the time does not mean you dont need to know all the possible problems and troubleshooting when it happens!

There should definitely be supervision and structured education before RNs (new grad or experienced) are allowed to care for complex VAD patients.