ACLS requires a doctor's order?

[BUNightingale]

My facility is telling us that we must have a physician's order to start pushing ACLS drugs. They are telling us that it is a violation of the Nurse Practice Act to start ACLS without an order and that we are operating outside of our scope of practice because we are administering meds without an MD order. We have, in the past, just paged the MDs and started ACLS with high quality CPR, pushing whatever meds the patient's condition called for, following the algorithm. I work in a large teaching facility so there is always an MD somewhere close by so this problem isn't really that important specifically to me but what do smaller hospitals do when there isn't a doctor handy? Has anyone else ever heard of this? What do we need certification for if we can't do it without an order? Wouldn't any RN be able to administer these drugs with a physician present?

[PMFB-RN, RN]

I am an RN ACLS provider/instructor at a large campus with subacute services. The acute care facility is across town. I'm on the front line in triaging and managing unexpected cardiac and neuro emergencies in an apparently healthy but high risk ambulatory setting (we stabilize and call 911). I don't have physician back up in an emergency or a code. Although there are physicians on the wards and in the clinics in other buildings. The institution has decided that a physician does not have to respond to a rapid response call or a code on our campus. There is a push to get the nurse managers ACLS certified here. Where does that leave me in an emergency? Am I allowed to push ACLS drugs per algorithm? Our medical director says yes - as long as we do it correctly (he is at the other campus). I have read our hospital policies, reviewed our state's nurse practice act (didn't address this type of thing), and briefly looked at ANA Scope of Practice (it looks like a text book). But I'm still unclear about my role and responsibilities and worry about the position I am being placed in. Can anyone help? I'm thinking of consulting an attorney. I don't feel communication is good at this institution at all.

*** I don't understand what your concern is? Lots of nurses run codes without a physician. There have even been times when I as an RN ran the codes and gave orders to physicians (interns and residents). Why is there any question of wether you can push meds in a code?

[weemsp]

At the risk of " beating a dead horse" here...I think the general answer to your question is: Find out the specific protocols for YOUR facility.