[LaurynRN]

Hello all,
I am orienting to ICU after being on an oncology/organ transplant floor for three years. I started in October and am supposed to be through with my 12 week orientation on Christmas Day. Up until now I have only had one course relevent to critical care, I did take the trauma core.
For weeks I have been asking about the critical care course and a dysrhythmia course and my manager has been not giving me any solid answers. Last week he told me I may not be able to come off orientation until my classes are met in January. I was fine with that.
HOWEVER, yesterday he informs me that I will not be attending the critical care course until Feb/March and he is still not sure about the dysrhythmia class. He basically tells me that I will be off orientation without these classes.
What do you think? Do I have a right to fight it? Is it worth it, the classes I mean.
My gut tells me that I shouldn't let him do this but I am not sure because I don't even know what the courses are like.

[nrsang97]

I have too made the transition to the ICU after working on a medsurg floor. I was given 6 weeks of critical care classes. In the critical care class we had a dysrhythmia class. I had already had these since one medsurg floor I worked on had tele pts. I had already had ACLS also.

I think your boss is giving you the short end of the stick if you don't have these classes. Tell him/her that you don't feel comfortable to go on your own until you have had these classes.

In my hospital we aren't allowed to go out on our own unless we have passed the critical care class and their rhythm competency and resp competency. Good luck to you.

[cardiacRN2006]

We had a spot JCAHO inspection a few months back. My chart was the one chosen to be reviewed (what luck!). The JCAHO people questioned me about my restraint policy, care plans, and such. Then they specifically asked if I was ACLS certified and if I had taken a critical care course.

You can't (check your P&Ps) work in an ICU without at least being ACLS certified. If one of your pts dies, and you don't have it, it's your behind that is on the line.

[aquaphoneRN]

Originally Posted by LaurynRN

I was fine with that.
HOWEVER, yesterday he informs me that I will not be attending the critical care course until Feb/March and he is still not sure about the dysrhythmia class. He basically tells me that I will be off orientation without these classes.
What do you think? Do I have a right to fight it? Is it worth it, the classes I mean.
My gut tells me that I shouldn't let him do this but I am not sure because I don't even know what the courses are like.

In my hospital, it would be a violation of union policy to come off orientation without completing the critical care courses. The manager would have a lot of explaining to do if they attempted this.

You owe it to yourself and your patients to fight for this.

[LaurynRN]

Thanks for all your thoughts. I am so happy to hear about what others think

[ElizabethJRN]

Originally Posted by cardiacRN2006

You can't (check your P&Ps) work in an ICU without at least being ACLS certified. If one of your pts dies, and you don't have it, it's your behind that is on the line.

Is this universal, or per hospital policy? I know you said check your policy and procedures, but I'm still curious. I've been on my own in our MICU for 6 months, and they won't let any new grads take ACLS until we've been on our own 6 months. (I take the class next week). They claim because we don't know anything yet. I think it's unsafe to work there without being ACLS certified. Does anyone know or have any links? I tried looking on the JCAHO
site but found nothing. Thanks.

[Ruby Vee]

To the original poster: Do you know your rhythms? If so, I think the dysrhythmia class can wait. If not, no. You won't be a safe practitioner if you don't know what rhythm your patient is in, or note changes in their rhythm.

As far as the ACLS classes -- some ICUs mandate being ACLS certified, others don't really care and some even discourage it. I think if you know your rhythms and your drugs, you're probably safe without it. It isn't as if you're ever going to be the ONLY nurse around -- believe me, if your patient tanks you're going to have as much help as you can handle. I can understand waiting until you've been on the unit for 6 months -- it increases the chances of you actually passing! The important thing is that you recognize and are able to respond to changes in your patient's condition.

[bluesky]

Originally Posted by cardiacRN2006

We had a spot JCAHO inspection a few months back. My chart was the one chosen to be reviewed (what luck!). The JCAHO people questioned me about my restraint policy, care plans, and such. Then they specifically asked if I was ACLS certified and if I had taken a critical care course.

You can't (check your P&Ps) work in an ICU without at least being ACLS certified. If one of your pts dies, and you don't have it, it's your behind that is on the line.

Actually, you don't legally need ACLS to work ICU. The level 1 trauma center I worked at for 2 years did not. Most hospitals, however, do.

[bluesky]

To the OP;

Now I don't know the details of your situation, however in your shoes I would sit down with the manager and lay it down point blank. You feel that you are ready to leave orientation in January and you want to know why you can't. THe class almost sounds like an excuse, *perhaps*. You may even offer to take an arrythmia class outside of the hospital... or buy a book, learn it on your own ( I recommend Dubin's book) and ask if you can test out of the arrythmia class. ACLS is a piece of cake. You could take the initiative and take it on your own (though it will cost you about $250 and it's hard to find on short notice). You could offer to take the BKAT.

[Christie RN2006]

At my unit (SICU), they require you to be ACLS certified within 12 months of being hired. Until you are ACLS certified you are not allowed to push meds during a code, or go on codes. They make you take CRRT classes before they let you care for a patient on CRRT. Before you go off of orientation, you have to complete and pass an EKG class.