[elizabells]

Has anyone been? I'm talking about the ECMO specialist training course. My unit keeps making noises about training RNs to run the pump bc we don't have enough perfusionists, so I asked if I could do the course. My boss now, of course, wants to know a) how much it costs and b) whether it would be worth it. So has anyone been to it? How long was it? Cost? Did you really feel prepared to run a pump afterwards? I emailed the sign-up person to ask all of this, of course, but I'd love to have the perspective of someone who has done it or knows someone who has.

[janfrn]

We do our own in-house ECLS specialist training. We have a lot of runs (we have three going right now) and our team is comprised of both RNs and RTs. I'm not sure what the cost to the hospital is for training people, but I imagine it's a large number of $. The hospital obviously thinks it's worth it though, because we're running another course in the new year. I'm not a specialist, but I'm very competent on the patient side...

[JennieJenRN]

Ok so I am confused are you working at U of M?? Because it does not sound like it. At the University of Michigan RN's or Rt's run ECMO at the bedside not perfusionists. If you are in house the cost is free with an understanding you will pick up OT. As far as out of hospital I do not know. Do you feel prepared Yes!! Its not easy!
GoodLuck!

[elizabells]

No, I don't work at U of M. I work in NYC, and we have an all-perfusionist team. However, we don't have enough perfusionists, and have on occasion had to send a kid up to the PICU if they have a run going already, and that perfusionist has to run both pumps. Our perfusionists also have horrible schedules. I once had one girl tell me she was on her 16th day of 12-16 hour shifts without a day off. We're the major pedi cardiac center for the region, and share the same perfusion team as the adult hospital, which is also a major center, so the perfusionists get tied up in the OR a lot. So the head of neo and the chief of surgery (who is also the head of the ECMO program) would like to start training RNs to run the pump. The training course page didn't indicate that it was only in-house, although I'm prepared now to get an embarassing email from the contact person telling me so.

[Kimbalou]

When i worked at a children's hospital, only RN's ran the pumps after the training program, in-house. I'm surprised your management isn't having a program for RN's, maybe you should start asking about it and finding out how many hospitals only use perfusionists.

[elizabells]

Hopefully this is a first step toward that, Kimbalou. We're behind on some stuff and ahead on others. Also, as I see it, it's problematic that I have less than 2 years out right now. Yes, I can have all the passion and training in the world (and do silly things like read ECMO textbooks in Central Park on my day off) but unless I get an NP or senior nurse on board I'm not going to be able to make this work, unfortunately. I may have to go to CHOP or something.

[irisRN]

I am definitely all for teaching the RNs to know how to run the circuit. However, it is A LOT of work. IMO, I feel safer having the perfusionist at the bed side, making sure that all is running well. The circuit requires many safety checks, and if you have 2 assignments, that is a heckuva lot of work. Granted if the kid is on ECMO its usually a 1:1 assignment, but hey, nothing is guaranteed. The hospital should be hiring more perfusionists, as well as educating its nurses, so that we may cover them, should they run out of personnel. Better yet, they should stop sharing our perfusionists with the adult side...

BTW, i think we work for the same place

[elizabells]

I think we may have been in the same hospital orientation group, actually, if you be who I think you be...

Anyway, I heard back from the lady at U of M. The program is 4 days (which seems incredibly short to me...) and costs ... ready? ... $2000. Holey moley. I don't think I'm going to be able to get the hospital to pay for that. Anyone know how to get funding for something like this???

[janfrn]

Originally Posted by irisRN

I am definitely all for teaching the RNs to know how to run the circuit. However, it is A LOT of work. IMO, I feel safer having the perfusionist at the bed side, making sure that all is running well. The circuit requires many safety checks, and if you have 2 assignments, that is a heckuva lot of work. Granted if the kid is on ECMO its usually a 1:1 assignment, but hey, nothing is guaranteed.

In our hospital, a patient on ECLS will have a nurse and an ECLS specialist, either nurse or RT. If they're really unstable they'll have 2 nurses, or sometimes 2 ECLS specialists. A couple of weeks ago I took a child on ECLS to CT... well actually it was me and five of my closest friends: 2 RNs, an RT, an MD and 2 ECLS specialists. As well, our ECLS team are usually scheduled for 6 hour shifts on the pump rather than 12 to prevent the fatigue and slipping attention that may come with a long shift of circuit checks and tweaking. This is our ideal, but right now we have 3 pumps running and not enough people to do the 6 hour shifts, so they're doing 12s.

[elizabells]

Originally Posted by janfrn

As well, our ECLS team are usually scheduled for 6 hour shifts on the pump rather than 12 to prevent the fatigue and slipping attention that may come with a long shift of circuit checks and tweaking. This is our ideal, but right now we have 3 pumps running and not enough people to do the 6 hour shifts, so they're doing 12s.

Wow, six hours? Ours routinely do an eight in the OR and then another eight if there's an ECMO on one of the units. I once had a girl (the aforementioned 16 days of 16hr shifts) get asked to stay for a lung transplant. She said she'd stay for it if they made her, but once she left that OR she was never coming back. They found someone else. Hence the thought of training nurses, I guess. We did have a hideous error once because of a miscommunication between RN and perfusionist about stopcocks. I wonder how much fatigue played a part in that.