Do you know how to do CPR well?

MrsWampthang, BSN, RN · Aug 30, 2006

(imagine ept and atropine being "pushed" into a running line without clamping above, etc etc).

Yeah, I can imagine it, I used to do it all the time when worked in the ER and on the ambulance as a medic. If the line is wide open, (as it is should be during a code) then it is going to run the medication in as fast as you give it, it isn't going to back up in the line for any length of time. Yes, I know in school they teach you to clamp when giving meds, and you should continue doing that, however, don't be surprised if, in a code situation, you see meds pushed without the line being clamped.

Pam

RunnerRN, BSN, RN · Aug 30, 2006

Yeah, I can imagine it, I used to do it all the time when worked in the ER and on the ambulance as a medic. If the line is wide open, (as it is should be during a code) then it is going to run the medication in as fast as you give it, it isn't going to back up in the line for any length of time. Yes, I know in school they teach you to clamp when giving meds, and you should continue doing that, however, don't be surprised if, in a code situation, you see meds pushed without the line being clamped.
Pam

As it should be lol. Like I said, this code was a cluster of mistakes, and they still had the fluids kvo. Plus the fluids were hooked to his dialysis access, and everytime someone lowered the bag a little, there was blood backing up. Not really at all :)

Regardless, I only do code in the ER now, and always clamp my fluids when giving my meds....it just seems safer to me. But we usually (hopefully) have a tech doing CPR, a nurse pushing meds, a nurse writing the code, etc.

Thanks for the reply! I love learning more about ER nursing vs "field" treatment, it is amazing the differences that exist (and I have nothing but respect and love for my medics!)

LydiaNN · Aug 30, 2006

I just recently got re-certified in an AHA class and the instructor was the worst I'd ever had. His primary concern seemed to have been getting us out of class early. Since I got my original certification when I was in high school 20-plus years ago and have been continually re-certified ever since, I didn't feel like it was a big deal for me personally, but I don't think the newbies in that group are at all qualified to perform CPR. I must say that I do feel this time I do have a Mickey Mouse certification.

kristen3g3tp8 · Aug 30, 2006

I was wondering..I graduated in May of this year..How important is to know CPR? I know some patients might stop breathing and the nurse has to do CPR on the patient right? I never done CPR on a live patient before..Was wondering do you have to know CPR very well in order to work? I know you have to have CPR certification but many of those places that certity people are just micky mouse type of certifications..

I agree... I took a full semester CPR course at my college, and then found out that I had to get the "new 30/2 CPR" certification for nursing school. So, I did what most students do and registered for the 4 hour pass no matter what course. I was amazed at how basic this class was. Half of the people in there did not preform the skills correctly... and they all passed! We graded our own exams, and that was it. If it were not for the semester long class I took under the old guidelines I don't think I would have ever been able to do CPR correctly. I understand why they have quick and easy CPR certifications for the public, but for professionals I think that this course should be more complex. You will use CPR on a regular basis, and you should be confident in your skills. Just remember... as a nurse, you will often be the person called upon in a emergency situation no matter where you are, so learn it... learn it well and be able to do it correctly is my best advise!!! :)

Dorito, ASN, RN · Aug 30, 2006

Just wanted to say that in our ER we do CPR alot and so far I have never seen or heard of ribs being cracked, if it is being done right the risk of that is slim.

You've never encountered broken ribs/ sternums? The first time I did CPR (prob 25 years ago) it was on an elderly woman. I felt a crack with my first compression (I'm sure adrenaline, her advanced age and the fact I had only practiced on manniquens was a factor). I know several codes I have worked on- the patient already had a cracked sternum or ribs by the EMT's before they got to us in the ER. Unfortunately sometimes with advanced age, medical problems etc. these things do happen- correct hand placement or not.

TazziRN, RN · Aug 30, 2006

Keeping lines wide open: lines should always be wide open during a code. Since the blood is not circulating as it should be, even during compressions, you need all the help you can get to circulate the med. The running fluids can help push it through.

Also, I've seen medsurg nurses (newbies, not oldies) look shocked when they saw us slamming meds in as fast as possible, rather than slow push! I actually had a supervisor come in to help in a code, and she pushed epi slooooooow. I finally grabbed it out of her hand and slammed the rest in.

glascow · Aug 30, 2006

On my AHA card: "This card certifies that the above individual has successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the AHA for the BLS for Healthcare Providers Program."
I am certified.

Sure, your card certifies that you successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the AHA for the BLS for Healthcare Providers Program."

This is not the same as saying you are certified in CPR, as another poster pointed out. The card only certifies that you completed the course and passed the written and skills exam. Unfortunately, we all know people who can pass test but in reality don't really "get it." They are just good at mimicking what they have seen, and will soon forget the info.

To be certified in an area of expertise, the wording would be different: i.e. AACN hereby grants certification status for the successful completion of all requirements for Certification in Adult Critical Care Nursing.

I know it sounds like symantics only, but this is a topic that has been hashed out many times about wether or not a person is "certified in CPR." It is not the same thing as saying, "I am certified in Critical Care." No "certification status" is granted in CPR. The card is only certifying that you successfully completed a course in accordance with nationally recognized guidelines.

Actually, the correct terminology is that one who has successfully completed a CPR course for healthcare provider (HCP)is now a Basic Life Support (BLS)provider. I know, I know, it's just words and am not usually anal about stuff like this, but I have heard this debate so many times, and now being an instructor, I want to clarify that although it is typically acceptable for someone, or an agency, to say they will certify you in CPR, or require you to be CPR certified, is incorrect.The card that you are given after you successfully complete a course only certifies you took a certain class, whether it be BLS, Heartsaver, ACLS, etc...

If listing credentials on your resume, I would not put:

1992-present CPR certified

The proper way to document this would be:

1992-present: BLS HCP

If you have taken a CPR course, you know that AHA has changed MANY of its guidelines as well as teaching methods. AHA has very strict guidelines for instructors to follow, and I am disappointed to hear that so many feel they did not get adequate training. But the way the rules are written, instructors do have a certain amt of "wiggle room." I.E. Having the book for the course. The AHA says that all instructors must have a student handbook available for the students. It seems as though many of you have had instructors who interpret this to mean they give you a book as you walk in the door! This keeps the price down for the instructor or student but is hardly useful.

I always make sure that each student has their book atleast 1-2 wks before the course and emphasize that they must come prepared, having already watched the new student CD that comes along with the book.

Also, AHA does not want the instructors to "teach" the CPR course, they want the video to teach the skills, and the instructor is there to provide feedback. AHA strongly discourages the instructors from "reteaching" the material learned from the film.

AHA also gives the instructor the ability to "tailor their classes to the students needs." It may take me 8 hrs to do a first time HCP course for nursing students, because all of the material is overwhelming! It may only take me 2 hrs to complete a class for a group of ICU nurses that I have worked with for yrs and participated in many codes with.

AHA also has strict guidelines about instructor to student ratio to manikins. If an instructor closely follows the guidelines for conducting a BLS course, you should walk out of their class feeling somewhat confident that you atleast know what needs to be done and in what order. i.e. Call first, call fast. ABCD.

OK, sorry for rambling about this, but just wanted to put my 2 cents in on the matter. If you feel you have taken a "mickey mouse" course I would find out which community training center the instructor is affiliated with and report them.

catlady, BSN, RN · Sep 1, 2006

I just recently got re-certified in an AHA class and the instructor was the worst I'd ever had. His primary concern seemed to have been getting us out of class early. Since I got my original certification when I was in high school 20-plus years ago and have been continually re-certified ever since, I didn't feel like it was a big deal for me personally, but I don't think the newbies in that group are at all qualified to perform CPR. I must say that I do feel this time I do have a Mickey Mouse certification.

I used to teach ACLS and that's how it was. I would no sooner be getting into my topic with the class than the coordinator would poke his head in and say, "Aren't you finished yet?" He did this to all the instructors to the point where we figured we were just supposed to sign off the skills checklists without doing any actual teaching. I'd hate to be on the other end of that code. After complaining about this a few times, I was no longer getting scheduled to teach, and without documentation of my classes through my affiliate, I couldn't keep my instructor credential. :madface:

LydiaNN · Sep 1, 2006

Sure, your card certifies that you successfully completed the national cognitive and skills evaluations in accordance with the curriculum of the AHA for the BLS for Healthcare Providers Program."
This is not the same as saying you are certified in CPR, as another poster pointed out. The card only certifies that you completed the course and passed the written and skills exam. Unfortunately, we all know people who can pass test but in reality don't really "get it." They are just good at mimicking what they have seen, and will soon forget the info.
To be certified in an area of expertise, the wording would be different: i.e. AACN hereby grants certification status for the successful completion of all requirements for Certification in Adult Critical Care Nursing.
I know it sounds like symantics only, but this is a topic that has been hashed out many times about wether or not a person is "certified in CPR." It is not the same thing as saying, "I am certified in Critical Care." No "certification status" is granted in CPR. The card is only certifying that you successfully completed a course in accordance with nationally recognized guidelines.
Actually, the correct terminology is that one who has successfully completed a CPR course for healthcare provider (HCP)is now a Basic Life Support (BLS)provider. I know, I know, it's just words and am not usually anal about stuff like this, but I have heard this debate so many times, and now being an instructor, I want to clarify that although it is typically acceptable for someone, or an agency, to say they will certify you in CPR, or require you to be CPR certified, is incorrect.The card that you are given after you successfully complete a course only certifies you took a certain class, whether it be BLS, Heartsaver, ACLS, etc...
If listing credentials on your resume, I would not put:
1992-present CPR certified
The proper way to document this would be:
1992-present: BLS HCP
If you have taken a CPR course, you know that AHA has changed MANY of its guidelines as well as teaching methods. AHA has very strict guidelines for instructors to follow, and I am disappointed to hear that so many feel they did not get adequate training. But the way the rules are written, instructors do have a certain amt of "wiggle room." I.E. Having the book for the course. The AHA says that all instructors must have a student handbook available for the students. It seems as though many of you have had instructors who interpret this to mean they give you a book as you walk in the door! This keeps the price down for the instructor or student but is hardly useful.
I always make sure that each student has their book atleast 1-2 wks before the course and emphasize that they must come prepared, having already watched the new student CD that comes along with the book.
Also, AHA does not want the instructors to "teach" the CPR course, they want the video to teach the skills, and the instructor is there to provide feedback. AHA strongly discourages the instructors from "reteaching" the material learned from the film.
AHA also gives the instructor the ability to "tailor their classes to the students needs." It may take me 8 hrs to do a first time HCP course for nursing students, because all of the material is overwhelming! It may only take me 2 hrs to complete a class for a group of ICU nurses that I have worked with for yrs and participated in many codes with.
AHA also has strict guidelines about instructor to student ratio to manikins. If an instructor closely follows the guidelines for conducting a BLS course, you should walk out of their class feeling somewhat confident that you atleast know what needs to be done and in what order. i.e. Call first, call fast. ABCD.
OK, sorry for rambling about this, but just wanted to put my 2 cents in on the matter. If you feel you have taken a "mickey mouse" course I would find out which community training center the instructor is affiliated with and report them.

In a sense, I do understand what you and the other poster are saying about the certification being for the class. However, that is the only certification available- granted, there are different programs and instructors, but what it all boils down to is that all that can be ''certified'' is the fact that you did take the course. No one can certify that when and if the time comes, you'll be ready, willing and able to perform CPR. When we're told we need to be certified, what is meant is that we need to produce documentation that certifies we've passed the course.

JessicaER-RN · Sep 1, 2006

I am so glad I had to take the Health Care Providers CRP course before I started nursing school. I took the class at a fire station this last May and not 2 weeks later I had to perform CPR on a downstairs neighbor (and I JUST started nursing school this month). I totally went into "the zone" and all of the training came back to me. I performed CPR on her for about 2 minutes until the paramedics arrived but unfortunately the woman died. If I had not have known how to do CRP we (me, my husband, and the woman's husband) would have been standing around freaking out. I am happy I gave that woman a chance for survival and the husband's family appreciated it too.

If any nurse or nursing student thinks their CRP course was crappy I suggest you take another one until you feel confident. It is TOO important.