I can't do chest compressions (CPR) will I be terminated?

[42pines]

I'm 66 and on Occupational Health Nurse Manager at a Fortune 500 company. In November one morning I woke up unable to stand on my right leg. Subsequently I was hospitalized, had a MRI then a CAT and given an spinal epidural of steroids whereupon I recovered over the next two months. I have severe bilateral neuroforaminal stenosis. This was quite to my surprise as I work out regularly in the gym (aggressively which may have caused the issue) and my lumbar radiograph is none to pretty.

I returned to work half days and my doc said: "What do you want for restrictions?" I answered: "Stand no more than one minute; Walk no more than 5 minutes and No lift/push/pull greater then 7 lbs. Well, I was at work for about two hours and someone came running into my clinic: "Come quick, someone is having a heart attack."

Indeed, that appeared to be the case. I said to one of our first responder team: "I can't do compressions, you do compressions, I'll bag." We did exactly that. The person giving compressions did an excellent job, we ventilated him, I shaved, slapped on the pads, analyzed and shocked. I thought we might save the fellow because of "shock advised," but it wasn't to be. It was great teamwork and I'm proud.

However, my CPR card just expired and now I must get a AH CPR card but I should not do compressions. Since CPR is an essential function of the job, I could be terminated because of this. So I wonder, am I covered under ADA?

I'd argue yes, as I would never be doing CPR one on one and there would always be another first responder to do compressions.

Any thoughts? Anyone face this sort of issue before?

[Amelia Montez]

Honestly In all my years of nursing if you cannot do Cpr you get terminated or get demoted to secretary or desk work and you can talk to visitors or something like that, stuff that won't make you work with people's health. CPR Is critical as a nurse, doctor, or whatever you are.

[applesxoranges, BSN, RN]

Talk to your manager. It sounds like you're already in a desk job except for the rare occurrence. If they want you to maintain CPR certification, they may have to move you into a role that would not require a CPR certification which is hard to do. I know there are call centers, utilization reviews, etc.

[Emergent, RN]

A close friend of mine is going through this right now. At my workplace they now require the certification on a mannequin. My friend is 5 feet tall and slight. She told me yesterday that she just can't pass the mannequin portion of the CPR certification. She's not strong enough, the machine keeps telling her to push harder. She's been a nurse for a long time and is close to retirement.

She told me that there is another, young nurse on her unit who is unable to pass the mannequin portion of the test as well. She's also it's very slender and short. Apparently the facility is making accommodations for people who aren't strong enough.

I work in the emergency room and it's usually the tech who does compressions. I haven't done them once in my six years there.The strongest, most capable person is the one who does it. Usually the nurse is pushing the meds.

I think this is a time for a common-sense accommodation.

[blondy2061h, MSN, RN]

Emergent said:

A close friend of mine is going through this right now. At my workplace they now require the certification on a mannequin. My friend is 5 feet tall and slight. She told me yesterday that she just can't pass the mannequin portion of the CPR certification. She's not strong enough, the machine keeps telling her to push harder. She's been a nurse for a long time and is close to retirement.

She told me that there is another, young nurse on her unit who is unable to pass the mannequin portion of the test as well. She's also it's very slender and short. Apparently the facility is making accommodations for people who aren't strong enough.

I work in the emergency room and it's usually the tech who does compressions. I haven't done them once in my six years there.The strongest, most capable person is the one who does it. Usually the nurse is pushing the meds.

I think this is a time for a common-sense accommodation.

I'm curious if they would let them try the mannequin portion standing on a stool.

[Flatline, BSN, RN]

Emergent said:

A close friend of mine is going through this right now. At my workplace they now require the certification on a mannequin. My friend is 5 feet tall and slight. She told me yesterday that she just can't pass the mannequin portion of the CPR certification. She's not strong enough, the machine keeps telling her to push harder. She's been a nurse for a long time and is close to retirement.

She told me that there is another, young nurse on her unit who is unable to pass the mannequin portion of the test as well. She's also it's very slender and short. Apparently the facility is making accommodations for people who aren't strong enough.

I work in the emergency room and it's usually the tech who does compressions. I haven't done them once in my six years there.The strongest, most capable person is the one who does it. Usually the nurse is pushing the meds.

I think this is a time for a common-sense accommodation.

This seems strange to me. I have always been taught, and performed, compressions with my body weight instead of my arms.

The idea was not to push with your arms which requires arm strength but to lift your body with your core, lock your arms like a piston, and drop your body weight to compress. Using your arm muscles seems like a great way to get tired.

I've seen kids and women around 100lbs be able to compress easily using their body weight. Many times things like step stools were used to help gain the height needed.

[BklynHeightsRN]

Rose_Queen said:

That is my thought as well. If the job requires CPR certification with the expectation of performing CPR if needed, then this would not be a reasonable accommodation.

I agree. Although the OP is legitimately disabled and restricted, if it is a requirement of her job, the employer should have the right to terminate. It is not discrimination in this case because they have no way to provide reasonable accommodation. It is not guaranteed that there will be another responder to do compressions which we all know comes before bagging in terms of priority.

If I lost my arm in an accident, I would not expect to be able to keep my job. I suggest the OP look into long term disability options - perhaps this is not a permanent limitation but as long as it is a limitation, she should accept that she is putting patients at risk by continuing to work.

[BklynHeightsRN]

If I can offer a personal anecdote, I had an instance a couple of years ago where I had to be hospitalized for a week and out of work for an additional week. After the total of two weeks, I was given written clearance to return to work by my doctor, with the limitation of being required to sit at a desk for the first week. The RNs at my facility rotated assignments daily and one of the assignments was sitting all day, making pre-op phone calls to patients, so I suggested I have this assignment for that first week of being back. My employer decided that if there were an emergency, responding to it is a critical component of my job. Therefore, they made me take another week of unpaid leave as I didn't have anymore PTO. Although this upset me at the time, I now realize it they were fully in the right, and I am just thankful I had a job to go back to.

The OP should also try separating her emotions and what she thinks is fair from what is right, and what the employer can reasonably do. Most employers require EVERYONE to have BLS certification. Mine requires all of us to have ACLS, and when I worked in the ED I needed BLS, ACLS, PALS and TNCC!

[applesxoranges, BSN, RN]

Emergent said:

A close friend of mine is going through this right now. At my workplace they now require the certification on a mannequin. My friend is 5 feet tall and slight. She told me yesterday that she just can't pass the mannequin portion of the CPR certification. She's not strong enough, the machine keeps telling her to push harder. She's been a nurse for a long time and is close to retirement.

I don't think being short has anything to do with it. I am short and I can only pass it if I stand on a stool. I only do compressions on a lower bed or if I have a stool. Unless they are on the ground/cot lower.

[SmilingBluEyes]

I am short too. And I can do compressions just fine. I just put my whole body weight into it. It's all in proper mechanics and procedure.

[BklynHeightsRN]

totally agree - I am also short (5'2") and every clinical area should have a stool for instances such as these... and that's only if the patient is in the bed. It sounds like in the OP's case the patient was on the ground?

[AceOfHearts<3]

BklynHeightsRN said:

totally agree - I am also short (5'2") and every clinical area should have a stool for instances such as these... and that's only if the patient is in the bed. It sounds like in the OP's case the patient was on the ground?

I haven't been through a real code yet, but when practicing one the other week at work I was told to not be afraid of getting on the bed so I did exactly that. I'm only 5'2" as well. I'll be seeing soon how practical it really is to get on the bed soon since I'm switching to ICU, but getting on the bed definitely makes a difference.

[FranEMTnurse, CNA, LPN, EMT-I]

Dear hurting nurse, I believe you are protected. As a former CPR instructor, I would advise you to recertify, but before you do, discuss your situation with the CPR instructor. IMHO, since you assisted with the CPR of the patient, You were legitimately performing CPR. The only case where there might be danger to you is if you were alone with the patient. However, even then you might be able to call for assistance.