Insulted by DNS

[tokmom, BSN, RN]

deleted

[HM2VikingRN, RN]

The bean counter lost sight of the value of your acquiring enhanced skills that may help prevent the need for a code

[JulieCVICURN, BSN, RN]

In my hospital, the nurses from my unit run the codes until the ER doc comes and takes over. However, sometimes the ER doc just stands by and only interjects if he's not happy with what we're doing, which is not common. My unit is a CVICU. The MICU runs the RRT's.

Having said that, I still think that it's valuable for you to know ACLS and the DNS was a jerk for belittling you in that way.

[CathyLew]

brain-fart....what is a DNS?

and ACLS will just make you a more valuable nurse. Period.

[llg, PhD, RN]

I read the whole situation a little differently ...

The main problem here is that your hospital should have a written policy that states who requires ACLS and who doesn't. The policy should also spell out who gets their ACLS certification paid by the hospital and who doesn't.

At the children's hospital where I work, only nurses in certain units get free PALS (the peds equivalent to ACLS). The nurses on other units (e.g. general med-surg units) get the PEARS course -- which gives them more than BCLS, but not as intensive a course as PALS. The hospital teaches the courses on site and people are scheduled to go as needed as part as their paid work time. So there is no reimbursment required for anyone.

We have a written educational plan for the whole hospital that states who gets what type of education -- from nursing assistants to housekeeping to security to secretaries to attending physicians, etc. The hospital has an education department to provide the classes and people as scheduled to go those classes as needed. If people want additional education, they are often allowed to go if it is reasonable and if there is room in the class.

That's the root of the problem. The DNS doesn't have a clear sense of who needs what course -- and the hospital hasn't developed a clear system for providing the needed education.

[Rabid Response]

Congratulations on getting your ACLS certification. I admire you for going beyond what is merely required of you and working to become a stronger nurse. Your DNS's reasoning is ridiculous and wrong. I work in an ICU, and a good number of my patients transfer from the med-surg floors. These patients don't become critical care patients just at the moment they enter the ICU; they are critical on the floors, and it is the med-surg nurses who must recognize this and be the first to act. At the very least you should be reimbursed for that class, and that DNS should be grateful to have a nurse like you working for her. Don't let her ignorance and short-sighted thinking diminish your accomplishment.

[PMFB-RN, RN]

I work in a large hospital SICU. We recover open heart surgery patients all the time. Nurses run all of our codes initialy. Eventualy one of the ER docs will get there. Sometimes they take over, sometimes they just stand by and offer advice and suggestions.

[caliotter3]

I read the whole situation a little differently ...

The main problem here is that your hospital should have a written policy that states who requires ACLS and who doesn't. The policy should also spell out who gets their ACLS certification paid by the hospital and who doesn't.

At the children's hospital where I work, only nurses in certain units get free PALS (the peds equivalent to ACLS). The nurses on other units (e.g. general med-surg units) get the PEARS course -- which gives them more than BCLS, but not as intensive a course as PALS. The hospital teaches the courses on site and people are scheduled to go as needed as part as their paid work time. So there is no reimbursment required for anyone.

We have a written educational plan for the whole hospital that states who gets what type of education -- from nursing assistants to housekeeping to security to secretaries to attending physicians, etc. The hospital has an education department to provide the classes and people as scheduled to go those classes as needed. If people want additional education, they are often allowed to go if it is reasonable and if there is room in the class.

That's the root of the problem. The DNS doesn't have a clear sense of who needs what course -- and the hospital hasn't developed a clear system for providing the needed education.

You complied with the instructions given to you upon hire, now it was time for the employer to honor their promise. If they want to deny payment to employees, then it is up to them to change the policy, in writing, and act accordingly. And if she couldn't see the benefit to you and the facility for you to have that training, then she is too dense for her position.

[tokmom, BSN, RN]

Thanks, everyone. My interim manager approached me at work yesterday, and told me that the DNS was wrong and med/surg should be trained. She opened up a huge can of worms over this by emailing HR, DNS (director of Nursing Services, for someone that asked) to get this clarified. The DNS will not be happy with her being second guessed, but she doesn't know a thing about a Med/Surg tele floor.

[tokmom, BSN, RN]

I wanted to add, that now I do know that some nursing units run the code. Not at this place. Way too many Alpha Dr's wanting to run them here.