Our telemetry and med/surg census has been low lately and so we frequently combine the two units to conserve on one CNA/ChargeRN/unit secretary. There is one particular nursing supervisor that would staff med/surg (non ACLS) Charge nurse as our Telemetry charge nurse. I find this practice unusual and was wondering if there is specific policy at other hospitals that would prohibit this pratice (I couldn't find a specific policy that says otherwise). I understand when they have to be floated to Telemetry from med/surg they have to be "covered' by the Charge Nurse for anything above the med/surg pratice (i.e. signed off telemetry, cardiac drugs). If there is a code on the floor- I would be the ACLS team leader untill the ICU charge Nurse arrive or another telemetry nurse because the charge nurse is not ACLS... i find that rediculous and an unsafe practice- He or she is not even qualified to read telemetry or break the telemetry techs.
Jul 29, '12
Are there not enough telemetry nurses to serve as charge nurse? Where I work, we've been short-staffed with PCU nurses lately...so we'll get 2-3 RNs floated to us from med-surg. We never put an MSU nurse in charge...it is always one of the PCU RNs. My hospital also does not have a specific charge nurse position except for on day shift, but only until 3pm and then another PCU nurse will serve as charge nurse until night shift arrives. Night shift charge is determined once we arrive.
As for ACLS, I find that the charge nurse never runs a code...by the time you start compressions, get the crash cart and hook it up to the patient, the rest of the code team has arrived. Sometimes the ER physician takes some time arriving to the code, but our nursing supervisor will begin to run the code via ACLS protocol until a physician arrives.
Jul 29, '12
I don't know policies or legalities. Different units and areas of hospitals have their own requirements.
The more I recert for ACLS, and from my memory of codes (it fortunately has been a while).....I know the basics of CPR are equal to, if not more important, than all the shocks and drugs of ACLS.
Is this charge nurse competent as a basic floor nurse? Is she good at making assignments? Is she helpful when the unit gets busy? I would value these, and a knowledge of the basics of CPR, above ACLS.
She can keep the log during the code, or assist in other ways outside of defibrillating or pushing drugs.
Why does it bother you?
Aug 1, '12
I am a director of a Progressive Care/Telemetry Unit. The basic rule is that the Charge RN needs to be Telemetry, acls competent. The saftey of the pateits can depend upon this as the Charge may need to intervein in the care of a monitored pateint especially in a cardiac event. Having ACLS is extremely important as codes often require quick interventions. Most hospitals have rapid responce teams, but if there is a delay in them getting to the patient there needs to be a comptent ACLS nurse in charge to initiate Shock or IV push of emergency medications. Only a ACLS nurse is covered leagaly to inticate ACLS protocol in the event of a physicin not being present.
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