do you have ACLS?

  1. Just wondering how many L&D nurses have ACLS, and does your hospital require it? I do not and only a few of us do....but I'm seriously considering becoming certified, I've only worked in L&D and don't intend to work anywhere else, but we often have critically ill patients and we do our own c-sections and recoveries in the PACU, so TECHNICALLY we're supposed to have acls, but we've been getting around it. We're a busy facility that does lots of high-risk, I'd like to feel more comfortable. What do you think about someone with very little telemetry experience becoming ACLS certified? Thanks all! SHelley
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  2. 14 Comments

  3. by   mark_LD_RN
    I am ACLs certified and think it is a good idea especially if you do your own c/s and deal with high risk patients.
    you don't need telemetry experience to get acls, just find basic course first then go for it. the main thing is to learn the algorhytms
  4. by   OBNurseShelley
    I found a great website, and I realized how much I really did know....it's about ACLS, check it out.....http://www.acls.net/
  5. by   SmilingBluEyes
    There was a thread about this earlier and I will repeat my take on this:

    ACLS is great, so much to learn about heart rhythms and the treatments......many meds and scenarios to know! But let us be realistic: How often do you use the skills in OB to be considered TRULY competent?

    Do you have the algorithms DOWN PAT?

    Will you have time to use your cheat sheet for algorithms you are unfamiliar with?

    Will you RUN THE CODE when your patient goes CODE BLUE status? If so, ARE YOU READY THIS MINUTE TO DO SO w/o HESITATION?

    Do you wish to be held, in a court of law, to a standard you are SUPPOSED TO MEET, but are not really "practiced" in?

    Yes, yes, I know. Most "codes" have respondent "teams" consisting of ICU/ER/Med-Surg nurses, cardiopulmonary, and docs who come running when a Code Blue is called. Your role will likely be relegated to doing ABC's or being "recorder" or something of the sort......

    But remember, being called "ACLS CERTIFIED" holds you to that standard of care when the stuff hits the fan....are you ready for that? I personally feel ACLS should be modified to the scenarios we see in OBSTETRICS and the logarithms we should know be memorized by heart. That is the standard of care we should be held to........

    I worry when I call myself "ACLS-Certified" cause even though I have been thru the training and carry the card, the skill is not used (it just isn't)----- and I don't feel like I would be "competent" using it! Just some food for thought......
  6. by   HazeK
    IF you do c/s on unit and IF you have a PACU...
    you & the staff should, by national standards, all have ACLS Certification.

    Now, will you be held to the same level of accountability as the CCU nurse?No, legally I believe a good expert witness could explain the difference in your proficiency levels in court....the "use it or loose it" phrase!

    REALITY: my 450+/yr unit has had FOUR FULL CODES this year!

    We all MUST be proficent in our ABC's, getting Codes activated, getting equipment to bedside, recording times and filling out code sheets, knowing where items are on the Code Carts, knowing the patient's history so we can give a history to the MD in charge of the Code Team, *REMINDING THE CODE TEAM THAT THERE ARE TWO PATIENTS IN THAT BED*, (ALL pregnant women who 'code' have a better survival rate if the baby is sectioned out...remember the blood bolus from the contracted uterus? So sayeth our sacred Perinatologists), getting unnecessary 'stuff' away from bedside to make room for the Code Team, SETTING UP FOR AN EMERGENCY C/S RIGHT THERE, INCLUDING SETTING UP TO RECEIVE A CRITICALLY STRESSED INFANT, calling NICU to attend c/s, reassuring other patients, getting pastoral care for family, getting security to the unit to control the hallways and keep the 'looky-loos' away, and remembering to care for all the rest of the mothers and fetuses on the unit by helping to cover other staff's patients!

    I'm sorry for being wordy....but I was the charge nurse for several codes.
    Needless to say, our response to the first 'on unit' code was more disorganized than the last. Even running 'mock codes', is a helpful skill!

    Hope you never, ever have to do this.

    Hugs!
    :kiss
  7. by   frazkw
    I am personally working on becoming ACLS certified. My hospital does not make it mandatory, but should since we are high risk and have our own PACU. I think it is a wise investment.
  8. by   RNnL&D
    Yes, I am and yes, my hospital requires it. We have to have it to recover our CS pts in our PACU.

    Yes, it's true that we really never have the opportunity to put our skills to practice, but since we have our recovery pts on telemetry, we have to be able to interpret the strip, and be prepared for the situation when ACLS might become necessary.
    Last edit by RNnL&D on Jul 24, '06
  9. by   mitchsmom
    We have to have it. We are LDRP & we just started using our unit's OR, but for the time being the OR/PACU crew comes to work it & we are just baby nurses. We are supposed to assume the OR duties at some point in the future.
  10. by   mjsobrn
    I have ACLS because not only do we circulate but we recover our own C/S but I will say that I enjoyed the class and even if I did not HAVE to have it I will recert when I need to.
  11. by   tntrn
    WE are now required to have it and I will say that taking that weekend class was one of the few most demeaning experiences of my entire 30 year nursing time. Our hospital did not offer any pre-classes to help us get ready: our unit was only allowed 4 of the books and on the weekend I did mine, there were 10 of us there, so do the math. Most of the class was composed of people who were renewing, so they new the "language" and we didn't and when we would stop the class to ask for yet another explanation of what some acronym meant, we were treated like bozos.

    Mine will expire September 25 and I'll not be subjecting myself to that again: at least not where I currently work. Maybe I'll find another place to take it, but more likely I'll find another place to work.

    Saying I'm ACLS certified means absolutely nothing to me. There's no way I am qualified to do anything more than call the code. And I'm smart enough to know that I'm not qualified (even though I have a piece of paper that says so) to help with drugs. I would be far more trouble than help.

    Now IF and this is a big one, there was a class that certified us for OB, then that would make sense. But this does not. It's just another way for the parent company to brag, but bragging about empty accomplishments is just another way to dupe the public. IMHO, naturally.
  12. by   deehaverrn
    Only a few nurses on my unit have ACLS, and most of those would not be comfortable in a code situation.
    We do have an OR and Pacu, which we staff ourselves. It is for exactly this kind of reason that I feel Cesarian sections should be done in a main OR and PACU with fully qualified staff. The "feel good" years of trying to assure moms and families that it was just an alternative type of birthing experience led to all of our OB units having their own ORs. It is great for docs now with scheduling since we are much more flexible than the main OR. We are definitely NOT as qualified, and I firmly believe that this trend should be reversed. Our pts DESERVE the highest possible standard of care. Its just not gonna happen.
  13. by   jwk
    Quote from HazeK

    REALITY: my 450+/yr unit has had FOUR FULL CODES this year!
    450 deliveries per year and four codes? Almost 1% of your deliveries involve a cardiac arrest? You gotta be kidding!
  14. by   jwk
    The whole idea behind ACLS is not to create experts in resuscitation. It's to familiarize people with the processes and currently accepted therapies. It helps you recognize trends and problems before you get all the way down the road to an arrest. No one is comfortable in a code when you only see one once a year or even less. No on expects L&D nurses to run a code from start to finish, but at least you won't be standing around with your thumb up your *** wondering what to do.

    The standards change. The algorithms and treatments are much more based in solid evidence and science than they were years ago. That's why it's important to stay current. 25 years ago, the first drug we gave was 2 amps of bicarb, which it was assumed was a good thing because all the patients were acidotic. Problem is that is was mainly a respiratory acidosis, at least early on, and patients were ending up with sky-high sodium levels that caused it's own set of problems and mortality. CPR changes as well, again, based on solid evidence and science instead of just assuming something works when it really doesn't.

    If you rotate through the OR and PACU in your unit, you should have ACLS - period. Anything less and you're cutting corners in patient care. Those of you who whine and complain about taking the class? Too bad. Trust me, I've heard it all - it's too hard, the instructor was a jerk, I didn't understand it, I don't have time, blah, blah, blah. Either you want to be able to provide the best possible care to your patients or you don't. If you don't, you're in the wrong profession.

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