Should OR RN's be ACLS/PALS certified?

  1. Ok, remembering that I work PACU my question occurs because out hospital has determined that it is unecessary for the OR nurses to take ACLS etc, except for BLS(basic life support) since there is an anesthesiologist in the room. This is purely a cost cutting matter we believe. Whats up in your neck of the woods? We are a 290 bed acute care facility averaging 15 cases(give or take) a day.
    Thanks,
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  2. 41 Comments

  3. by   suzanne4
    There is an ER Doc in the room during emergencies in the ER, and they still require the nurses there to be certified. ACLS isn't just about intubation. Same with PALS.
    I actually have ACLS, PALS, and NRP. I used to work NICU and still keep it up when working OR as you can get newborns into surgery for an emergent procedure at any time.
  4. by   sharann
    Exactly Suzanne! Just because the nurse doesn't intubate, he/she must still know WHAT is being done to the pt and how to assist or even run the code if there is an unusual occurence (say the anesthesiologist has a MI...)
  5. by   shodobe
    Not required here. I did go through the ACLS and let it expire because no reason to have it. I have been around long enough if my gas passer drops dead I think I know what to do. Mike
  6. by   IamRN
    Quote from shodobe
    Not required here. I did go through the ACLS and let it expire because no reason to have it. I have been around long enough if my gas passer drops dead I think I know what to do. Mike
    So do you still review updated ACLS protocols...that is, w/o bothering to get the certification?
  7. by   shudokan-RN
    Quote from shodobe
    Not required here. I did go through the ACLS and let it expire because no reason to have it. I have been around long enough if my gas passer drops dead I think I know what to do. Mike
    no flames please
    Big syringe, little syringe, little syringe, turn on gas.... read magazine tease circulator...turn off gas...PRAY
    marci
  8. by   lifeisbeautiful
    Yes, I feel all OR Registered Nurses should be ACLS/PALS certified. I am a PACU RN, so I have had plenty of experiences with patients coding in the OR. The alarm rings and the light flashes in the PACU when there is a code. This is our signal to assist in the OR. The problem I have with this is that we are very busy in PACU with our patients and it can be very difficult to drop whatever we may be in the middle of to help. I say this because sometimes out patients are experiencing problems and need a nurse at the bedside. Plus, I can't stand it when I get in the OR and may of the RN's are just standing around because they don't know how to assist me..they need to be able to help if necessary. I feel this certification is an extra safety precaution for patients and staff.
  9. by   shodobe
    lifeisbeautiful, don't take this wrong but it seems to me you have a lot of stupid RNs working back in the OR. None of the nurses I work with would be "standing" around waiting to be rescued by the PACU. Sorry, just sounds dumb. Mike
  10. by   sharann
    Quote from shodobe
    lifeisbeautiful, don't take this wrong but it seems to me you have a lot of stupid RNs working back in the OR. None of the nurses I work with would be "standing" around waiting to be rescued by the PACU. Sorry, just sounds dumb. Mike
    Mike,
    I work with some real doosies in the OR. Thats probably why I asked the original question. These nurses DO stand around and wait to be rescued. They have no clue beyond their "little box of comfort".
    You happen to work with nurses with minds(lucky you!)
  11. by   lifeisbeautiful
    Quote from shodobe
    lifeisbeautiful, don't take this wrong but it seems to me you have a lot of stupid RNs working back in the OR. None of the nurses I work with would be "standing" around waiting to be rescued by the PACU. Sorry, just sounds dumb. Mike
    No Mike, the RNs are not "stupid" as you called them, they are not certified. If the OR Nurses began administering drugs during a code and they are not certified, they are working outside their legal scope of practice! The OR nurses have to "stand around waiting to be rescued by the PACU" because it is the hospitals policy that OR nurses DO NOT have to be ACLS certified. They don't have a choice.Yes it is dumb policy and I hate practically abandoning my patient in PACU to help the OR with the code! I don't know about you, but I certainly wouldn't want an RN pushing drugs into me that isn't certified to do so.
  12. by   sharann
    It's not stupidity that I see as a problem, but lack of motivation. I fault the hospital though for not providing the need to certify(and re-cert). Just having the class doesn't actually "Certify" one, it just helps provide a sense of competence/confidence that one can assist in the BEST and most current way as possible. It doesn't help that every single year the AHA changes a drug or dose or some minor number(so as to sell the new updated books)
  13. by   DNRme
    I know I'm going to here a lot of negatives about this but...

    The more sh** you know, the more sh** you get. I worked at a facility that wanted the OR nurses to get ACLS so they could bill the patient for the sedation instead of anesthesia billing. At the time, they also wanted the same nurse to monitor the patient and circulate. That, to me, is just a disaster waiting to happen. I went from the ICU to the OR (a long time ago). I decided to let my ACLS lapse. We are put in enough difficult situations every day without looking for trouble.

    Anesthesia where I work is great. Together, we can handle any situation we need to.

    In the facility where I work, we rarely have a code in the OR. When we do, we almost never call the code team. They are called "the fleas" for the way they come from nowhere and attack (teaching facility). In the past year, at a trauma center, I have had maybe two codes. I'm not attacking, but your post sounded like this was not a rare occurance where you are working. Maybe the problem is bigger than the OR nurses not having ACLS cert.
  14. by   shodobe
    Mostly I meant that to stand around and do nothing implies one has no clue on what to do during a code. I am lucky in that the RNs I work with do know what to do and we do have a great anesthesia team. I do what I am told to do and do not go beyond that. We do have to call a house code because it is policy. Most of the time the code team comes and usually leaves right away. I do agree the more you know the more your going to be responsible for. This is why I let my ACLS expire. I have no reason to have it. IF I had to use my knowledge on a pediatric patient, then something is wrong in my book. Where is your anesthesiologist or the surgeon? It is their responsibility to direct any problem that occurs with the patient. On the other hand, patients that are in PACU, be it adults or peds, don't always have the luxury of anesthesia's presence or the surgeons. This is why these certs are essential in the PACU and not for the OR. I also agree that the mandatory requirement of these certs for OR personel is just another way for the hospital to save money and "kiss up" to the surgeons. The scenario being, the patient hasn't been NPO long enough and the surgeon doesn't want to wait, nurse manager say "that's OK I'll just have my nurses give a little sedation". I don't mind giving sedation for adults but WILL NOT do it for anyone under the age of 18, no exceptions! I always have an anesthesiologist in house so there is my back-up. I have also found out that smaller rural hospitals make it mandatory for their OR staff to be ACLS cert, Why? Because they not only make the staff do the procedure they also make them recover the same patient. This is an economical reason, they are to "cheap" to hire real PACU nurses. If there are two cases, the second one has to wait until the first patient is recovered and sent to their room. Poor use of time. I don't think it is a dumb policy to not have the OR nurses certified. I have have been doing this for 27 years and have found not one time where I actually needed any ACLS knowledge. Why, because as I said before I always have had a proven MD in the room for ALL codes I have been involved in. Sorry to rant, I think I put more than my 2 cents worth in. Mike

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