I have been a nurse for going in 11 year and have worked with adults in SICU and ER. I now work in a well known Pedi CVICU who care for quite a few adult patients that have had previous congenital heart surgeries that come back for things like valve replacements or just revisions. I let my ACLS lapse because they wouldn't pay for it or even agree to give me time off to take it. I has been times when a 40-50 years old goes into a funky rhythm or codes and the damn dr does know the dose for vasopressin or that the rhythm is A-flutter and they are about to push adenosine. This really worries me; I know he algorithm but the others don't and the Drs don have ACLS. We take their money to care for them but we aren't certified to care for them as the adults they are. I tried to find research on this but was unable to to try and make a change before we have a sentinel event; as our unit usually does things in reaction. Any advise/comments?