ACLS question

MedSurgeMess · Jul 17, 2009

not that I'm aware of. I asked our ICU director as well, she says she doesn't think so.

dyaryan · Jul 17, 2009

Thanks....I had a fellow nurse who jumped in during a situation with my patient. I literally was in the process of preparing her to go BACK to the cath lab. She had just had a stent put into her LAD and obviously based on her R on T rhythm, she was shutting that stent down. The cath lab nurses were even there to transport. This nurse comes out with Lidocaine and pushed it by herself. Earlier in the shift, she had her own patient back from a procedure that was symptomatic and bradycardic...she grabbed atropine and pushed 1mg without a doctor present or an order...in both situations. I just wanted to know if this was "legal." I've pushed those drugs, too. But only during a code. :yeah:

PAERRN20 · Jul 17, 2009

Thanks....I had a fellow nurse who jumped in during a situation with my patient. I literally was in the process of preparing her to go BACK to the cath lab. She had just had a stent put into her LAD and obviously based on her R on T rhythm, she was shutting that stent down. The cath lab nurses were even there to transport. This nurse comes out with Lidocaine and pushed it by herself. Earlier in the shift, she had her own patient back from a procedure that was symptomatic and bradycardic...she grabbed atropine and pushed 1mg without a doctor present or an order...in both situations. I just wanted to know if this was "legal." I've pushed those drugs, too. But only during a code.

No order? Not legal!! Did you report this nurse to your manager? I sure hope so.

ChristyRN2009 · Jul 17, 2009

No, it was not. You always have to have a doctor present or doctors order-even in a code. Being ACLS does not give you the license to practice medicine, so you cannot order meds and give them without that supervision.

FlyingScot, RN · Jul 17, 2009

An ACLS certification does not cover you in any way to push code drugs at any time even during a code. It's your facility's policies that do. The AHA is pretty clear about this. The "certification" is simply a way of showing that you successfully completed the program. They "certify" that you passed the class but this does not authorize you to push the drugs. For example, in my current job even though I am ACLS certified I cannot give emergency meds without a physician present, however, at my previous gig I could run entire codes without a physician because it was part of my job description. Hope this makes sense.

classicdame, MSN, EdD · Jul 17, 2009

no. The certification does not override your scope of practice. The certification is just to train you to anticipate the orders and to react to them.

allnurses Guide · Jul 17, 2009

Just as the others said, ACLS does not qualify you to push drugs in any situation without a doctor's order. Knowing what to expect, get ready for and how to administer them is what ACLS does.

PostOpPrincess, BSN, RN · Jul 17, 2009

This is a tough question to answer.

Legally, NO you are NOT covered by just a certification.

However, if the PRUDENT nurse thought those meds were necessary to be given and gave them and basically saved the patient's life--she/he can get an order written by the doc.

ICU/NICU/SICU/Trauma/ER does this ALL the time--any place where somewhat autonomous, clear headed, and urgent critical decisions are made all the time. You have to be extremely confident in your skills as well as in the doctors you work with. Some expect out of you and will question why it wasn't done when the situation called for it. It is very, very independent THINKING. This comes with time, experience, and a basic understand between medical colleagues. The nurse knows the doc will trust her judgement. THAT is why a new nurse will never do it; and that is why experience truly, truly matters when it comes to life and death.

I hope this answers this very confusing situation.

FlyingScot, RN · Jul 17, 2009

This nurse comes out with Lidocaine and pushed it by herself. Earlier in the shift, she had her own patient back from a procedure that was symptomatic and bradycardic...she grabbed atropine and pushed 1mg without a doctor present or an order...in both situations.

How many time has this nurse "heroically" pushed un-ordered drugs on patients? Sounds kind of fishy to me. Or maybe I've just watched too many crime shows.:uhoh21:

MedSurgeMess · Jul 17, 2009

Like FlyingScot said, I'd make sure your dept director knows about this just in the case of an adverse event. It sounds way to fishy to me too. Someone else jumping in on my patient and pushing any med without me asking for the assist is just a big no-no unless that life was in jeopardy at that second.

I'd also ask this nurse why she did this, in a learning way, so that you understand her reasoning as well. How much experience does this nurse have, and how much do you have? This may be one explanation for the "help". Again, speak to your director about this, and make sure that this administration is documented somewhere, to CYA.

FlyingScot, RN · Jul 17, 2009

Of course I was going with the "whack-job nurse who kills patients to save them" theory not so much the "lack of experience" theory because it's way more trashy!!!!!!