acls

[valene]

we currently do walking epidurals in l&d, our director now wants us all to have acls to care for epidurals in l&d (note we do not recover our own c/s)

we all have nrp, many of us have cerification in inpatient ob, and many of us do an extraordinary amount of committee work for our department. we are opposed to this additional certification. do any of you have acls just for the purpose of monitoring your labor pt who has had an epidural placed?

[SmilingBluEyes]

EXACTLY GAIL!! THAT IS WHAT I WAS TRYING TO SAY, but OBVIOUSLY lacked the words!

[anitame]

Valene, sounds like me facility is similar to yours. We are not required to have ACLS and do not circulate or recover our surgeries. The two nurses that cover (24/7!) transport call ARE ACLS certified. Apparently at one time a bunch of our nursres became ACLS certified, someone thought it was a good idea. They never used it and the whole thing kind of fizzled out.

Anita

[valene]

thanks for all your replies. i think it is important to designate what type of ob nursing we do. we do low risk l&d, nursery level I and II, and post-partum. we do not circulate, scrub, or recover c/s. what we do have to be competent in is four areas mentioned above. many of us are certified and all of us are certified in neonatal resusciation. i have found that many of the nurses who do circulate, scrub, and recover c/s's are nurses who work in the labor unit alone. in our ob dept. we must be proficient in all four areas which is a tremendous challenge, switching modes from caring for the laboring patient with pih to caring for the level II infant, often during the same shift. the necessary competencies are too numerous to mention. acls brings to mind the old adage: be careful what you wish for: those OB nurses with acls may be held to the same standard of care as an rn in er who uses this skill frequently. another consideration is the code team that most hospital's have. they are the most qualified to handle adult codes, as we are most qualified to handle neonatal codes. i respectfully disagree with lyla that "more training is better". ob nurses are a special breed, we must focus on perinatal nursing, there are infinite opportunities for more ob training, but when we are forced to learn that which is not pertinent to our practice, we are diluting our knowlege base.

i believe in the case of our institution, our nurses would benefit much more from performing hands-on mock emergency competencies including most importantly, stabalizing the labor patient who has coded while awaiting the code team, caring for the neonate if delivered, pp hemorrhage, stat c/s, pih complications, dic, neonatal pneumothroax, just to name a few.

there exists a great number of opportunities to become a better ob nurse.

i do believe acls is appropriate training for the nurse who recovers c/s.

thanks for your support, smilingblueyes, gail, and anita

valene