ACLS

[Dixiecup]

I work for a FQRC (fed rural clinic). We recently had to do ACLS training. It was very stressful but I got through it! I just don't see why we need to be ACLS certified working in the clinic setting. I can tell you I will not be doing a code in the clinic. CPR and wait for EMS is a far as i'll go! Now they are telling us we are also going to have to be PALS certified!

[VivaRN]

I don't get that. I work in a clinic and it's not like we're going to intubate or start pushing meds. We have BLS and that covers it.

What is their rationale? It's probably expensive for them to pay for all that.

[carachel2]

We aren't required to be ACLS but after years of having to be certified as an RN I gotta say it is very helpful. I haven't had to use any of the interventions, but just the critical thinking process and the EKG training is helpful.

[nurse2033, MSN, RN]

Geez I would't want to be seriously ill in your clinic. ACLS is to save someone's life. What is the response time of your EMS? And do they have ALS? Rapid intervention can prevent a near code. How will you not do a code at your clinic? Do you mean that you personnaly won't code someone? Or that people don't code there? Do you expect the MD to just bark out a bunch of orders? The idea behind ACLS is to create a team approach and knowledge base so that everyone on the team knows what to expect. There is too much to do for one person to explain everything to everyone. Nurses must know which drugs do what, their dose, and how to recognize lethal rhythms. Wouldn't you hate to stand by and watch someone die because you didn't know what to do?

[linearthinker, DNP, RN]

I don't know why a workplace would care, but no way am I paying $175 to recert, when I can be paid $200 to attend the class offered in the system! I yawn all the through it and silently count how much I've earned sitting there, lol. It's easy and nothing to be afraid of.

[Spacklehead, MSN, NP]

Do you give vaccinations at this clinic? If so, how well equipped are you to treat an anaphylactic reaction? I, personally, would prefer a clinic to have staff trained in ACLS/PALS if they are giving vaccinations - especially to infants/children who may have never had a specific vax before. I would also prefer for said clinic to have a pediatric crash cart on site. I know my ped's office does, and so did the peds clinic where I did my pediatric clinical rotation. It is always a great idea to have staff knowledgeable in the meds/equipment they might need to use in case of an emergency.

[Dixiecup]

I guess I should have clarified a little more.

I work in a rural clinic. Me and the nurse. That is the extent of the staff there. No physician and no other help. So there would be no "team". So under the circumstances, yes, CPR and EMS is the treatment they will receive.

I do have a crash "suitcase" but as I stated, there isn't any staff to help. If my nurse could get an IV in while I was doing CPR I might consider pushing some epi but that would probably be it.

[Spacklehead, MSN, NP]

Is there no cardiac monitor/defibrillator on-site? In the rural ED where I used to work, it was sometimes just myself and the physician when we had codes - you could still carry out ACLS/PALS protocols with just two people.

If I were to be administering epi to a patient - no matter where I was - I would still think it would be prudent to have ACLS/PALS certification on board.

Just my 2 cents.

[AbeFrohman, BSN, RN]

ACLS is easy. Unless they are requiring you to have it and not paying for it then I don't see a problem.

[MacD]

If 2 paramedics can run a code, why cn't you an an acls trained nurse run a code.. The odds for patient survival increase with early defibrillation. Rather than just CPR

[traumaRUs, MSN, APRN]

Do you have an AED in your clinic? That's a must wherever you cohort pts.

[ImThatGuy, BSN, RN]

I guess I should have clarified a little more.

I work in a rural clinic. Me and the nurse. That is the extent of the staff there. No physician and no other help. So there would be no "team". So under the circumstances, yes, CPR and EMS is the treatment they will receive.

I do have a crash "suitcase" but as I stated, there isn't any staff to help. If my nurse could get an IV in while I was doing CPR I might consider pushing some epi but that would probably be it.

Paramedics do the work of an entire code team (chest compressions, intubation/ventilation, IV access, pushing meds, interpreting ECGs, documenting, shocking, etc) all by themselves, and this is done in the back of a moving vehicle. You, as an advanced practitioner, can't at least do some of it, along with your trained and experienced nurse, to save your patient's life?

And like Trauma said above me. You need an AED if you at least don't have a full monitor/defibrillator. Your ACLS exposure may have introduced you to the need for early defibrillation. It's a rural area so EMS response time is likely a long wait. Many people seek care of their "doctor" when they feel ill so there's a large chance of someone coding in your clinic. I guess early defib. doesn't matter to you though.

Forgive me if I come across as a bit obtuse. It just irks me how some clinicians seem to be so leary of medical emergencies and anti-ACLS. It's not for everyone though.