Do you know how to do CPR well?

Home Health Columnist / Guide · Aug 29, 2006

Remember Mom or Dad saying "Practice makes perfect"...same with CPR.

More courses one takes or chances one gets to use skill working in hospital setting vs out patient area, better one gets at CPR. There are few "perfect" codes outside critical care units + hospital setting. HOWEVER, many lives HAVE been saved due to prompt recognition of heart attack and CPR started by lay persons.

When in nursing school, our instructors used to take an individual student to witness a code so we could get an idea what went on/roles etc. Teaching friendly places often had student participate in chest compressions or bagging patient.

With new grads during orientation, we tried to get them to attend code on our or neighboring unit: observer, recorder then participant role. Checking crash cart afterwards allowed one to get to actually SEE where equipment stored with advent of locked carts. Working in a teaching facility, educators developed "post code wrap-up" where change nurse/resident discussed what went right, problems encountered and areas of improvement needed ---everyone on team thanked for their participation. In home health past 10 year, staff are provided CPR training and rarely get to use that skill: we mostly call 911 for transport prior to point of CPR. Those agencies handeling vent patients have higher chance of using skill.

American Heart Association and American Red Cross are the organizations who provide training and where instructors obtain cards. If someone NOT providing proper training, please report them to group listed on card.

There are scammers in every part of our lives....part of our professional obligations to report substandard care and training...just not talk about it.

RunnerRN, BSN, RN · Aug 29, 2006

Ditto to the above poster - you have to DO CPR to be good at it (and that doesn't mean doing it on the mannequins). My first experience w CPR was on a guy who crumped during dialysis...I was on a ride-a-long w paramedics, and the code had been handled poorly before we arrived (imagine ept and atropine being "pushed" into a running line without clamping above, etc etc). I always saw these big firefighters and medics doing CPR one handed, so I thought I could do that too once I started to get tired. My poor medic friend I was riding with had to redirect me. Unfortunately, the pt died....was dead before we even pulled up.

The whole point of the above story is that the first time you do CPR on someone, it is a scary thing. Just remember to go for the chest and go hard. I'd rather break a few ribs than not perfuse the brain. It is just like everything else in nursing-you won't be good at it until you try it.

TazziRN, RN · Aug 29, 2006

When I took my first 8 hour CPR class, I was confused and a little overwhelmed- and very unsure if I was ready to use my new skills on a real person. Of course, we have chosen this profession because we are the type of people who help when we can- so I'm sure I would have at the opportunity. During recertification, I remembered my first class, and I was confident.
So my reply to the poster is- when the time comes, you will do just fine.
You know, it would be nice if the Red Cross would make available their training tapes free of charge. I wonder if they do.

Health professionals are taught AHA guidelines, not Red Cross. RC only teaches bystander for non-professionals.

Medic/Nurse, BSN, RN · Aug 29, 2006

Yes.

To clear up some common "misconceptions"

NO ONE - AHA, ARC conducts "certification" - they conduct courses that meet a prescribed standard (their own, well researched, etc). You do not get certified in BLS, ACLS, PALS - you get a COURSE COMPLETION CARD. I may be a, Licensed Registered Nurse or Board Certified Emergency Nurse or a Nationally Registered Paramedic, but I am not "certified" to do CPR. I took and met the standards for COURSE COMPLETION. "License" and "Certification" are typically reserved for professions operating under some type of authority.

NEXT, Healthcare facilities can use any organizations "standard" that they want. Whammo! There it is - now does it count? Depends on what counts? I think there is an obvious answer, but... What may count to the facility is the "card". But, rest assured if someone they love were to need your knowledge of CPR - you better bet, they'd want to at least be able to call 911, err... activate the emergency response system (Just Kidding )

Now, that being said - many states LEGAL licensing/certifying agencies/boards only recognize certain (usually AHA, ARC) providers courses. The other "spot" this get muddled is if the JOINT COMMISSION is involved. But, keep in mind the JCAHCO only holds you, generally, to your own policies.

ALSO A NOTE - The AHA and ARC, to my knowledge, do not POLICE the CPR industry. If one completed one of "their" courses in some questionable manner. Yep, they will want to know. The "handing" out of "COMPLETION CARDS" is not an acceptable activity. FYI - there was a big "legal" fight some years ago about the "certification" aspect of these entities. The word CERTIFICATION has been eliminated over recent years - but, for those of you OLD enough to remember - you would be correct in noting the language used to be different.

To the OP: CPR is important. The ability to good CPR is important (important for every level of provider). It is a psycho-motor skill - the base knowledge of the info with the ability to do correct motor skills. Luckily, in most all settings - help is coming. Good CPR (along with early defib) is an key piece of the resuscitation puzzle (the best ACLS in the world does little without a good start). Oh yeah, I'd watch about the "mickey mouse certification" references - there are some sensitive types out there. I took your comment to refer that "nobody FAILS", and on that account you'd be correct.

TazziRN, RN · Aug 29, 2006

Okay, let me rephrase.....hospitals in this section of CA require AHA-issued cards. And as long as my card says that it certifies, I consider it a cert.

gonzo1, ASN, RN · Aug 29, 2006

Eric, my ER serves all ages. And above posters are right of course that most cracked ribs occur on the elderly.

This thread brings up many good points and hopefullly a lot of people will see it.

P_RN, ADN, RN · Aug 29, 2006

I took my last course about a month before I retired. It was a total of about 10 minutes.

For 30+ years it had been an 8h course with written tests, ratios, breaths, compressions, strips etc etc etc.

" Annie Annie are you all right? "

That last year for some reason they "taught" what they called heartsaver. They propped the dummy on the edge of the stage in the auditorium, and we had to show where to place our hands and do 5 compressions. That was it.

I was working in a university medical center, with its own heart hospital.....so they thought duh? BUT I lived an hour away and chances I'd need a little more knowledge at home...at the grocery store etc.

Wondered what the world was coming to. I guess out here in the boonies Annie won't BE all right.

rjflyn, ASN, RN · Aug 29, 2006

I was wondering..I graduated in May of this year..How important is to know CPR? I know some patients might stop breathing and the nurse has to do CPR on the patient right? I never done CPR on a live patient before..Was wondering do you have to know CPR very well in order to work? I know you have to have CPR certification but many of those places that certity people are just micky mouse type of certifications..

Well we generally dont do CPR on live patients. Yeah in some instances we do but for the most part technically they are dead.

As far as nurses skill at doing CPR no offense but in general if you are not working an area where you do it often we/you are not so good at it. I a few years back as part of the hospitals program where as i was afforded the opportunity to become and maintain my CPR instructor designation I had to do one monthly reverifiction for hospital staff a year. Sadly most nurses unless they worked ER or the ICU- thats all this small hopsital had for critical care didnt do very well. I would have to basically take them by the hand walk them through it once or twice and then let them attempt to check off.

vampiregirl, BSN, RN · Aug 30, 2006

Health professionals are taught AHA guidelines, not Red Cross. RC only teaches bystander for non-professionals.

Actually, the Red Cross does offer a course geared toward health professionals, "CPR/AED for the Professional Rescuer". It covers the same skills as AHA's "BLS for Healthcare Providers". Both the AHA and Red Cross's current CPR classes are based on the ECC 2005 standards.

PANurseRN1 · Aug 30, 2006

I was wondering..I graduated in May of this year..How important is to know CPR? I know some patients might stop breathing and the nurse has to do CPR on the patient right? I never done CPR on a live patient before..Was wondering do you have to know CPR very well in order to work? I know you have to have CPR certification but many of those places that certity people are just micky mouse type of certifications..

I cannot believe that someone who graduated from a nursing program could ask a question like this.

CMarie,RN · Aug 30, 2006

Yea, I dont think ratting out places is good thou..I know a lot of places that are mickey mouse..It is just that they have a lot of people in the class..Maybe it is two instructors with 25 people..The ratio is bad..People get certified regardless..

I am shocked - my husband (a Lieutenant/Paramedic/Firefighter) teaches First Aid/CPR to Daycare centers when he is not at the fire station. His class (approved by the State of Florida Dept. of Children and Families) is an abbreviated version (specific to Day Care Center environments) and still takes 4 hours to complete (he typically teaches by himself with a class of 10-15). EVERYONE in the class is personally tested on CPR manuevers/technique and he will not give certification until the Day Care Worker can return demonstration with rationale (I have been to many of his classes just to observe - I thought I wanted to be a BLS instructor while in nsg school but it is a very heavy responsibility that I realized I was not ready for). So I find it very hard to believe that anybody could legitimately use the excuse of . . . too many students . . . in the class to justify making a quick buck at the expense of safety and integrity . . . there is no excuse for that. If those instructors cannot properly teach CPR - but pass out certifications like they are candy, then they SHOULD be reported.

Please find yourself a reputable American Heart Association BLS Class to attend - usually community colleges will offer classes on a regular basis.

RGN1 · Aug 30, 2006

I spent 9 years nursing and faithfully attended my regultion 3 hour CPR class every year. I too wondered if it would ever actually be any use because I had never "done it for real".

Well a few months ago it actually happened to me. A patient fully out & out coded in in my ward.

I tell this story because I want you nurses who don't work in ICU or ER that YOU CAN DO IT!!!!

We did exactly what we had been taught, even used the automated de-fib as we shouold have (only got it on the ward 2 weeks prior to this incident). None of us had ever seen a real code before but we did it and we did it correctly & we had her back just as the crash team came racing round the corner.

They were miffed that we'd beaten them to it! :lol2:

So please, go to your class, do the best you can to get it right and to remember what you have learned because you may be the one who makes the difference at work or on the street. You never know.

So don't belittle that training and don't think you can't do it properly just because you don't get to do it for real on a regular basis. I'm living proof that that this training matters!!