Why does everyone need to be ACLS cert?

Nurses General Nursing

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There has been a push at hospitals in my area for ALL nurses to be ACLS certified. There are repercussions for those who choose not to do the training. Fewer hours, more w/e, and generally not treated as well. I can understand the PEDs floor, ICU, ER, Cath lab..... but just plain old med surg, I don't understand. There is a code team, so it's not like there aren't enough RNs to respond. Is this a trend everywhere?

Specializes in Hospice, ONC, Tele, Med Surg, Endo/Output.
Wow, you sound a bit burned out and a little cynical. First, I am bothered by the fact that twice in your posts you have referred to the "drug seekers". I have no idea what field of nursing your are in but be careful about generalizing- it leads to inept pain control of those non-drug-seekers. (Even though I believe everyone has the right to pain control. But that is a whole other can of worms.)

Second, are you in a hospital? Every unit is more than just babysitting or pill pushing. Patients conditions change and need constant monitoring. Critical thinking skills are a must in every unit of the hospital.

Sorry for sounding so cynical but "drug-seekers" have caused me lots of problems in my career with nursing management. Once one of them stole a pca from the nurses station and took all of her demerol at once, and of course, the nurses were in trouble for it and pt was wide awake and laughing about it. In my family as well the alcoholics and drug users got the most attention and were enabled while those that worked hard got none. This has been the same for me in nursing. It seems some patients, mainly those who want narcotics, have the ability to frighten and manipulate staff into making sure the prn meds are given atc by the nurse because they call every half hour. The busier i get the more they seem to want and they don't care that i have other patients. I keep being nice and saying "i've called the doctor and asked to get your meds increased or changed but the doctor is not doing that yet, maybe when doctor visits the issue will be readressed." Invariably they ask for the manager who clearly sees which meds were given, but i have still been written up because patient wanted to speak with management. One of the patients even got me fired because he kept calling for meds, his vitals were fine, heart monitor fine, no fever, spent all day laughing on his cell phone, and when manager went to check to see if patients were happy with care--yes i actually heard her ask him "are there any nurses who have not been attentive?" I was fired at the end of the shift due to this patient.

Specializes in Community Health.

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Specializes in Hospice, ONC, Tele, Med Surg, Endo/Output.
A babysitter and a pill-pusher? If you don't respect yourself and your profession how can you expect respect in return?

It kills me that someone with your attitude has a job and I can't even get an interview :down:

I've had 3 interviews for 3 different positions--all last week and have 3 job offers as a result. All pay over 35 dollars/hourly. And the registries have been begging. My phone has been ringing off the hook today. And i still have time to read "fascinating" knee-jerk posts such as yours. Let me know when you get an interview,now. Check your attitude and your experience--you've been a nurse less than a year? This country would sooner give the position to a foreign nurse who has more experience than to you, though i do not condone that either. Try nursing for 15 years then i might take you seriously. Sounds like you'd be perfect for management, btw.

Specializes in Med/Surg, LTAC, Critical Care.

I didn't take the time to read all 4 pages of replies so far so someone else may have already said this....

The OP mentioned med-surg nurses relying on the Code Team. Well....it takes time for them to get there...who gets the crash cart set up, who starts compressions, who bags, who starts IV access before they get there? Or do you think you should just stand there twiddlin your thumbs? During the code, is the nurse gonna stand there because they don't know what is going on or are they going to be knowledgeable about all aspects of the patient care (as they should) and say "Ok better get an IV pump for that bolus we're gonna need", or "mmhhmm....BP sucks...what they gonna do?".

As a nurse YOU are responsible for knowing everything about your patient. If a patient is on telemetry and that nurse doesn't know how to read a rhythm then what kind of slack program did they graduate from? The telemetry tech can be wrong.

I'm only a LVN. December will be 2 years since I graduated. I was a CNA for 3 yrs before that (I'm currently working on my RN). I've worked ICU, PCU, ED, med-surg, telemetry....I've seen (and participated in) more codes than I care to remember. Even on the med-surg floors, the nurses don't just stand there and say "oh no...my patient don't look too good". Nursing school teaches us critical thinking and assessment skills for a reason. Time is life. In our codes we have usually started an extra big bore IV site, got the crash cart hooked up, started CPR, and got the drugs ready before the ICU nurses, RTs, ED doc, and House Sup even get there.

On a side note, after briefly glancing at some of the comments, it seems that some nurses actually have to pay for ACLS? That's weird. My hospital gives us that weekend off if we are scheduled to work and they even give us "seminar pay" for it.

Specializes in Community Health.
I've had 3 interviews for 3 different positions--all last week and have 3 job offers as a result. All pay over 35 dollars/hourly. And the registries have been begging. My phone has been ringing off the hook today. And i still have time to read "fascinating" knee-jerk posts such as yours. Let me know when you get an interview,now. Check your attitude and your experience--you've been a nurse less than a year? This country would sooner give the position to a foreign nurse who has more experience than to you, though i do not condone that either. Try nursing for 15 years then i might take you seriously. Sounds like you'd be perfect for management, btw.
Well, I went back and retracted the post because I felt like maybe I was being too harsh but it appears my original opinion of you was correct. Congratulations on your job offers, $35 an hour to be, as you put it, a pill-pushing baby sitter sounds like a pretty sweet deal.
Specializes in Community Health.

On a side note, after briefly glancing at some of the comments, it seems that some nurses actually have to pay for ACLS? That's weird. My hospital gives us that weekend off if we are scheduled to work and they even give us "seminar pay" for it.

I don't know about others but I paid for ACLS and PALS out of pocket because I wanted to take it and figured it would look good on my resume...I think most hospitals do pay for it for their employees.

Specializes in floor to ICU.
Sorry for sounding so cynical but "drug-seekers" have caused me lots of problems in my career with nursing management. Once one of them stole a pca from the nurses station and took all of her demerol at once, and of course, the nurses were in trouble for it and pt was wide awake and laughing about it. In my family as well the alcoholics and drug users got the most attention and were enabled while those that worked hard got none. This has been the same for me in nursing. It seems some patients, mainly those who want narcotics, have the ability to frighten and manipulate staff into making sure the prn meds are given atc by the nurse because they call every half hour. The busier i get the more they seem to want and they don't care that i have other patients. I keep being nice and saying "i've called the doctor and asked to get your meds increased or changed but the doctor is not doing that yet, maybe when doctor visits the issue will be readressed." Invariably they ask for the manager who clearly sees which meds were given, but i have still been written up because patient wanted to speak with management. One of the patients even got me fired because he kept calling for meds, his vitals were fine, heart monitor fine, no fever, spent all day laughing on his cell phone, and when manager went to check to see if patients were happy with care--yes i actually heard her ask him "are there any nurses who have not been attentive?" I was fired at the end of the shift due to this patient.

Sorry to hijack the thread!

I guess I can see why these patients are a thorn in your side. We have all had (and always will) be required to care for those whose narcotic needs are, let's say, never up to their standard. However, please, please do not forget that each patient is an individual and requires an individual assessment. There are many legit patients out there that have chronic pain that require larger loses of meds. Tolerance of a med is an expected side effect of long term use. I cannot stand to hear in report "they are watching the clock and asking for their pain meds right on the dot!" To me, this only perpetuates the "drug seeking" attitude that then carries over from shift to shift. My response to that is, "Really? Wow, they must really be in pain then." Also, patients perceptions of pain differ. Try not to project your past experiences onto other patients- no matter how similar they seem.

I know there are patients out there that try and push the limits and maybe they really aren't in pain. They are constantly calling the nurse saying their pain is 10 out of 10 while chatting on the phone and eating a cheeseburger. I know. We have all had patients like that but it not our place to judge. If it's time, give the med. If they are calling for it two hrs early, call the doc and let him/her know. If the doc says no more, then you have been a good patient advocate and done your job. Update the patient and set boundaries. Maybe writing on the dry eraser board when the next pain med can be given. I know they are challenging to care for.

As far as the patient that got you fired: Were there pain meds ordered and not given?

Specializes in ER.

enchantmentless

I have a reputation as a cynical burnout, but you are honing in on my territory. Back off! this is my stroll.

Er, I mean troll.

Stupid patients, by the time they get to the hospital they don't do ANYTHING for themselves. The whining, pooping, and puking can get to you after 12 hours. And don't get me started on families. If they wanted 10 warm blankets and fresh icewater they should have stayed home and hired a maid. The hospital is for medicines and procedures- and not when you want them either. Those are for my amusement, and to shut people up when they get too rowdy. Pain honey, I'll show you pain...can't breathe? well you're talking ain't ya?

I'm going back to work tomorrow and I just can't wait. Maybe I'll sign in to the ER tonight and agitate the waiting room. Get all the bad karma out of the place before MY shift starts. Wonder if the customer service specials are valid for employees too?

Specializes in Hospice, ONC, Tele, Med Surg, Endo/Output.
Well, I went back and retracted the post because I felt like maybe I was being too harsh but it appears my original opinion of you was correct. Congratulations on your job offers, $35 an hour to be, as you put it, a pill-pushing baby sitter sounds like a pretty sweet deal.

Nope, you still have it wrong--am no longer in acute setting and haven't given pills in awhile. I'm actually in advocacy for patients and doing hospice and home health. Quite busy and very happy. Also getting ready to do nurse advocacy for nurses such as yourself. I'm sure glad to not be as hard on you as you have been to me. Good luck w/ your job search.

Specializes in acute care med/surg, LTC, orthopedics.
Nope, you still have it wrong--am no longer in acute setting and haven't given pills in awhile. I'm actually in advocacy for patients and doing hospice and home health. Quite busy and very happy. Also getting ready to do nurse advocacy for nurses such as yourself. I'm sure glad to not be as hard on you as you have been to me. Good luck w/ your job search.

You couldn't advocate for your hospital patients but can do so for hospice and home health patients?

I'm confused.

:uhoh21:

Specializes in Hospice, ONC, Tele, Med Surg, Endo/Output.
Sorry to hijack the thread!

I guess I can see why these patients are a thorn in your side. We have all had (and always will) be required to care for those whose narcotic needs are, let's say, never up to their standard. However, please, please do not forget that each patient is an individual and requires an individual assessment. There are many legit patients out there that have chronic pain that require larger loses of meds. Tolerance of a med is an expected side effect of long term use. I cannot stand to hear in report "they are watching the clock and asking for their pain meds right on the dot!" To me, this only perpetuates the "drug seeking" attitude that then carries over from shift to shift. My response to that is, "Really? Wow, they must really be in pain then." Also, patients perceptions of pain differ. Try not to project your past experiences onto other patients- no matter how similar they seem.

I know there are patients out there that try and push the limits and maybe they really aren't in pain. They are constantly calling the nurse saying their pain is 10 out of 10 while chatting on the phone and eating a cheeseburger. I know. We have all had patients like that but it not our place to judge. If it's time, give the med. If they are calling for it two hrs early, call the doc and let him/her know. If the doc says no more, then you have been a good patient advocate and done your job. Update the patient and set boundaries. Maybe writing on the dry eraser board when the next pain med can be given. I know they are challenging to care for.

As far as the patient that got you fired: Were there pain meds ordered and not given?

You have made some great points. The person you described "eating cheeseburger", etc... are the very ones who get me into trouble. They don't want you to figure out they are crying wolf just to get high. They grow a brain when management is around and will lie about you to manipulate the system. These types are the ones i can't stand. I have known plenty of heroin addicts and alcoholics who were quite pleasant to care for. But when a rude patient says give the iv fast so i can get a buzz, why are you so slow, when i tell them why we give it slow they roll their eyes. Pt who got me the ax: Pt had received dilaudid q 4 hours x 2-- it was ordered prn q 4 hrs. He would ask for it q 30 mins and laugh every time i turned off his call light. He was also on ativan q 4hrs prn and got that twice but wanted it q 2 hrs. He was on norco q 4 hrs atc and got that as ordered. He was very upset the physician would not let him have a pca or dilaudid q hr. Pt had been admitted for foreign body in rectum and member, and had debridement/i&d, had hx of repeat foreign bodies and i & ds, had hx of depression, anxiety, bipolar, and as MD put it in the h & p had multiple admissions and drug- seeking behaviors. Pt's room also had dry erase board with my hospital phone, name, title, etc... Management was alerted early on that pt was causing lots of distress but assignment not changed and other nurses did not want him--travelers always get the pt's other nurses don't want and the traveler is the first to float or be let go. Trouble is--there were no cnas to assist with the basics so just about everything annoyed this man because he couldn't get stuff fast enough and he had to be bothered for frequent vitals while on tele. Also, as a hospice nurse i do understand the pain patients have with their many sequelae. Even in med-surg one can't fault all patients for drug seeking. One patient, actually quite nice but very needy called q 20 mins and insisted she had a funny feeling in her stomach. The MD was called promptly but would not allow her more narcotics or additional anti-anxiety meds, or order add'l tests. She was only 48 y/o and later on, after a week of nursing and even m'gment begging MD for assist, a specialist was called in, ordered MRI, CT, etc, Cea, and patient diagnosed with tumor and died few weeks later.

Specializes in Oncology; medical specialty website.

Pretty daggone dumb of the nursing staff to leave a loaded PCA unattended at the nurses' station. Pretty daggone smart of the patient to sneak up to the nurses' station and steal it, then figure out how to jailbreak it so she could get her high.

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