Why does everyone need to be ACLS cert?

Neferet · Feb 1, 2012

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?

I agree!

And I totally agree with Coopter1 and all that he said.

I don’t want to be certified for something I've only see on my floor about twice in the last 4 years. There are no mock codes, no further training….but still we are required to KNOW the stuff.

It’s impossible, and a liability to me. Learning something last year doesn’t mean I’m gonna remember it when a code happens this year. Same for the carbon cycle or kreb cycle we had to learn in bio. I’ve had to relearn those cycles about 4 times throughout college, and never remember anything, because we never used it.

If you don't use a skill, you loose it.

It’s unnecessary to carry a license for something that you’re not competent in because you don’t have any practice in it.

It could be something as easy as putting the darn Epi pen together. If last year is the last time you’ve ever put that thing together…then it will take you some time to remember or figure it out. And many little things like this and remembering medications, time frequency, and rhythms, which you won’t even remember if you’re not used to working with them.

Running a code is not just book stuff, but takes real hands on practice, and you can’t do that if there is no continuous training or experiences.

One person above said that ACLS mostly involves CPR, and you really only have to identify shockable verses non-shockable rhythms. Oh really???? Last time I checked you have to know all the meds in the crash cart, when to use them, and be familiar with all rhythms, and within what time period you must give the meds. I think that it’s second nature for nurses experienced in trauma, ICU, ER, OR to know these things….they use it all the time. However, on Medsurg and lower acuity floors it becomes a liability especially if you don’t push any of these meds on the floor or read tele.

Being ACLS certified doesn’t just mean its “nice” to have it. I think in a court of law you could be liable if you did not perform ACLS accurately in order to save a patient, since you are ACLS certified. The same goes for BLS, so why not ACLS?

I think it’s dangerous for hospitals to have everyone be ACLS certified just so that they could boast about it. Without proper training, and practice to help nurses keep competent in ACLS, nurses’ licenses are on the line. And so are the patient’s life.

It’s not about nurses not wanting to continue their education. I’m for anyone who wants to continue their own education. But I don’t think this should be made mandatory, nor pushed onto nurses. I’m arguing the fact that it’s ridiculous to demand such certification especially in a field that nurses won’t be using it much. That only opens nurses up for error and uncertainty.

Of course you will be more prepared to deal with a code if you took ACLS and PALS than if you didn’t. But that doesn’t necessary mean that you will be competent in ACLS when you experience a code.

Then here goes my question. If you’re licensed in ACLS, aren’t you required to run a code in the case that there is no one else available on the floor?

The answer should be yes… Same for CPR. If you are in a room and a pt coded, you are to do CPR. Then there is no such things as ACLS is easy, just a few rhythms here and there….and it’s just something “nice” to know.

If you’re certified and expected to know it, then you should know it. Which again, makes it difficult for nurses working in lower acuity floors who don’t get much codes or practice.

classicdame, MSN, EdD · Feb 1, 2012

it may not be boasting. There may be more to the picture. For instance, we are trauma designated and have to have a percentage of nurses who work in areas be ACLS/PALS certified if they work where trauma patients may be cared for. Since we cannot quarantee a percentage every shift we require everyone in those areas to be ACLS certified. There is no ACLS "license". It is a certificate. As for requirements, that would depend on where you are when the incident code occurs. In our facility, the staff nurse starts CPR and then the code team arrives to take over. You cannot perform ACLS alone and without equipment, so the only expectation is call for help and CPR. But I do agree that having a certificate does not make you proficient. I recommend you talk to your CNO to determine the purpose of the requirement and how people can maintain skills and what are the REAL expectations.

imintrouble, BSN, RN · Feb 1, 2012

I posted this thread over a year ago. Just visited it again today. What I suspected would happen when ACLS was pushed on the nurses, has indeed happened. Med/surg nurses have been floated to ICU, et tele. New grads who thought it would be great to continue learning on the job, got a wake up call when they were floated to ICU due to call ins. They were/are not equipped to handle an emergency much less run a code. Yet because they have those initials behind their name they are responsible for vents and cardiac gtts they have no idea how to titrate. Sure there are other nurses to hold their hands, but not for a 12 hr shift. At the end of the day, ACLS allows the hospital to schedule you in ICU, whether you're qualified or not. There is no excuse for infusing a med wrong, not monitoring heart rhythms correctly, or calculating a critical care med incorrectly. ACLS means you have a certain level of critical care expertise, whether you do or not.

I still have not become ACLS certified. Neferet put it well. Explained exactly why I don't want that responsibility around my neck..or after my name. My hours have been cut. My pay has not advanced in step with those of my fellow med/surg nurses who chose to become ACLS certified.

What I do retain however, is the peace of knowing I'm not going to step off the elevator and into the ICU responsible for a critically ill pt.

Not every hospital would put their nurses at risk. Wouldn't put their patients at risk. I don't work at such a place. They don't have my best interests at heart. That responsibility is mine.

GilaRRT · Feb 1, 2012

In charge of vents? Surly your facility has respiratory therapists.

DookieMeisterRN · Feb 2, 2012

In my hospital ACLS certification does not = ICU experience. A med/surg nurse would never be floated to critical care. Most of our units are tele equipped so we are expected to be tele/ACLS certified within our first year. No one is expected (in my hospital) to lead a code just because they've been thru ACLS. A code is a team effort, we have a rapid response and code team plus there is always hospitalists, residents, RT's, anesthiologists, surgeons, teaching service in the house. Why a floor nurse would be expected to lead a code is really stretching what in reality would never happen. A nurse should be pro-active and take responsibility for their practice. There is always something to learn. I don't care if you've been a nurse for 5 or 50 years, you couldn't and don't know it all, and not above keeping your practice current and up to date with the times. This is 2012 not the 1980's and things are always changing. If your unwilling to keep up your education as your employer asks I don't blame them for cutting your hours. There are plenty of qualified nurses willing to take your place.

imintrouble, BSN, RN · Feb 2, 2012

In charge of vents? Surly your facility has respiratory therapists.[/quote
Not at night. We're on our own after 9p

imintrouble, BSN, RN · Feb 2, 2012

In my hospital ACLS certification does not = ICU experience. A med/surg nurse would never be floated to critical care. Most of our units are tele equipped so we are expected to be tele/ACLS certified within our first year. No one is expected (in my hospital) to lead a code just because they've been thru ACLS. A code is a team effort, we have a rapid response and code team plus there is always hospitalists, residents, RT's, anesthiologists, surgeons, teaching service in the house. Why a floor nurse would be expected to lead a code is really stretching what in reality would never happen. A nurse should be pro-active and take responsibility for their practice. There is always something to learn. I don't care if you've been a nurse for 5 or 50 years, you couldn't and don't know it all, and not above keeping your practice current and up to date with the times. This is 2012 not the 1980's and things are always changing. If your unwilling to keep up your education as your employer asks I don't blame them for cutting your hours. There are plenty of qualified nurses willing to take your place.[/quote
Hospitalists? Anesthesiologists? Not everyone is so lucky as to work in a large hospital. The majority of hospitals where I live are critical access/25 bed facilities. We don't even have an ER doc on staff full time. Imagine what I've just described. Just TRY to imagine. After 9P:
No RRT
No hospitalist
MDs who WON'T come to the hospital for pts YOU'RE sweating bullets over.
No pharmacy.
No cafeteria/Dietary
No full time ER MD.
Then imagine that magical ACLS behind your name. Imagine what is expected of you. Mr DM, your post made me angrier than I've been in a long time.
You CANNOT imagine the conditions some of us are expected to work in.
Last week I had 9 (NINE) pts. Three on tele. I did serial EKGs on each of those pts. I drew their blood for serial cardiac enzymes. I mixed ATB for 4 pts. I gave neb tx to 5 of them Q 4 hrs.
The nurse watching tele was responsible for 5 med/surg pts of her own. She was fresh off her ACLS class and absolutely terrified. I had to rely on HER cardiac rhythm expertise, which terrified me.
Do you want to take my place? In an economy where most nurses can't find a job, we can't keep them.
Before you dismiss my concerns, spend a night in a facility with absolutely NO ancillary staff, DookieMeisterRN ACLS.

imintrouble, BSN, RN · Feb 2, 2012

I apologize for my over dramatization. DookieMeister please accept my apology for my angry post.

I tried to edit but was too late.

I'm always in trouble.

DookieMeisterRN · Feb 3, 2012

No worries....I feel very grateful for working where I do and that's why I love my job. If I had to work under the conditions you've described above, I'm sorry, but I'd be looking for a new career. I know it's not that easy but dang you all need a union to start with.

That Guy, BSN, RN, EMT-B · Feb 3, 2012

Im on a code team. I wish more people were ACLS trained. Walking in to a room by the time you respond and seeing nothing done is painful to see. If you get the chance people, please please get ACLS.

RN/WI, ADN, BSN, MSN, RN, APRN · Dec 16, 2016

It's another crap control technique, yet once again like the b s n we so needed! We must all have more credentials then our administrators again and they're trying to hold us down.

EllaBella1, BSN · Dec 16, 2016

It's another crap control technique, yet once again like the b s n we so needed! We must all have more credentials then our administrators again and they're trying to hold us down.

#1- This post is almost 5 years old.

#2- How is a class that you can take in one day another "crap control credential" when it is absolutely relevant to practice? I didn't read this whole thread, but I 100% agree with the (5 year old) post right above yours. The number of times that I have walked into floor codes with the nurses frantically standing around the bedside unsure of what to do is ridiculous. Knowing ACLS, whether or not you actually push ACLS meds/deal with this routinely in your job role, can save lives.