Would I be wrong if...

JustBeachyNurse, LPN · Feb 19, 2015

No you are not wrong. That's why the current recommendation by the AHA is if no BVM or face mask activate EMS, do compression only CPR until AED or EMS arrives. If too tired to continue compression only cpr and EMS is delayed. If no pulse the rescuer can stop.

As I learned in first aid, EMS and even professional CPR a dead rescuer does no one any good.

AnnieOaklyRN, BSN, RN, EMT-P · Feb 19, 2015

The AHA has recognized that there is a risk of contraction infectious diseases by doing mouth to mouth, even while using a face mask, which is one reason why non-healthcare workers are taught compression CPR only, there is no longer ventilations, unless it is your family. They also wanted to keep it simple for the lay person in order to increase the amount of people that are willing to do CPR, the point is to make it as simple and low risk as possible in order to save lives.

With that said if you are a healthcare worker you should have a bag valve mask available to you, so there is NO mouth to mouth, if you do not have a BVM it becomes compression only CPR, again this is due to the AHA realizing that a mouth to mask does not protect from infectious disease such as Hepatitis.

You are correct in not doing mouth to mouth! You should remember too that most adults die from cardiac related arrest, thus they drop with plenty of oxygen still remaining in their blood so that even when compression only CPR is done they will still be oxygenated for a while since the cells are going to use very little.

Annie

Nonyvole, BSN, RN · Feb 19, 2015

Because we are. Not quite sure who is so firm on the fact that we, as nurses, can't put ourselves first, because think of it this way.

If you're sick, or injured, or passing out from hunger, what does that do for the patients?

In the situation that you posted about, I'd do only chest compressions. Because, um, ew. I don't want anything that's coming out of the patient's mouth to go into mine.

In the larger world, I won't delay cares to go get something to eat or to use the restroom, but at the same time, I'm also not afraid to say that I'm ducking out for a couple minutes to grab my meal/whatever. Of course, I work on a unit where I can do that.

Safety Coach RN · Feb 19, 2015

I refused to perform mouth to mouth resuscitation without any PPE on someone with saliva and sputum and other secretions present around the person's mouth?
The question was presented to me earlier this week in class and said that that's not something I'm comfortable with. Well, I was told I was selfish. lol. I was also told I was "unrealistic about the nursing profession" because I said I vowed to never be the type of nurse that doesn't take a lunch break or refuses to use the restroom when I need to.
To me, this brought up a bigger issue; Why is it that as nurses we aren't allowed to put ourselves first without being deemed as selfish or self-centered?

We need to take care of ourselves in order to take care of our patients, right?

Libby1987 · Feb 19, 2015

It's not about putting ourselves first. This isn't Lifetime, it's about appropriately following protocols and employee safety, emptying your bladder falls under some labor law..

Your cohorts need to grow up.

Libby1987 · Feb 19, 2015

On second thought, I bet this is an argument of extremes.

Reality is you're going to work harder than you ever thought possible but you can sprint to the BR to pee now and then and you don't have to have mouth to bodily secretions contact.

JWG223 · Feb 19, 2015

I refused to perform mouth to mouth resuscitation without any PPE on someone with saliva and sputum and other secretions present around the person's mouth?
The question was presented to me earlier this week in class and said that that's not something I'm comfortable with. Well, I was told I was selfish. lol. I was also told I was "unrealistic about the nursing profession" because I said I vowed to never be the type of nurse that doesn't take a lunch break or refuses to use the restroom when I need to.
To me, this brought up a bigger issue; Why is it that as nurses we aren't allowed to put ourselves first without being deemed as selfish or self-centered?

No, it's not wrong. No, it's not self centered. I agree 100%. I am an employee, not a slave.

JWG223 · Feb 19, 2015

The AHA has recognized that there is a risk of contraction infectious diseases by doing mouth to mouth, even while using a face mask, which is one reason why non-healthcare workers are taught compression CPR only, there is no longer ventilations, unless it is your family. They also wanted to keep it simple for the lay person in order to increase the amount of people that are willing to do CPR, the point is to make it as simple and low risk as possible in order to save lives.
With that said if you are a healthcare worker you should have a bag valve mask available to you, so there is NO mouth to mouth, if you do not have a BVM it becomes compression only CPR, again this is due to the AHA realizing that a mouth to mask does not protect from infectious disease such as Hepatitis.
You are correct in not doing mouth to mouth! You should remember too that most adults die from cardiac related arrest, thus they drop with plenty of oxygen still remaining in their blood so that even when compression only CPR is done they will still be oxygenated for a while since the cells are going to use very little.
Annie

Anyone who has ever seen the bloody mess blown into an ambu-bag and would still do mouth-to-mouth is either crazy, or talking about their own kid.

jadelpn, LPN, EMT-B · Feb 19, 2015

OP, this may be a great paper idea for you! Seriously, as evidence based practice suggests that chest compressions are most important in the face of someone's heart stopping.

So take the emotion out of this--it has not a thing to do with Ewww gross, I am not putting my mouth there (and would not blame you, I wouldn't either) but that proper CPR protocol, backed by evidence based practice suggests that the quality of compressions outweighs the mouth to mouth portion of CPR.

So, in fact, you are not being unrealistic about the nursing profession. You are however, seeing all sides of the profession, using your evidence based practice guidelines, and realizing that regardless of the personal need of some to be "saviors" you are a realist, and use what you are meant to (evidence based practice) to provide competent care of a patient.

(YES, I know, I used evidence based practice about 500 times in this post, however, it is a key term to success in your nursing education.)

Best wishes.

llg, PhD, RN · Feb 19, 2015

On second thought, I bet this is an argument of extremes.
Reality is you're going to work harder than you ever thought possible but you can sprint to the BR to pee now and then and you don't have to have mouth to bodily secretions contact.

I agree. In reality, you should seek a realistic middle ground. No, don't do the mouth-to-mouth.

Yes, you should be able to take a bathroom break and/or grab something to eat as needed. However, don't expect to get your "full lunch break" every shift -- or be able to dictate the exact time, etc. You can't expect to be able to take extended bathroom breaks whenever you want. Understand that the needs of the patients often take precedence over you wants.

However ... when you accepted the patient assignment, you entered into a form of "contract" with the patient. You agreed to give high priority to their needs -- to take care of them in exchange for compensation. That is what society expects of us and a responsibility we accept when we call ourselves professional nurses and accept jobs as nurses. It's up to each of us to meet the needs of the patients we have agreed to care for -- and that often means moving our own wants down on the priority list below the patients' needs.

That doesn't mean you shouldn't get decent breaks, etc. Your employer has an obligation to provide a reasonable work environment. But we need to flexible and not expect our wants to be the highest priority all the time. If you come across to your colleagues as someone who won't bear her fair share of the burden on a busy day (when compromises have to be made), nobody is going to want to work with you.