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Discussion

LPNs: What if your pt codes while an RN student?

This is something that is worrying me, honestly. I know that we go to great lengths at my hospital to try to keep a nursing student from having a pt's who's probably going to die that shift, but we all know crap happens.

I'm ACLS certified, and my question: if I'm a RN student, and my pt goes into arrest, what am I allowed to do?!? I mean, I understand that I'm working under my teacher's license, but can't you just see me getting dragged into court with a lawyer going, "You mean you are a licensed nursed, ACLS certified, have worked numerous codes before, yet you stood there and let this pt die to keep from getting kicked out of nursing school?!" And, honestly, I don't think I could just stand there with my hands in my pockets and let someone die.

I've asked my teacher, and she said they've never had a LPN with ACLS for it to come up, and they're looking at it. Is it just CPR only? Oral airway? Pushing epi/atropine/whatever according to the pt's rhythms? Using a defib for vfib okay? What have you guys been told?

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Personally...I would call the code, start CPR and wait for the cavalry to arrive. Once the cart appears and the code team shows up there should be more than enough people to take care of everything without you.

I was an ACLS certified LPN when I was a RN student, too. You are still expected to remain within your scope of practice as a LPN during the code. That still leaves plenty of stuff to do, outside of pushing the meds. Even though you may be there in the capacity of a student, you still have a license to uphold, and have a responsibility to act in the manner that any other prudent LPN with ACLS certification would act in the situation.

If your instructor would have a problem with you starting compressions on a coding patient, then that seems just plain wrong.

I would hope your school would recognize your duty to the patient first.

  • Author

Today, they told me I can do CPR, and that's it. No airway, no pushing meds, just CPR until the code team arrives.

do cpr

That's an interesting question! I'm in the same boat...Tele nurse, ACLS certified, will even be doing clinicals at my hospital (so I know and have even done codes/METs with some of the nurses there). When I get to that point, I'll have to be sure to ask for guidelines as far as what I'm allowed to do from the school's standpoint.

I'm so not looking forward to dealing with the limitations that will be placed on me in clinicals. I'm too independent and will have been practicing as a LPN for ten years by the time I get to clinicals...I may develop multiple personality disorder trying to deal with it!

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