IABP

[AnnieRN]

To all ICU nurses;

How much training did you recieve before you were expected to be able to safely care for a patient with a balloon pump? I work in a community hospital that has decided to be the premier community hospital that will be using the balloon as a "bridge" to stablize our patients and ready them for transfer to a tertiary care center. We are a young staff in terms of critical care experience and none of us has ever worked with a pump. We are also extemely short staffed. Our unit is often staffed with two RN's, one who may only have been in ICU for less than six months. We have seven beds open but often must hold the census due to staffing issues. Now they want to intrduce the balloon pump. So far the training has consisted of one eight hour class..some of us were not privelged enough to even finish the class because we were expected to work. We also had a two hour mock insertion with the sales rep. I do not feel this is adequate. Am i being unrealistic to think that we we need more training??

[Biffbradford]

Are you in SLMC CVICU? If 'yes', send me a PM! (I used to work there). One thing in that particular CVICU that hasn't been mentioned yet, is that we had at least one biomechanical engineer on call 24/7. You could often get one to come to the bedside to answer any questions during the day, or call them at home in the middle of the night. Truely lifesavers.

[CCL RN, RN]

No matter what, IABP=1:1.

if they are sick enough for a IABP then they are sick enough for one nurse.

We had the same 8 hr class when I worked ICU, For cath lab, I'm just supposed to know it. No training.

[Biffbradford]

Besides the training, you simply need to get your hands on it until you're comfortable. If it's not your patient, see if you can do a timing check, or print a paper strip, just something to keep your head in the game. Then when you're on that run to the CT scanner, and the IABP starts screaming at you while you're crammed in the elevator , you'll have the confidence to trouble shoot the problem and be on your way. (gee, how would I ever think up a senario like that? )

[ghillbert, MSN, NP]

They don't need to be 1:1 for the IABP - what staffing they need depends on how sick they are. People are not always "super sick" (comparatively) when they have an IABP - sometimes it is extra perfusion/lower workload in people with AMI, or to offload the heart prior to putting a VAD in someone, etc etc. Sometimes they are put in almost electively if someone has the potential to be unstable.

If you are competent/trained correctly, the management of the console/device itself is not time consuming (assuming all goes smoothly).

[Biffbradford]

Okay. You take the IABP and first admission. Hope that it doesn't happen when the doc wants to pull the balloon in the AM.

[ghillbert, MSN, NP]

No problem. They can pull the balloon whenever they want - won't be me holding pressure on it!

[Maevish, ASN, RN]

That all sounds very unsafe....you worked hard for your RN and this is a disaster waiting to happen.