I recently took the PALS course to work in PICU. It had a lot more information about running codes than NRP did. For those of you who have taken both, did you find that the PALS course was helpful?
I really think NICU nurses need to have the mock code scenarios in PALS. The NRP was also half as long as PALS. The PALS course also covers different dysrhythmias, I know most babies don't have these, but it sure was interesting knowledge to have.
I strongly recommend this course to any critical care nurse.
The NRP doesn't really go into a lot of code situations and what you would do in them. PALS gets you to think quickly about what to do if your baby/kid is crashing.
The NRP class I took went into all of this, quite a bit actually ..... and we did mock codes.
I agree that STABLE is a great class, very interesting.
Of course we do codes:lol2:. I work in a LARGE unit. We covered all those scenarios in NRP and that was specific to neonates as was STABLE. I suspect it was your teacher. I think SVT is pretty obvious, I recognized that in babies long before I took PALS. The rest (other than bradys, asystole, tachys or PVCs) are really hard if not impossible to diagnose off the ECG monitors most NICUs use and because NICU nurses see them so infrequently. It could also be because I worked NICU for years before taking PALS, but I just don't find it to be relevant enough to NICU. I think NRP and STABLE are way better. If your NRP didn't go into detail about epi, boluses, CPR and different code situations then you didn't get a very good course.
You can google STABLE on the internet. It's a course specific to neonates and basically goes over everything you should be doing to initially stabilize your babies (Sugar, Temp, Airway, BP, Labwork, Emotional support). I could see how newer nurses would like pals, but if you've been in the unit for a long time I don't think it's particularly valuable. You should already know how to code a baby.
We can agree to disagree here. I have been a NICU nurse for 17 1/2 yrs., mainly in a big unit. I've found that my NRP class was not as helpful with doing mock codes as PALS was. It must have been the quality of teachers and how it was taught. I did google STABLE. It sounds good. PALS and NRP cover the more difficult things like codes, and it appears that STABLE is basic stabilization of a newborn. I have observed over the years that a lot of NICU nurses, esp. new grads, are not comfortable in codes and I think PALS is useful for that, because you are put into the position of running the code (team leader). Hopefully even a new nurse will know the things taught in STABLE already. I don't think it's a bad thing to widen your knowledge base when caring for infants and if you occasionally (or often) float to PICU which a lot of NICU nurses do.
This is JMO, but I can't imagine a new grad EVER feeling comfortable in a code. EVER.
I've only been in the NICU for a year and a half, and I still don't feel comfortable. Yeah I feel more comfortable and more confident in what I'm doing than when I was a new grad ....... any code that goes on I at least try and get in there and do something. The more codes that I'm involved with and see, the more comfortable I get. And I think that's the only thing that's going to make a new grad comfortable with codes ...... experience, and that's the one thing they don't have yet.
Some things just take time. Not everything can be learned with a book or class ..... you can't learn experience. And this is one of those things that experience counts for everything.
i agree with what you're saying. The point I'm trying to make is that it wouldn't hurt to expand our knowledge by taking PALS. Most nurses don't really feel comfortable in a code, but I think practicing mock codes in NRP and/or PALS helps nurses feel a bit more confident. Also, there is a PALS algorhythm card that nurses and doctors can look at during a code to figure out what to do next. It's really a helpful tool.
I think you just didn't have the greatest teacher for NRP. Every NRP class I've taken, we were each given several scenarios that ranged from delivery room to the unit. We were expected to run each of these on our own. (remember, NRP is "primarily" directed at delivery room resuscitation) We couldn't pass until we had mastered each scenario, intubation, drug dose, etc. I have been BLS, PALS, ACLS, STABLE, Arrythmia, and TNCC certified for 6 years, and haven't found anything useful to NICU except arrythmia, NRP and STABLE. There are also now physical assessment and cardiac modules of STABLE, which are excellent, if you ever get a chance to take them. Having PALS could be helpful, but also confusing, especially when you're trying to figure out compression/breath ratios, drug doses, etc on a preemie.
Our NRP code consisted of all of us at the table and we talked through one as a 13 member group. That I found disturbing. But I also know there is always experienced nurses in my unit with me.
Our NRP code consisted of all of us at the table and we talked through one as a 13 member group. That I found disturbing. But I also know there is always experienced nurses in my unit with me.
Our NRP code consisted of all of us at the table and we talked through one as a 13 member group. That I found disturbing. But I also know there is always experienced nurses in my unit with me.
That was a lot like my NRP, nurses sitting around and discussing the situation, not really taking charge one by one like we did in pals
I've taken PALs for transport and it really isn't pertinent to NICU. We had to take it as we transport cardiac kids for other hospitals. I would hope that your group said something about the poor quality of your NRP, that is something that needs to be evaluated and reported to your education and training.
...but I find that the combination of NRP and STABLE is a lot more beneficial to the NICU nurse.
I just had the opportunity to take the STABLE course last week and it was wonderful. We had the extended course with the physical and gestational assessment portion.
I have to go with the majority and say NRP (properly taught with mock codes) and STABLE class are the way to go, from the new nurses, to refreshers for older nurses.
RainDreamer, BSN, RN
3,571 Posts
The NRP class I took went into all of this, quite a bit actually ..... and we did mock codes.
I agree that STABLE is a great class, very interesting.