dyaryan

Thank you everyone for your input. In the situation where the RN pushed atropine, she indeed pushed 0.5mg. When it was brought to the attention of the physician who had performed the procedure on the pt...she said "you should have pushed 1.0mg" Scary...huh...the RN was better prepared to address this pt's bradycardia. With 0.5mg, the pt immediately jumped to the 70's-80's, and needless to say felt SO much better. In the case of my patient, I work in a small unit. Everyone was doing something...getting an EKG, replacing the fluid that was almost out, I was on the phone with the cath lab/Dr.when the RN pushed the lidocaine. I'm really torn...she probably prevented that patient from going into V-tach/fib by her quick thinking. I realize the significance of "preventing" a code and she is far more experienced at dealing with cath lab situations-gone-sour than I am. My experience is tele..more "floor" nursing. I'm used to calling a pre-code(ACAT) team or a code, starting CPR and having the team arrive and run it with a doctor ordering what and how much to push. This hospital has few protocols or standing orders. A frustration I tried to remedy on Tele before I left...to little avail. I feel sometimes like there is little in place to protect me ..the RN. This entire experience has been a huge learning experience. I've spent a lot of time picking them apart and analyzing why, what, when. Now I need to research what was "legal" according to hospital and our state board of nursing. Thanks again everyone.

Thanks....I had a fellow nurse who jumped in during a situation with my patient. I literally was in the process of preparing her to go BACK to the cath lab. She had just had a stent put into her LAD and obviously based on her R on T rhythm, she was shutting that stent down. The cath lab nurses were even there to transport. This nurse comes out with Lidocaine and pushed it by herself. Earlier in the shift, she had her own patient back from a procedure that was symptomatic and bradycardic...she grabbed atropine and pushed 1mg without a doctor present or an order...in both situations. I just wanted to know if this was "legal." I've pushed those drugs, too. But only during a code.

I am ACLS certified. In other situations besides a code, can I push ACLS drugs without a doctor present and without doctor's orders? In other words, does the certification cover me in situations other than a code?