Why does everyone need to be ACLS cert?

[imintrouble]

There has been a push at hospitals in my area for ALL nurses to be ACLS certified. There are repercussions for those who choose not to do the training. Fewer hours, more w/e, and generally not treated as well. I can understand the PEDs floor, ICU, ER, Cath lab..... but just plain old med surg, I don't understand. There is a code team, so it's not like there aren't enough RNs to respond. Is this a trend everywhere?

[Fribblet]

"Why does everyone need to be ACLS cert?"

I guess the wider question would be: why not?

I was told in another thread (where I dared suggest that every nurse be ACLS certified) that it might be too hard for some nurses.

Seriously. No one is asking that you manage a fresh, post-op heart. Just know a few deadly rhythms, what to shock, and a few drugs.

ACLS is a good thing. If you have RN behind your name, you need to know it. It should be a requirement to maintain licensure, imo.

[canesdukegirl, BSN, RN]

OP, I understand your hesitation. My hospital pulls nurses onto other floors too. One night we had 5 transplants going on at night and they pulled a PACU nurse to circulate in the OR!!! Can you imagine?!?

[EricJRN, MSN, RN]

I'd think of it as two separate issues:

1) Can med-surg nurses benefit from ACLS? (I definitely think so.)

and

2) What should the process/restrictions be for preparing med-surg nurses to float to critical care areas? (That, to me, is better addressed within your own unit.)

[enchantmentdis, BSN, RN]

It's ridiculous that we all need acls. Bls should suffice. All hospitals have a rapid response team. If a patient has a significant change in condition the RRT is called. If a patient codes we know to do the ABCs and then start compressions, apply oxygen, etc...the code team then takes over. We don't need ACLS to do this stuff because we are never really alone with the patient--MD, RT, RRT, etc... all arrive and take over anyway. The ones that take over know the ACLS. It's useless that nurses have to be certified for every little thing, especially since i am basically babysitting dementia patients, handing out pain meds to the drug seekers and passing out pill after pill to patients who don't really need this polypharmacy. In fifteen years as a charge nurse i have never given epi or lidocaine to a coding patient, yet it costs me $250.00 every 2 years to renew the ACLS. I don't review the rhythm strips--the tele tech does. If i see a heart block, v fib, svt on the machine i am in the room and calling the code team. If there is a rhythm i don't see the tele tech pages or phones me and i tell them to call RRT as i enter pt's room. This is all common sense. Always go in the room and evaluate the patient. A lot of nursing is common sense. Let the MDs, Respiratory txs, and code team do their jobs.

[enchantmentdis, BSN, RN]

It's also ridiculous that hospitals now mainly want only BSNs or even all RNs for that matter. Don't they realize how much money and time is involved to go back to school to get all these credentials to be a babysitter and pill-pusher. And we aren't getting any more respect from nurse management or from the MDs for all of these extra letters behind our names. And patients are not receiving better care because of all of this because the ratios don't match the acuity levels. For instance, if i have a loud, belligerent, drug-seeking patient who thinks he is the only patient in the ward, he is taking all of my time and the other patients are being ignored. He knows he can get a nurse fired no matter how many certifications he/she has. We are not respected or valued for all of our hard work and extra education we obtain and can be fired at any time. Lots of money spent just to ultimately get the ax or be treated like garbage. I am currently looking into going back to school to become a medical technologist or pharmacist so i won't have to deal with patients, medical doctors, or other nurses. If i am going to be a pill pusher or have to deal with body fluids i might as well be a pharmacist or clinical lab scientist and avoid patients all together. And you don't need ACLS in hospice or home health, btw.

[Up2nogood RN, RN]

It's ridiculous that we all need acls. Bls should suffice. All hospitals have a rapid response team. If a patient has a significant change in condition the RRT is called. If a patient codes we know to do the ABCs and then start compressions, apply oxygen, etc...the code team then takes over. We don't need ACLS to do this stuff because we are never really alone with the patient--MD, RT, RRT, etc... all arrive and take over anyway. The ones that take over know the ACLS. It's useless that nurses have to be certified for every little thing, especially since i am basically babysitting dementia patients, handing out pain meds to the drug seekers and passing out pill after pill to patients who don't really need this polypharmacy. In fifteen years as a charge nurse i have never given epi or lidocaine to a coding patient, yet it costs me $250.00 every 2 years to renew the ACLS. I don't review the rhythm strips--the tele tech does. If i see a heart block, v fib, svt on the machine i am in the room and calling the code team. If there is a rhythm i don't see the tele tech pages or phones me and i tell them to call RRT as i enter pt's room. This is all common sense. Always go in the room and evaluate the patient. A lot of nursing is common sense. Let the MDs, Respiratory txs, and code team do their jobs.

What if there were several codes or rapid responses simultaneously? I'd rather have an 'overqualified' nurse taking care of my family member anyday.

I had no issue taking ACLS, in fact I requested to. Maybe I'll never use those skills but it's nice to know I have them should some unforeseen disaster happen.

[enchantmentdis, BSN, RN]

In the ACLS classes i have taken the nurses have to be coached through the whole process and don't really understand it anyway. You get your certificate at the end because you paid for it--the instructors basically tell you what to do in the event of a code and then you practice it and memorize the meds. If you don't use it you lose it--that's why, only one of the reasons, it's needed every 2 years. In nursing school most of the students could not pass statistics, organic and inorganic chemistry on the first try. When this happened the university had us take these classes in the summer and we were allowed to take the final 3 times until we passed it. We even got to take open book tests in statistics until we passed. This is not done in medical schools but is common in nursing schools.

[enchantmentdis, BSN, RN]

The hospital does pay for it, but I have reservations for several reasons. There is always the possibility that I would be pulled to tele, or ICU if I have ACLS behind my name. If I wanted to work in such stressful areas I would already be there. I do not handle stress well. I've been a med/surg nurse long enough that there's very little that can be thrown at me that I can't handle. It's a personal choice...ACLS..that I didn't sign up for and I mildly resent it being pushed. It angers me that the nurse I am, what I contribute, is not good enough without those 4 initials.

Having read the above posts, I may have to stop whining and comply.

I agree about the stress part. I wanted to do only med-surg, outpatient(pre-op), or endoscopy and was talked into acls years ago. Since then i am always floated to tele or DOU, which i hate,--monitors always going off, so much noise, patients removing the monitor over and over. If they were all chest pain patients under 75 years old and could walk and talk --no problem. Post-caths are the best. But often the patients are very elderly, demented, needing sitters, have multiple decubiti, afib which makes their monitor alarm constantly and should have been made a DNR years ago and yet are still on tele. If a patient codes in outpatient or endoscopy the MD is right there to take responsibility and yell out which meds to give. Hospitals are forcing ACLS because they are afraid of lawsuits yet are giving the nurses too many patients to care for. If you are pulled into tele they will make you care for 5 patients but let the charge nurse interpret your strips, but you will still hear those noisy monitors and have to reapply the pads throughout your shift while your nursing assistant hides--and vitals are q 4 and they won't be much different than 4 hours ago.

[ChristineN, BSN, RN]

I would hope that every nurse would have a desire to keep continuing their education in some way or another to better provide care for their pts. I personally do not have ACLS (I am PALS though), but I have already requested to take the ACLS class. My plan is to take ACLS a month or so after I get my Tele certification. Do I need either for my job? Technically no. I work in the float pool, and am not required to be tele or ACLS, but I believe that since I go everywhere (including tele floors and take non-tele pts), that it would benefit me to have a ACLS. I can say from my peds experience, I felt much more prepared to deal with code situations after I took PALS.

[Esme12, ASN, BSN, RN]

The hospital does pay for it, but I have reservations for several reasons. There is always the possibility that I would be pulled to tele, or ICU if I have ACLS behind my name. If I wanted to work in such stressful areas I would already be there. I do not handle stress well. I've been a med/surg nurse long enough that there's very little that can be thrown at me that I can't handle. It's a personal choice...ACLS..that I didn't sign up for and I mildly resent it being pushed. It angers me that the nurse I am, what I contribute, is not good enough without those 4 initials.

Having read the above posts, I may have to stop whining and comply.

I hear what you are saying and understand your anxiety but going to ICU and tele is more that just ACLS certification. I would ask your manager if that is the plan and tell them of your concerns. BUt I do feel that ACLS is helpful for the floors as it would make you more comfortable in emergency situations, make you more helpful to the team whem they arrive, and possibly help you intervene earlier before the code occurs.........knowledge is power!:redpinkhe

[Dalzac, LPN, LVN, RN]

You will be, more times than not, the first responder. in the few minutes before the code team gets there you should have a crash cart, CPR started, an airway established. ACLS gives you more confidence that if you needed to be more at ease in a crisis situation. It isn't near as hard as it used to be 20 years ago. Nobody flunks it anymore. It is more like an extension of regular CPR classes. I got mine when it first came out in 1986 and it was really tough. I honestly think it would improve syour nusing career.

[General E. Speaking, RN, RN]

It's also ridiculous that hospitals now mainly want only BSNs or even all RNs for that matter. Don't they realize how much money and time is involved to go back to school to get all these credentials to be a babysitter and pill-pusher. And we aren't getting any more respect from nurse management or from the MDs for all of these extra letters behind our names. And patients are not receiving better care because of all of this because the ratios don't match the acuity levels. For instance, if i have a loud, belligerent, drug-seeking patient who thinks he is the only patient in the ward, he is taking all of my time and the other patients are being ignored. He knows he can get a nurse fired no matter how many certifications he/she has. We are not respected or valued for all of our hard work and extra education we obtain and can be fired at any time. Lots of money spent just to ultimately get the ax or be treated like garbage. I am currently looking into going back to school to become a medical technologist or pharmacist so i won't have to deal with patients, medical doctors, or other nurses. If i am going to be a pill pusher or have to deal with body fluids i might as well be a pharmacist or clinical lab scientist and avoid patients all together. And you don't need ACLS in hospice or home health, btw.

Wow, you sound a bit burned out and a little cynical. First, I am bothered by the fact that twice in your posts you have referred to the "drug seekers". I have no idea what field of nursing your are in but be careful about generalizing- it leads to inept pain control of those non-drug-seekers. (Even though I believe everyone has the right to pain control. But that is a whole other can of worms.)

Second, are you in a hospital? Every unit is more than just babysitting or pill pushing. Patients conditions change and need constant monitoring. Critical thinking skills are a must in every unit of the hospital.