Why does everyone need to be ACLS cert?

Esme12, ASN, BSN, RN · Oct 17, 2010

enchantmentless
I have a reputation as a cynical burnout, but you are honing in on my territory. Back off! this is my stroll.
Er, I mean troll.
Stupid patients, by the time they get to the hospital they don't do ANYTHING for themselves. The whining, pooping, and puking can get to you after 12 hours. And don't get me started on families. If they wanted 10 warm blankets and fresh icewater they should have stayed home and hired a maid. The hospital is for medicines and procedures- and not when you want them either. Those are for my amusement, and to shut people up when they get too rowdy. Pain honey, I'll show you pain...can't breathe? well you're talking ain't ya?
I'm going back to work tomorrow and I just can't wait. Maybe I'll sign in to the ER tonight and agitate the waiting room. Get all the bad karma out of the place before MY shift starts. Wonder if the customer service specials are valid for employees too?

Wow.....harsh.........I thought the post was about ACLS for all actue care RN'S..........any thoughts?

Esme12, ASN, BSN, RN · Oct 17, 2010

Also, as a hospice nurse i do understand the pain patients have with their many sequelae. Even in med-surg one can't fault all patients for drug seeking. One patient, actually quite nice but very needy called q 20 mins and insisted she had a funny feeling in her stomach.The MD was called promptly but would not allow her more narcotics or additional anti-anxiety meds, or order add'l tests. She was only 48 y/o and later on, after a week of nursing and even m'gment begging MD for assist, a specialist was called in, ordered MRI, CT, etc, Cea, and patient diagnosed with tumor and died few weeks later.

You consider this patient drug seeking? I look at this patient and I think how sad that this poor woman could not obtain the pain relief she deserved and had one of those MD's who can't see the forrest for the trees. Did this woman's care suffer because she was "LABLED" a "SEEKER?" HOw sad....

back to the post should floor nurses get ACLS? I believe they should.....it would better prepare the floor nurse to have more input and knowledge when a patient codes.......not all hospitals have real "rapid response" teams. I think knowing the crash cart and the drugs wouuld be an asset to the code team when they arrive.

Esme12, ASN, BSN, RN · Oct 17, 2010

Smart indeed. Her nurse was fired and i was on suspension for one month until all was sorted out. Pt suffered no ill effects and when i returned, she of course was back in the hospital and i overheard her tell her nurse "now i get my demerol every hour so just give it to me." -i was in charge with an assignment of patient's that day and stayed away from that pt. Her MD would not allow a pca. Her nurse was busy, busy so i helped out with her other patients when i could.

A good lesson.......real drug seekers are very creative and desperate. Someone once said about a patient like this to the MD............"Just treat them like a hijacker......give them what they want so they will release the hostages and we can all get back to the other 32 patients on the floor" :rolleyes: :lol2: :lol2:

I bet the you or the other nurse will never lay a narcotic down and walk away again............valuable lesson,hard price to pay.

enchantmentdis, BSN, RN · Oct 17, 2010

A good lesson.......real drug seekers are very creative and desperate. Someone once said about a patient like this to the MD............"Just treat them like a hijacker......give them what they want so they will release the hostages and we can all get back to the other 32 patients on the floor" :lol2:
I bet the you or the other nurse will never lay a narcotic down and walk away again............valuable lesson,hard price to pay.

Just thought i'd let you know that the nurse did not lock the key in the med cart. I never had the pca key--the patient's nurse did.

ZooMommyRN, ADN, RN · Oct 18, 2010

The way I see it is you are going to get paid to sit in class for 2 days and learn, win win situation! I took ACLS for the first time as a new grad because I wanted to understand what the code team was doing and why (where I work there isn't a code team persay, code is called and the ER doc, an ER nurse and an ICU nurse take off for it) and if in the even you ever want to transfer to a critical care unit you already have 1 requirement out of the way.

Coopster1 · Oct 20, 2010

As most of us probably know, theory and practice are radically different. It's wonderful if your facility makes ACLS an option for all staff to get. Should it be mandatory? Probably not. Unless you use it, you truly lose it. I have seen nurses who've had ACLS for years (but never/rarely had to use it) completely gap mentally during a code...the worst possible time to not remember what you're doing. When you couple a med-surg RN who's been in one code a year with a resident/intern who happens to pick the short straw that month, the pt will suffer. Our facility uses nurses from the ICU's to cover codes, dividing the hospital between the 3 ICU's. That way we have code savy nurses responding and if there's more than one code, the other icu can back us up. Codes are already difficult situations, inexperience makes it worse. Working a code is more than just getting an ACLS card. For the pt's sake, it takes an experienced nurse to strongly suggest/guide the resident's orders. Otherwise you end up pushing any drug that you have, shocking asystole (pointless) and ending up with the same dismal outcome unless you're lucky that night.

I think we should all be doing excellent CPR before worrying about ACLS. I'm all for every nurse having ACLS, but it shouldn't be forced upon us. If everyone is required to have it, the concept of a code team or having specific units respond could vanish...outcome poor! Get your ACLS and then you can have some idea how to help out in a code, what to expect, etc. No offense, but if I drop in the hospital, I want people who run codes every week working on me over those who do it say once or twice a year.

And to the poster who said that if you can't handle a code, find somewhere else to work (I paraphrase)...Some RN's are really good at pt care, not at critical situations. That's why they choose to work med-surg, etc. and not er/icu. I'm an ICU/ER RN...I love the rush of crisis, but I know it's not for everybody.

Hope you can take this in stride...If you can't, I'm OK with that too..

MemphisOBRNC, BSN, RN · Oct 20, 2010

What about L&D, Nursery and NICU? We have BLS and NRP. In the 25 years I have worked in OB, I have seen 1 patient who needed resuscitation, and she threw a PE. She needed BLS on the way to the OR, STAT.

anniemm · Oct 20, 2010

ACLS doesn't just focus on the lethal rhythms and their treatments. It also covers bradycardia, respiratory arrest and post resusitation care. You may not be able to give the medications or provide a difinitive airway on your own but you should be able to provide airway support and identify crashing patients. That is what ACLS is about. A patient or visitor can 'fall out' anywhere even in the cafeteria.

GreyGull · Oct 20, 2010

Not everyone in ACLS is a "code". Recognizing unstable patients by HR, either fast or slow, and initiating the correct response or preparing for it is just a vital so the patient doesn't code. Calling for the team is just one step. You still need to be at that patient's side doing something even if it is providing oxygen and checking the BP. Also assigning the CNAs to clear the room of excess furniture and getting the bed ready to move is a big help.

You also give medications everyday for long term treatment of arrhythmias such as A-fib or ventricular ectopy. I believe you need to know how to recognize basic arrhythmias or suspect them by assessment and the basic concepts of those rhythms.

Maybe you don't need to know "how to work" a code or be expected to do so after just an ACLS class, but you really could acquire more knowledge from the information provided in that short course.

janetrnc · Oct 20, 2010

EVERY nurse in our facilty is ACLS trained including NBN. We haven't been floated more but are way more comfortable during the rare times when we had codes in L/D or needed rapid response for a gyn patient.

MaritesaRN · Oct 20, 2010

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?

:rolleyes: I think knowing ACLS is definiteley a plus, knowing you can do what you need to do ...but also you can only be good at something if it is used frequently . In the med surg it is not used frequenly , and there is the code specialists that does this ALL the time, and becomes 2nd nature. I took ACLS even though I only worked in a regular floor .....and you know what? I did not use it so I forgot what I learned. thisis a highly specialized skill that needs to be used all the time ti make it a 2nd nature and respond accordingly. I see the bad part wherein the hospital will use to float nurses in other highly sensitive areas justt to fill a census and a shortage of staff in this area.....this is not good !!!! But some hospitals will do this....just rememb:nurse:er that it is your license.

mactheknife · Oct 25, 2010

I don't think you will get pulled in to ICU you need far more than ACLS to work in ICU. Having said that, you are a nurse and if you did get pulled in to an area like that you will be needed for nursing care and that is all. I have been in OR for 27 years and on the occasions that I have been sent to help in ICU it was to assist the nurses there they did all the complicated stuff and I did the stuff I knew. Relax you know more than you think. I have my ACLS and feel proud of it.