1. Brooke, Penny Simpson APRN, MS, JD

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I'm an experienced ICU nurse just starting a new job. Most of the other RNs in this ICU are relatively inexperienced. The hospital has recently instituted use of an intra-aortic balloon pump (IABP). We don't have enough staff to ensure a 1:1 nurse/patient ratio for patients with an IABP, and I'm the only nurse with years of experience using this technology. My colleagues got 8 hours of classroom education, but no hands-on practice.


The nurses are expected to help transport patients with an IABP to other facilities, which makes me fear a medical and legal disaster. My nurse-manager brushes aside my concerns, saying the decision to bring in these pumps is nonnegotiable. Am I right to think that 8 hours of training is insufficient?-p.l., r.i.


Yes. To safely use this technology, your colleagues need more training and experience. They must be familiar with IABP setup, operation, and troubleshooting. Your nurse-manager may not realize the seriousness of the responsibility they're being forced to assume.


Although smaller transport IABPs are available, using them calls for training and hands-on experience too. Your facility should have a protocol for transporting patients on an IABP. The company that manufactures the pump probably has an experienced person who can support the staff while they gain experience.


Put your ultimate concern-patient safety-in writing to your nurse-manager. Consider suggesting a reasonable plan, drafted by you and your peers, for giving the staff the education and support they need to safely care for patients on an IABP. Keep a copy of all your communications. If administration doesn't respond adequately, submit an event report to alert risk management of this dangerous situation-preferably before a patient is injured.