Webb delineates the case for experience over hierarchy in advanced resuscitation scenarios.

1. Why can’t nurses take
command?

4. Critical Care Nurses

6. Advanced Life Support
2013 Training Requirements:
Advanced life support
The advanced life support (ALS) course must be completed during introductory, basic
and advanced training and develops advanced skills in managing cardiac arrest and
other medical emergencies. While the course covers advanced resuscitation skills, it is
also designed to develop leadership and team skills in managing such emergencies.
ALS teaches skills that are required during training and by specialist anaesthetists.
If the trainee does not attend a specific ALS course, their hospital department may
organise a similar course or study as approved by the supervisor of training. The
supervisor of training is not responsible for organising the course but should assist the
trainee.

7. The Truth…

8. Nurses and resuscitation
leadership
Source
Purporse
Setting
Design
Findings
Gilligan
et al.
(2005)
Do nurses with
ALS training
provide good
team leadership
in cardiac arrests
Five UK EDs
Prospective
quasiexperimental 57
participants in
simulated
scenarios
Lin et al.
(2009)
Is a senior nurse
more skillful at
resuscitation
1200 bed
metropolitan
medical
centre,
Taiwan
Cross-sectional
observational
study 55 head
nurses
Kirk
(2006)
Review of the
Rapid
Response Team
10 acute care
hospitals
U.S.
Literature review
Makinen
et al.
(2007)
Assess
resuscitation
skills to facilitate
an educational
program
2 University
Hospitals
Sweden and
Finland
Observational,
convenience
sample of 150
nurses
Nurses trained in resuscitation leadership
had superior non-technical skills.
Clement
s&
Curtis
(2012)
Assess the
impact of nursing
roles in trauma
and in hospital
resuscitation
Australia
Literature review
Nurses involved in trauma and other
resuscitations contribute to effective
communication, leadership and team
work, which ultimately impact patient
outcomes.
•
•
•
•
Nurse’s time to defibrillate were equal to
those doctors with ALS training.
Recommendation that experienced nurses
assume the ALS leader role where a
senior doctor is not available.
Age, work experience related to skills in
assisting with CPR.
Nursing leadership ensures clear definition
of roles and responsibilities.
13 papers
18 papers

10. Traditional chains of command
Awareness of each other’s
Non-technical skills

11. Dr Michael DeVita,
University of Pittsburgh

13. !
!
S
Should Critical Care nurses take
a leadership role in
resuscitation?
E
Y
Teach ALS and CRM
Empower
Ask
Mentor

14. References
•
•
•
•
•
•
•
•
•
Churchman JJ, Doherty C (2010) Nurses’ views on challenging doctors’ practice in an acute hospital. Nursing
Standard. 24, 40, 42-47. Date of acceptance: March 5 2010.
Clements, A., & Curtis, K. (2012). What is the impact of nursing roles in hospital patient resuscitation?
Australasian Emergency Nursing Journal.
Eastwick-Field, P. (1996). Introducing nurse-initiated management of cardiac arrest. Nursing standard (Royal
College of Nursing (Great Britain): 1987), 10(26), 46.
Foot, C., Host, D., Campher, D., Tomczak, L., Ziegenfuss, M., Cohen, J., & Nunnink, L. (2008). Moulage in highfidelity simulation-A chest wall burn escharotomy model for visual realism and as an educational tool. Simulation in
Healthcare, 3(3), 1-5.
Gill, F. J., Leslie, G. D., Grech, C., & Latour, J. M. (2012). A review of critical care nursing staffing, education and
practice standards. Australian critical care.
Gilligan, P., Bhatarcharjee, C., Knight, G., Smith, M., Hegarty, D., Shenton, A., . . . Bradley, P. (2005). To lead or
not to lead? Prospective controlled study of emergency nurses’ provision of advanced life support team
leadership. Emergency Medicine Journal, 22(9), 628-632.
Numata, Y., Schulzer, M., Van Der Wal, R., Globerman, J., Semeniuk, P., Balka, E., & FitzGerald, J. M. (2006).
Nurse staffing levels and hospital mortality in critical care settings: literature review and meta‐analysis. Journal of
advanced nursing, 55(4), 435-448.
RPN, R., & Alberto, L. (2006). Consensus Forum: worldwide guidelines on the critical care nursing workforce and
education standards. Crit Care Clin, 22, 393-406.
Stein L (1967) The doctor-nurse game. Archives of General Psychiatry. 16, 6, 699-703.