How I Survived ACLS

Before I begin to describe how I survived ACLS let me remark on the impact of the initial American Heart Association ACLS class in the early 1990’s

As the owner of Nurses Educational Opportunities, a recognized American Heart Association ACLS, BLS and PALS certification provider, I have come across countless of veteran nurses who remain scarred, particularly, by the first-ever Advanced Cardiovascular Life Support class (ACLS). In fact, the trauma many nurses experienced inspired a T Shirt with the statement, I survived ACLS. Aside from my own experience, I often ask nurses what is was that made ACLS so difficult. Reasons why nurses find the ACLS course difficult include:

• The EKG Interpretation portion of Advanced Cardiovascular Life Support.
• Testing for a class that is hardly utilized in a specific field.
• Having physicians teach the course.
• Further, having to perform skills in front of the entire class while being berated by instructors.

ACLS comes with a TON of responsibility

Most notably, there is a high expectation that if you are in a cardiac arrest situation, you should know what to do. At that moment of a patient’s care, you need to be confident in your knowledge and skills for the reason that someone’s life is on the line if you are not prepared.

Nurses Educational Opportunities understands that not all nurses required to complete the AHA ACLS class actually utilize ACLS. Nonetheless, all nurses, regardless of their chosen field, must be aware of CPR and Advanced Cardiovascular Life Support practices. Rather than teaching a course to get nurses through the day, Nurses Educational Opportunities works hard to facilitate the information to promote long term retention. This is what makes our organization unique. However, not every nurse receives the ACLS experience they deserve. In fact, neither did I prior to opening my own continuing education center. Here is my story.

The story of how I survived Advanced Cardiovascular Life Support

On the Telemetry Floor, there was Pam. Pam was our charge nurse. She was our matriarch. When she was in charge, all was good. If ever our patients began to deteriorate, she was right there helping us to stabilize the patient. After report she always stated, “OK you guys, let’s GO and SAVE LIVES.” Because of Pam we had the glue that kept us together.

One day the “higher ups” sent a memo to the Telemetry Floor announcing that we were to become certified in the dreaded AHA ACLS. We looked at each other with shear fear. “What are we going to do?” we asked each other. Afterwards, we learned of a good ACLS presented at Pomerado Hospital. Therefore, we all decided to sign up for the Pomerado Hospital’s Advanced Cardiovascular Life Support course.

When we arrived at the hospital we saw nurses sitting on folding chairs in the middle of a large room. As we approached to find a chair the other nurses said, “You’ll have to get your own folding chair from over there,” pointing to a stack of folding chars. The cluster of nurses grew larger in the middle of the room. A woman appeared and made her way to the middle of the cluster.  She began to speak, “If I say something three times, it is a test question.” Subsequently we began to listen.  Our pencils poised to our notebooks on our laps.

Soon there after….

After a dreadful lecture we were given a break then we were to return for the “skills labs.” The first skill station was determining EKG rhythms. Tables and chairs lined the room. We sat facing a large monitor at the front of the room. An instructor prompted when the bell rang a rhythm would be presented and it was our job to determine the rhythm. They had given us 10 seconds to identify the rhythm before the bell would ring again and another EKG rhythm would appear. There were about 25 rhythms to identify. Next, we were instructed to place our answers on the score sheets provided.

We then progressed to the Airway Skills Station. Manikin heads lined up along a long table. Everyone went from head to head and demonstrated placement of oropharyngeal and nasopharyngeal airways as well as bag/mask ventilation. Last we had to demonstrate ET tube placement. Upon completion of the skills nurses who successfully performed became “checked off”.

Finally…

Afterwards, we were directed to another building for our Mock Code Simulation. Upon arriving at the designated building we had to line up single file at the door. By the time I arrived the line extended down the side and around the building. Like lining up to get into a theater. Inside the building we were told that there were three stations. Each station had an instructor to evaluate the nurse on her ability to call the code and recite the interventions of what the instructor was prepared to “nail us with.” We stood in line a long time.

“Hey, someone fainted.”

While in line, someone alerted the line “Hey, someone fainted.” I stepped out of line to see who fainted. IT WAS PAM!!!

As Pam neared the entrance of the door, she panicked and passed out! Holy Cow, if Pam panicked, “What in the world was behind the closed door?”

Trembling I entered “the room.” But the instructor was kind or just plain weary from all the nurses to be checked off and I PASSED my first AHA ACLS class!!

The goal of this entire event was to inject FEAR. They succeeded this with even the strongest, Pam!!

Becoming a BLS Instructor

Soon I returned to the Telemetry Floor with a bright and shiny Advanced Cardiovascular Life Support card full of confidence and renewed energy. The CPR Coordinator, Cindy,  sent out a Memo that stated she was hosting a BLS Instructor class for RT’s and if any RT was interested, they should sign up. I wanted to take the class but I wasn’t an RT. I asked Cindy if I could be part of her BLS Instructor Class. “NO,” she snapped, “It’s just for my RTs” “Please” I said,” “No” she snapped, “I said it was just for my RT’s.”

I’m kinda a persistent chick, “I’ll try again,” I thought. A week later I approached Cindy again. “Please, please, please, Cindy can I be in your BLS Instructor class?” “No” she again snapped, “I told you that the class was just for my RT’s” “Please Cindy” I said. “I said NO,” she barked.

However a week or so later, Cindy sent a Memo to the Telemetry Floor stating that she was planning to place a manikin in a bed in a patient’s room. When the nurse assigned to this patient arrives, Cindy would be sitting in the bedside chair and evaluate the nurse on her skills to “Call the Code.” I had a plan.

Putting the plan in play

Meanwhile I told the charge nurse “Pull that little scheme on me” “I would shine.
“I would make our unit look good, but I have only one request,” I said. “Pull it on me next Tuesday, I will be prepared,” she agreed.

Tuesday came and I was prepared.  Reporting and ready for the floor. I Noticed all nurses seemed to be extra quiet. However, I knew why they were quiet. On the other hand they didn’t know that I knew what was about to happen. Down to my last patient I took my report. The report stated: admitted last night from the ER with ‘chest pain and bla bla bla.”  At that point I knew that was the manikin and Cindy was waiting at bedside.

Pulling back from my chair I announced “Everyone have a good shift.” Still there was silence. I approached the room to find the door shut! No one ever shut the patient room doors. There was a feeling of nurses watching me. I opened the door. There was Cindy. Without looking at the bed I said, “Well Cindy, welcome back from vacation. How was your vacation?” “Fine, Jane” she said, without a smile. I then looked at the manikin in the bed and jumped into action. “Are you OK, are you OK” as I placed my hands on the manikin.

“Code Blue, Code Blue.”

Then I went to the door and bellowed “Code Blue, Code Blue.”  I returned to the manikin and began chest compression’s. A nurse came to the room and I told her to Bag the Patient. When another nurse arrived and I told her to hang a big bag of normal saline. Next nurse arrived with the Crash Cart and I told her to hook up the patient to the monitor. When he last nurse arrived and I told her to draw up 1mg of Epi.

Cindy gets up from her chair and says, “Well Jane that was pretty good.” “Thank you, Cindy” I said. As Cindy was leaving the floor, I said “Now can I be in you CPR Instructor class?” “I’ll see,” she mumbled and hustled down the hall with her heels clicking on the hardwood flooring and her white coat flapping the breeze. That afternoon Cindy came back to the floor and said “I’ll let you in my BLS Instructor Class.”

“Holly crap!” all that just to take a BLS Instructor class!! But, I had become proficient on  how to call the code and designate the task in a Code Blue. Thus becoming a BLS Instructor.

On to becoming an Advanced Cardiovascular Life Support Instructor

Some time after, the CPR coordinator was later replace by Shelly.  Shelly was an RN that I had worked with on the Telemetry floor.  I found Shelly in an office area of the accounting room – no more room than a closet! Shelly didn’t have the spacious office space that Cindy had. “Shelly,” I said “this is your office?!!” She looked up at me and curled her lip and frowned “I guess.” “What can I do for ya” she asked. “I would like to take your ACLS Instructor Class,” I remarked. “Sure,” she said. “Holy Cow,” I thought, “that was easier than signing up for BLS Instructor class.”

I took Shelly’s ACLS class for instructors. When she taught she made the class so fun yet “learn-able.” When she presented the Code Blue call, I remember her with a long over-sized patient robe running around like Abbott and Costello. She was funny, as a result her class was enjoyable. “When I teach ACLS,” I thought, “I want to make my classes enjoyable.

Soon there after I became a skills instructor in her classes. Occasionally she was ask me to help instruct along side her.  In conclusion I made myself available for her classes.

When working on the Telemetry Floor, we were often asked to “float.” No one liked to float. But I stepped up to the plate when the Charge Nurse announced “Who wants to float to the NICU?” “The NICU is a place where nurses are warm and fussy,” I thought. I floated to the NICU many times and determined this may be a better place for me. When an opening became available in the NICU, I applied. They knew me and I knew them.

Progressing to the NICU

In the NICU, I had to take NRP (Neonatal Resuscitation). I passed NRP and again wanted to become an instructor for NRP.  The matriarch of the NICU, Marty seemed to have doubts of my ability to teach NRP. Marty was the Queen of the NICU. She had wrapped up 35 years in the NICU. She knew everything. Marty reluctantly agreed to check me off on my presentation.Marty observes my first NRP Skills course.  During the session I became really frustrated because Marty consistently interrupted with her own thoughts. I became so disgruntles with so many interruptions, I said in complete frustrations “You teach this damn class, you seem to want to anyway.” Marty sanctioned me as an instructor! “OMG how did that happen?”

During my NICU experience, Cindy called. (Remember Cindy, the CPR Coordinator?) She wanted me to assist her with a PALS (Pediatric Advanced Life Support) class by checking people off on their skills for NRP. I accepted and off I went to assist Cindy. PALS seemed difficult. I began to entertain the idea of becoming a PALS instructor. Since I can’t remember how I became sanctioned for PALS, it must have been uneventful.

Transitioning from NICU to NEO

Once I became an of NRP, BLS, ACLS, PALS and ACLS class instructor. It was my goal to leave that hospital and open my own Training Site. My Training Site, Nurses Educational Opportunities.

I asked Shelly, (remember Shelly? The CPR coordinator) if she would suggest if anyone needed any of these courses to refer them to Nurses Educational Opportunities. “No,” she said, because we refer all of our Healthcare Providers to “The Boys.”

“The Boys”

“The Boys” were a couple of “dudes” that presented ACLS all over Southern California. Thinking it would be a “good idea” to call these “dudes” and ask if they would allow me to align as at Training Site under their Training Center. When I called I talked to John and he suggested that I attend the class they were going to present in San Diego and speak to them in person. “I’ll be there,” I said.

There were at least 100 Healthcare Providers there getting certified for AHA Advanced Cardiovascular Life Support. “The Boys” had about 10 instructors situated around a large room checking off students. At the entrance of this room sat a large dude. Typing cards and taking money, he was one of “The Boys.” I introduced myself and told him that we had an appointment to chat about alignment. Looking up at me and said “I’m busy right now.” “I’ll wait I replied.” I sat in front of him while I waited – so he wouldn’t forget me. As I waited I observed an instructor, one of “the Boys”, check off another nurses ACLS skills.

The nurse had her head down as the instructor was barking questions at her.  He barked “You think about that, I’m leaving and when I come back you better know the answer.” The nurse stood there in silence with her shoulders hanging to her knees. The instructor returned and barked the question again. She didn’t know the answer. He left again and told her she better know the answer when he returned. She still didn’t know the answer. Sometimes I wonder if she is still standing there! Probably not, but I’m sure she never took ACLS again. “Why does everyone make this so difficult and scary,” I thought.

“Other half” of “The Boys.”

As I’m waiting, the large dude gets up from his chair and leaves. “I’m sure he will come back he knows I’m here,” I thought. He didn’t come back. A skinny dude approached me by the name of John. I said “Thank-you John, all I want to know is if you can align me to your Training Center.” he handed me a card.  John said “No we would not be able to align you but this is a name of a Training Center that might be able to do that.” I grabbed the card and left.  Boy was I mad, I took a day off just to have “The Boys” treat me like the “scum of the earth.”

Heart Start

When I got home I called the name of the card, Heart Start.  They were an American Heart Association training center known as Heart Start. They aligned me!! I was aligned I called the “big dude” on the phone “How dare you just leave me sitting there. I took a day off from work to meet with you. You just walked away from me!”  I really let him know what a jerk he was.

Time passed I had overheard “The Boys” were no longer in business! “Good Lord,” I thought “what happened.  The American Heart Association researched all instructors they discovered “The Boys” never took an AHA Instructor class.  “The Boys” were not sanctioned to teach ACLS! Think about that, “How many Healthcare Providers did “The Boys” sanction and all those ACLS cards provided by “The Boys” were invalid! All of those Healthcare Providers with cards from “The Boys” had to take an AHA ACLS class from a sanctioned provider.

“My Business Exploded”

Nurses Educational Opportunities had an alignment with Heart Start an  American Heart Association Training Center. I began to teach ACLS/PALS/BLS and NRP. I figured if my classes were enjoyable, I could be successful.

A year or so later, as I was teaching an ACLS class a large dude saunters into my class late. I said, “Hi” and he turned and looked at me.  “I think we know each other.” I announce to him.  He mumbled “No we don’t, we’ve never met.” I knew exactly who this large dude was. He was one of “The Boys.”  “Oh yes, we do know each other, I need to see you in my office,” I said.” Of all the times Nurse Mangers dragged me into their office and told me to “Sit down and close the door,” I got my chance to do the same.

In conclusion, I hope that you, the reader, finds an ACLS class taught by passionate instructors. I feel empathy for the healthcare provider who doesn’t receive the ACLS certification they deserve. However, nowadays there are valuable resources such as Yelp, Facebook and Google to research reviews. We wish you luck and be sure to study for your upcoming Advanced Cardiovascular Life Support certification in class or online course.