Acls Megacode

  1. I'm an RN with 9 years experience (6-peds, 4 rehab & oncology) In July I started work in a small 15 bed ER I currently have BLS, PALS, and am required to have ACLS. I came to the ER with zero cardiac experience. I've taken a rhythms course, can identify the basic rhythms. Here's where I need some input: I've taken ACLS twice and failed the Megacode twice. The first time I attended the 2 day course. Day 2, 1400 was the Megacode test. Did I mention I'm a night person? At the point I froze, I couldn't think, my brain was fried and I didn't pass.
    After a month I retook it, having received special help for 2 hours a week for 2 weeks from the clinical educator at my facility.; not to mention continuin g to study my rhythms, reading the manual, and working withan AHA 2005 giudelines ACLS simulator, The secound time I took the test , I only had to attend the second half of the day 2 as I had met all the other requirements. I came in at 1215 and there were practices until 1425 when we began the real Megacode testing. By the time it's my turn I have a pounding migraine, compounded by the stress of 1 failure, and knowing how important it is that I pass. Which I again did.
    I know the information, The format of repetitious practice and taking it (night person) late in the afternoon is not conducive to my test taking. At that point I'm at sensory overload with a migraine. I'm ready to give up.
    I demonstrated my ability to function in all the code team roles. I've asked if It would be possible for me to just come in 1 day with 2 of the instruction and do the megacode, or if I can take it online. I live in the State of Maine.
    I'm a good nurse but find by the end of the ACLS format I'm on overwire. It's not that I can't handle stress. This testing format just isn't working for me. Now my facility wants me to take the original 2 day course. Demonstrated not passing twice, I doubt that the 3rd time is going to make a difference; because it's not lack of knowledge. I'm just a person who likes to go in a get things done. all the repetition just gives me a migraine. I would greatly appreciate any helpful input anyone can give me.

    Much thanks. DBERRN
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  2. 11 Comments

  3. by   TazziRN
    There is an online course that is AHA-sanctioned, let me try to find the website and I'll be back.
  4. by   TazziRN
    Here it is: ACLS Certification, CPR Class and CPR Certification

    Check this place out, it costs about as much as a classroom course and the only thing you have to test out on is airway. You can have anyone sign you off on that, even the ER docs you work with.
  5. by   dragonflyRN
    Why did they make it so hard? I took ACLS...pretty much guarenteed I would pass. My tele experience helped. The megacode was hard...but the instructors helped to make sure you made the right decision. I think I would take it with a different set of instructors if you failed it. Unfortunatly, they don't offer anything for us night shifters and it's vary hard to convert to days...especially for a class
  6. by   MomNRN
    Just finished it this month. While there was not a "guarantee" that you would pass, they pretty much would spoon feed iyou f you needed it.

    It helped that the class took place in our hospital. Although they wanted you to know your stuff, they knew we needed to pass.

    If you get a copy of the "new, revised" ACLS guidelines, there is a really good disk that comes with it.

    Good luck to you - you can do it!
  7. by   Dalzac
    The ACLS I took wasn't a pass/fail thing. The absolute best advise I got was take 3 long deep breaths, take your own pulse first and slow down your own brain. then proceed at your pace and don't rush it.
  8. by   dragonflyRN
    I guess it wasn't guarenteed. I was scared of the megacode. I didn't have all of the answers....but I had great instructors. They didn't give me the answer, but helped me find it in the knowledge I obtained. Yes....I was spoon-fed a little bit, but I had never been in a code situation. It's been 6 months since I have had acls and I have not had an opportunity to use it. Good for the patients....I think my unit is good at preventing a code situation.
  9. by   purplemania
    AHA requires that you take the 2-day provider course if you are unsuccessful with the previous course plus one re-attempt. So it isn't your facility that is making you do that. I would recommend another facility where they don't know you and where you might be exposed to another set of instructors (ask if they are in the same training center as Facility #1. If so, they might share instructors and that would defeat your purpose). We have many nurses stress over the course, even had one guy faint, but in "real life" they are excellent nurses. They put the stress on themselves. See if an instructor from the fire dept will work with you. We rely on them a lot - good bunch.
  10. by   cthorn518
    sounds like your instructors were not helpful in helping you. I'm an instuctor and can usually tell if it is just nerves or if the student doesn't know the material. Try ACLS. It has the new algorithms and practice tests. I agree with the other reply--take it somewhere else---maybe the next instructors will be more helpful.
  11. by   BrnEyedGirl
    "did i mention i'm a night person?"

    you bring up an excellent point about us "poor night owls",.they would never, never ever, consider asking the day shift to come in for a staff meeting, acls,pals,etc at 0200,.but we are expected to be at all of them!! not sure what the answer is for that,..but i agree w/the previous posts, all of the acls classes i've ever taken, the instructor tries really hard to get everyone to pass, it is a group setting, we get to use any notes or acls cards,..don't give up! you can do it!
  12. by   Larry77
    The whole point of the megacode is to make it seem like a real-life code...I'm just wondering if you would respond the same way without instructors and with a real patient.

    I think the stress of a code situation is even higher when you have a real flesh and bone person on the stretcher. Maybe ER nursing is not for you?

    On a nicer note, I have seen very stressed out newbie nurses overcome their anxiety and become awesome ER nurses...I wish you luck in your adventure.
  13. by   UM Review RN
    i used some memnonics i found online. i don't know if this was how you were tested, but my tester would just sit there and say, "ok the patient has gone into this rhythm, what is it?" and hold up a picture. i'd say, "ok that's vt" and then he'd ask what i wanted to do about it.

    i've been to about a jillion codes and not once have i been able to determine everything that's going on, especially all that's pertinent to acls, because there's just too much going on in an actual code.

    anyhow, here's the site. use it as a basic memory trick, but check it out against current acls first to weed out whatever's no longer relevant, so you don't learn excess info. so, for instance, you have "asystole," you think pea-- "problem, epi, and atropine." this method really helped me get it organized in my mind and it might work for you. best wishes on the next try.

    acls.net acls algorithms

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