Quote from yesdog
I am a new grad and landed my dream job in the SICU of a level 1 trauma hospital. It has been an incredible experience! However, I am freaked out. On Tuesday we will be running ACLS megacodes. Our nurse educator said we need to know all the algorithms without hesitation. YIKES! I have my ACLS card, but I basically just learned enough for the exam. Anyone have any suggestions for learning them AND remembering them? I googled, but all I find are learning aides for old versions of ACLS. I appreciate any help I can get! Thanks!
The truth of the matter is that you can kill yourself trying to memorize algorithms but it's only that---book learning by rote. The odds are all of what you have spent hours memorizing will blow out the window when the real thing happens.
Learn the meds and what they do. Learn WHEN you are supposed to use them and, just as important, when they are contraindicated. Learn your shockable rythyms.
IMHO your instructor is a bit of a bully and is being unrealistic and counterproductive.
Reminds me of when I took my first ACLS many moons ago, when dinosaurs roamed the earth and defibrillators were hooked up to lightning rods. The instructor was an EMT whose head was so big his ears scraped the sides of the doorway when he entered the room. He was more interested in showing us how much he knew and showing us how much we didn't know than he was in seeing us learn anything. He was an ass. And this was back in the days when you could actually fail ACLS so we were all pretty much terrorized. Yep, pay your money, fail, and walk out the door with nothing. I passed but a few did not.
You're not going to be running codes any time soon. As a member of the Code Blue team I can assure you that it will be a long time before you will be expected to be anything but a go-fer during a code. It depends on your facility, of course, but you might be expected to push meds if you are the patient's primary nurse. If you are the primary nurse please step up and offer information about the patient---why he's in the hospital, recent surgeries, co-morbidities, whether he's received narcotics, anything you think might be important.
Offer to be the recorder, note the clock, the numbers of amps of epi and atropine (especially atropine), the defibrillation joules, the gtts that are running.
The really messy codes usually involve difficult intubations, tracheotomies, chest tube insertions, TVPM insertions and of course traumas and surgical patients who are bleeding out while they're coding. The most awful, IMO, are the codes in L&D that require c-sections while the mom is coding. You won't be a major player or decision maker in these for quite a while.
Mega-codes are nice and neat and all the "patients" live. It's so much easier to yell out the next step in an algorithm when you're not slipping in a blood slick and the patient is not vomiting into the ETT. You always have really good venous access with the ACLS dummy, they never weigh 500 pounds, and they're always found neatly on their backs (never wedged between a toilet and a wall, lying in a pool of liquid stool). Ahh, just reminiscing here..
Advice? Learn what you can, learn WHY we give the meds when we do, why we shock when we shock and why we don't shock when we don't shock.
The algorithms are a natural progression once you understand the basic mechanisms of the arrhythmias, the actions of the code meds, and the purpose of defibrillation.
Good luck and don't beat yourself up over this.