A different type of ACLS renewal question

[Perpetual Student]

Very recently I lost my only close family member, my mom. I arrived home from work to find her dead, after having talked to her during my lunch break that afternoon. She was feeling fine when I spoke with her, and appeared fine when I left that morning, and had no acute illnesses (well, she said her sinuses were bothering her :l ). She did have a significant history including MI, DM, smoking, and the usual suspects that go along with that. It was definitely unexpected, though, as she was still shy of her 60th birthday.

She was still warm and I didn't want to accept what was readily apparent based upon my assessment. I did a round of CPR and then pulled the phone out of her pocket to call 911. Long story short, never observed a rhythm other than asystole, and probably for the best given the fact that she doubtlessly was down long enough that there was no chance for a good outcome. The ME declined the case, so I'm not really 100% sure what the cause was, but my best guess is an MI based on her history and the sudden nature.

Anyway, I have a feeling that when it comes to doing compressions and what not during my ACLS renewal this week I'm going to have a hard time not breaking down in tears. This certainly wasn't my first rodeo, but it's my first experience with losing someone I love (I've lost other relatives, but I've never been close to any other than my mom). Whenever I come home I cry like crazy.

Does anyone have any ideas regarding what to do to minimize my chances of losing it in class? Not taking it is not an option, as I've got to renew by the end of the month or get suspended. If I were working on a real patient he'd be my focus and I'd not break down (at least not during the situation), but when doing the whole pretend thing I think it's gonna be tough. I don't want to sob uncontrollably in front of a room full of strangers.

If I am struggling to compose myself due to remembering what happened, what would be the best way to express that so they don't just tell me I fail? I am familiar with all of the algorithms, knowledgeable re: drugs and rhythms, competent in the relevant skills, etc. I'm not sure I'll be able to perform 100% in a simulation, though I'll certainly give it my best. I'm sure I'll do fine on the written test.

[Dixielee, BSN, RN]

I am sorry for your loss and what you are going through. It is never easy to lose a parent and you always feel a hole in your heart. If you must take ACLS now, you may want to speak with the coordinator of the class and give a brief synopsis of what is happening. You can take your written test and other stations before the "megacode". You may want to get the code over with early so you don't think about it, but if that is the only thing left, it will show that you were prepared.

Also, when I have taken ACLS, the person being graded is running the code but not actually preforming each task. You shouldn't actually have to put your hands on the manikin to simulate CPR, but direct someone to do so like you do to give meds, start line, intubate, etc. This may help take some of the emotion out of it, but if your instructor understands your situation from the beginning, they can be more sensitive about it.

It takes a long time to grieve. I know you don't want to cry in front of your co-workers, but you are a human being who suffered a great loss, not a robot who can turn off and on at will. At one time or another, we all lose a loved one, so you are not in this alone.

May peace be with you as you travel this lonely road.

[Morainey, BSN, RN]

I'm very, very sorry for your loss :hug:

[ClearBlueOctoberSky]

:hug:

I can't add anymore than what Dixielee said. Talk to the instructor before class, just to let them know what is going on. Sending lots of positive thoughts your way.

[Double-Helix, BSN, RN]

I'm very sorry for your friend. As nurses, we learn to professional distance ourselves during emergency situations at work. When it's a personal situation with a friend, it's a totally different ballgame. :hug: Take care of yourself. It sounds like this is really causing you some stress. Is there someone you can talk to? Is it possible to take some personal time off work?

My suggestion would be to sit toward the back of the class. If you have to excuse yourself at some point to go to the bathroom and compose yourself, then do so.

I agree that it would be helpful to explain the situation to the instructor of the class prior, if that's something you're comfortable with. While you might not have to do CPR during the megacode, I did have to demonstrate that I could correctly perform CPR on a mannequin prior to the megacode testing.

Best wishes to you. You might find that when you're in the class you are able to revert back to "professional distance" mode and keep your mind on the medical task, rather than thinking about your friend. I hope so. Thoughts and prayers for you.

[Perpetual Student]

Thanks for the kind words everyone. I definitely will let the instructor know in the morning before the class kicks off.

Taking time off work probably wouldn't help. Now when I'm not at work I mostly find myself alone in the house I just bought for the two of us, which now seems enormous. I went to work the very next day, which was in the middle of a 13 day stretch. I have no problem doing my job, and it brings me comfort. I believe Dixielee is correct: it's going to take a long time to grieve. If I stop working and leading my normal life I don't know if I'd ever be able to get back in rhythm.

The only problem I have with this class is I might not be able put on my mental nurse hat, because there won't be a real patient who needs me. There also won't be my extremely awesome and supportive colleagues.