Taking ACLS Class Tomorrow...

[westieluv]

I have been an RN for over 22 years, but I have never had more than my BLS certification, because I never worked strictly on a cardiac floor. However, I recently got hired by the internal agency of a large hospital system and one of the requirements is ACLS certification. I am taking the 8 1/2 hour training class tomorrow.

To anyone here who has taken this class and has their ACLS certification, do they walk you through the content pretty thoroughly before testing you on it? I have this irrational fear that I won't be able to do it, mostly because of those long algorithms and all of the various cardiac meds. Common sense tells me that, having been an RN for all these years and having done just fine, even when one of my patients coded years ago and other times when I noticed cardiac and/or pulmonary problems and got them transferred off the unit, I will be okay, but there is this nagging little worry that I just won't be able to do it.

Help?

[turnforthenurse, MSN, NP]

I think you should be fine. They do suggest that you read over the book prior to taking the class, though. ACLS isn't a dysrhythmia course - they will expect you to know your cardiac rhythms. Know your ACLS drugs and dosages. Typically an ACLS class is split into two days - the first day if the review and the second day goes over your skills. I did mine in one day and it ended up being nearly 12 hours. We broke off into groups and were tested on BLS skills and NPA/OPA selection/placement. Then we went to the different algorithm stations - one for tachyarrhythmias, bradycardia, and of course the megacode. For the megacode portion, each person takes turn being the team leader so you have to your team members what drugs you want to give, when to do the rhythm check, when to shock (if the patient is in a shockable rhythm), consider your H's & T's and then go over the ROSC algorithm.

Remember for your tachyarrhythmias and bradycardia algorithms, always determine first if the patient is stable or unstable.

I think you will do just fine! Good luck!

[Do-over, ASN, RN]

GO through the book, know shockable vs non-shockable rhythms, H&Ts, and yes, stable vs unstable is important. KNow the drugs and dosages - there are only a few.

I just renewed, and it took one day.

THey want you to be successful, so just prepare beforehand and you should be fine.

[westieluv]

Thanks for taking the time to reply. Sounds like I need to study some more, but you have put my mind somewhat at ease, and I appreciate it.

[akulahawkRN, ADN, RN, EMT-P]

ACLS is, as they said above, not a dysrhythmia course. There are only about 10 rhythms that you need to know. It basically boils down to: too fast, too slow, wide, narrow, or asystole. They have really simplified the course over the past few years, down to that. I've taken the course a few times, but I need to renew my certification soon. At some point it becomes essentially a merit badge.

Just know the rhythms, the ones in the book, and look at the algorithms. You will find that it pretty much boils down to that: fast, slow, wide, narrow, flat line. The post resuscitation guidelines are going to be a bit different, but nothing that should throw you sideways. Also just know what rhythms are shockable and which ones are not, and know the dose of electricity needed with each shock. Honestly, ACLS is really not that hard.

Just do some reading, get some good sleep, take some snacks with you, and enjoy the learning experience. Very few people fail.

[westieluv]

Thanks for all of the kindness and support! I wanted to report that I passed with a 98%. Our instructor was AWESOME and I learned so much from him, but most of all, I now have a lot more confidence in my ability to care for cardiac patients.

Thanks again!

[akulahawkRN, ADN, RN, EMT-P]

Good job! What you now possess is another ticket to learning! Use it wisely, and always strive to learn something new, something that you didn't know before, in your daily practice. And if you take the course again, or participate in working some codes, take a second in to grab the total picture. If you took it with some Paramedics or some other experienced providers, I hope you had a chance to observe how they run the codes. As you participate in codes, take that same time to observe how those are run and see if you can find ways to improve upon that. You won't bring 'em all back, but you can learn, improve, and you'll know it wasn't because you did something wrong, they were just too sick, if you lose a patient during a code.

Also, I hope you keep your eyes open and learn what the pre-arrest patient "looks" like... it's far easier to prevent a code than it is to work one.

[westieluv]

Thanks, Akulahawk, for your reply. Actually, I have to say that my pre-arrest observation skills are pretty good after 22 years, which is one of the reasons why I have never been in a code--I know when to call a rapid response and get them out of there and off to critical care before they get to the code stage, thank God! My main concern was knowing what to do during an actual code situation, since I had never been in one or seen one on any of my patients. There have been codes on floors where I was working, but you know how it is when it isn't your patient and the entire code team is present, you just kind of stay away unless someone asks you to help, which has never happened to me.

Thanks again! : )