Emily Gauthier submitted 2020-10-02
I am interested in the ACLS Scholarship for Healthcare providers as a Registered Nurse in an Emergency Department. I believe I have an interesting perspective as someone gaining confidence in an ACLS (Advanced Cardiac Life Support) scenario, but not yet completely comfortable in a situation where I have to perform the skills. I am currently working under my nursing license while completing my Bachelor’s degree in nursing. I have been at my position for about 1.5 years and performed ACLS with my team numerous times.
Everyone involved in healthcare, and many other disciplines, is required to attend a BLS (Basic Life Support) course. Many, in addition, are required to take an ACLS course which delves into specific heart rhythms, medication, and different defibrillator settings. In theory, one just has to “follow the algorithm” set forth by the American Heart Association for whatever heart rhythm the patient exhibits. However, the vast majority of people never find themselves in a situation where they have to actually perform the skills. I, as I would imagine other healthcare providers to be, am someone who excels in the classroom but at times can “freeze” in real life. Because we have all taken a similar skills-based course, I would like to discuss a few things I have learned about “running a code” that they do not teach in the classroom.
The first is the concept of “the scene is safe”. The American Heart Association teaches this as the first step of BLS. A lot of times this step is missed—as healthcare professionals we want to jump in and help immediately. However, making sure the scene is safe ensures that the healthcare provider has what he or she needs to safely and effectively provide care. For example, one phrase I hear a lot lately is, “there is no emergency in a pandemic”. This is something I have heard countless times at work this year. It is the concept that you have no business running into a critical situation without the proper Personal Protective Equipment on. It goes against all of our critical-care and life-saving instincts, but if we do not protect ourselves and make sure “the scene is safe” we cannot give our patients the best care they deserve.
Another important notion is effective and vulnerable communication. If you encounter a critical situation, take a breath, calm down, and call for help. Speak calmly but firmly. It’s okay to say “I’ve never done this before”. It’s okay to say “I need to switch out after this round of compressions”. It’s okay to say “I need some help with this”. Do not take offense to anything in the moment because it is a high-stress situation for all. Communication should extend to after the scenario as well; try to find someone to de-brief with. Keep in mind that a lot of ACLS scenarios can be traumatic for healthcare professionals as well as patients and families. Talk about what happened, what you felt went well, what you thought could have been improved, and any questions that may have arisen.
The final idea I would like to talk about may seem funny at first but I am telling you in all seriousness: Find your song. If you know absolutely nothing else about BLS or ACLS, you can definitely do compressions. In fact, if you are the least experienced person on the team, you will most certainly be doing compressions. In that case, one needs to have the proper depth and rhythm. Someone will be monitoring the effectiveness of compressions with a pulse Doppler, an EKG monitor, or both. It is hard physical work to perform effective compressions. Ensuring proper body mechanics (engaging your core and glutes) takes stress off of the arm muscles, reduces fatigue, and prolongs ones’ ability to continue. In my experience, singing a song in my head helps keep the beat and helps me focus on the task at hand. Though “Stayin’ Alive” is a classic, keep in mind that many songs have a beat of 100-120bpm, you just have to find your favorite!
The only way to learn is to immerse yourself in as many ACLS scenarios as possible. There are many situations in the field of medicine that you simply cannot learn without firsthand experience. It may feel intimidating to jump in but it is honestly the best thing to do to gain competence and confidence. Some days it will seem not worth it, but with perseverance, time, and humility you can and will excel. A career in emergency healthcare is one of the most challenging, scary, emotional, but rewarding careers you could choose.