ACLS, PALS, TNCC, BLS are all valuable tools that are used regularly in my regional hospital in Washington state. As a young Registered Nurse, I always found myself intimidated by these letters and what they meant. I did not start my career in a “big” hospital but in a rural setting, where at any given moment I could be caring for six or seven medical/surgical patients, “catching” a baby down the hall, and assisting in our small emergency room. It was some of the most challenging, and at times, stressful years of my life; but they were worth it.
Nursing chose me when I was in my late 20’s. I had two small children at home and no sense of direction at the time. Lost and drifting I came across the local college pamphlet and decided on the spot what was needing to happen. I had had a lovely labor nurse with both of my sons and had often played around with the idea of nursing. My husband was a firefighter/EMT who regularly encouraged me to at the least take an EMT course. I always admired him when I was with him when he would respond to a call. He so calm and in control. So, I did it, I enrolled in college full time and got my EMT. Best decision I have ever made! It was my first term when my oldest son, six at the time, was diagnosed with type 1 diabetes. I knew at that moment on that day that I was finally on a path that had meaning.
Working at our small rural hospital brought a lot of experience and a lot of challenge. Knowing BLS inside and out was a must. A lot of the time it was 1 floor RN, 1 ER RN, 1 CNA, and a PA. That is what we had to work with when things went sideways. Fortunately, we also had a direct line to the local EMS agency, and they could be on site within 4-5 minutes. Running a code became second nature but would not have been possible with out the valuable training I had received from ACLS, PALS, TNCC, and BLS. These classes offer the opportunity to be that calm collected and in charge person that I saw my husband as. They are not easy at first, they took work and practice, but I know that I owe many a saved life to what I learned at the knee of my instructors. One of the most valuable pieces of advice I have ever received was from one instructor in my first BLS class. She said “Stay calm, this is not your emergency. If you find yourself unable to focus or unable to perform, take a deep breath and remember that you have the necessary training to get your patient through what ever scenario you find yourself in.” I still to this day find myself taking a deep breath before any life saving effort.
About five years after starting in the rural setting I made the choice to move to a higher level of care in our regional hospital. It was night and day difference as far as responding to CODES. There was a team, and my assistance was not always necessary. In a way this was a big relief and in other ways I felt like I was going to lose skills. It was not long before I moved into the ICU where all my hard-earned skills would come into play regularly and with a phenomenal team at my side. I was gaining a confidence that I never knew I was capable of. I had learned how to recognize sick/not sick from the doorway and this skill serves me well to this day, I often refer to it as a 6th sense.
At the end of the day the skills learned in ACLS, PALS, TNCC, and BLS have helped me become an effective bedside nurse. They have granted me confidence as I go about my daily routine, and they have ensured that I approach emergencies with a calmness that I never knew I was capable of. No matter how many times I attend one of these classes I always walk away with a new pearl of knowledge. I now attend with less anxiety and dread and more excitement about what is going to be covered. Practice and dedication as well as a need to be prepared for the unexpected is all you need to get through any tough situation. And when you find yourself unable to focus or perform the learned skills, just breathe.