ACLS recertification training days are stressful. You wake up early even on your day off, feeling nervous and anxious. You pack you lunch and head out knowing you have a full day ahead of you. You looked over the materials, read through the ACLS study book, reviewed the EKG rhythms, and memorized medications the night before knowing you will be tested at the end of the day. You double check to make sure you have the pretest score sheet printed and safely tucked in your bag as this is the ticket into the class. But this is nothing compared to the actual moment when you stand over the patient whose heart in arrest, and you are “it.” You are the person who is pumping on that chest, the difference between life and death.
Few weeks after my ACLS recertification I ran into a code that took place three rooms down from my patient’s room. I was one of the first nurses to arrive with the code team. “I’ll take over, you go give report!” I yelled over the noise and chaos and resumed chest compression. What no one knew in the room was that this was my first time ever performing chest compressions on a patient.
In the last three years as a bedside nurse, it had never come to my turn in the long line of nurses lined up and ready to perform the next cycle of compressions. I have given reports, administered medications, hung IV medications, documented codes, and have run up and down the unit grabbing and delivering whatever the team needed. But I have never had the chance to perform chest compressions – to feel the patient under my hands sinking and rising rhythmically yet lifelessly in sync with each compression I delivered.
It took few seconds to realize I was counting out loudly and that someone had slipped a stool under my feet. It was as if my body knew what to do and it had been prepared to perform this life-saving action all along. What no one tells you, however, is how shaky your hands would be and how out of breath you would feel even after one cycle as you step away from the patient for the next person to resume the chest compressions. I only realized in the thick of the moment that each compression was delivered with a desperate prayer and plea to God. While my mouth was shouting “twenty-two, twenty-three, twenty-four,” my mind was screaming, ‘please, God, please. Let this work. Bring her back.’ And as if this were the turning point in my career, I was pulled into several more codes that week. But I will always remember my first chest compressions: she did not make it.
Being a nurse is difficult. It is physically demanding and emotionally draining. All jobs related to healthcare are difficult, but no one spends as much time with a patient by their bedside as do nurses. We take in all – the good, the bad, and the ugly. We take them moment by moment for twelve conservative hours. I have been slapped, punched, and kicked by angry, sad, scared, and confused patients. I am the person family members turn to when the physician walks out of the patient’s room, asking me to explain what they have just learned. I am the person family members call at 2 AM, asking for updates. And it is my hand patient’s grab in fear as they whisper, “I don’t want to die.” I have held hands of many patients on their last moments, praying they know they are not alone. I return each shift, hoping for strength and patience to be the source of emotional and physical healing for my patients.
ACLS now has new meaning in my life. I have recently become a first-time mother. Motherhood is by far the most difficult role I have ever assumed. It makes nursing seem like a walk in the park. Being a mom is exhausting and terrifying. But it is also one of the most rewarding jobs I have ever been privileged to have. But as I wade through this new chapter in my life, I can breathe with a sigh of relief knowing should anything happen to my baby, my skills in ACLS will kick in. My instinct to save my child’s life will be supported by the skills I have carefully engraved and instilled into muscle memory thanks to the ACLS courses.