Mallory Maxwell submitted 2020-02-22

As a certified Advance Life Support (ALS) instructor through the Red Cross, the ACLS Scholarship for Healthcare Providers interests me because it is extremely important to me to educate healthcare providers on how to respond to emergencies. To give a brief background on myself, I have been a nurse for going on four years. I obtained my Advance Cardiac Life Support (ACLS) and Pediatric Advance Life Support (PALS) certifications during my senior year of college, which I have kept renewed throughout my nursing career. My first nursing job was on a medical-surgical telemetry unit. After working there for two years, I joined the Air Force and currently work in ambulatory surgery, including in the pre-operative phase and in the post-anesthesia care unit (PACU). I am now pursuing my Doctor of Nursing Practice degree to continue my career as a Pediatric Acute Care Nurse Practitioner.

I remember as a nursing student on a cardiac floor witnessing my first code blue, meaning the patient went into cardiac arrest. It was a very scary and surreal moment in my career. I just stayed back as a fly on the wall observing while my preceptor participated in doing chest compressions. Everyone came together as a team to help the patient and they were able to revive him after a few cycles of CPR. The patient was able to continuing living because of the nurses, providers, respiratory therapists, and patient care assistants jumped into action. This may not have turned out the same way if they didn’t have the proper training. Unfortunately this wasn’t the only time I’ve been a witness or participant in a code. In both of the care settings I have worked in, I have helped in cardiac and respiratory emergencies. What I have learned from these situations is that basic CPR saves lives. I always emphasize that when teaching ALS. If you are in the middle of an emergency and can’t remember algorithms or medication doses, starting chest compressions and breathing will help save the patient’s life until a more experienced provider arrives to give further instructor.

It is hard to mentally and physically prepare for these moments because until it happens you don’t know how you or your team will respond. One thing we do as a unit to prepare is to have mock codes where everyone participates as if we are working on a real patient. This allows us to define roles and perform CPR in less stressful environment to see how we react and what we can do to improve as a team. It allows us to be confident and mentally prepares for when a real code blue occurs. Physically, CPR is exhausting. We prepare for this by ensuring we have enough responding team member that we can alternate who is doing compressions. We have a crash cart on the unit that is always readily available. We inventory it monthly to ensure there are no expired medications. The PACU is a unique setting because we work with a variety of patients, anywhere from ten months to elderly. This means we always have to closely monitor our patients and know what to expect for different age groups. Our anesthesia providers prepare the nurses by communicating effectively on the risk level of the patient when bringing them out of the operating room.

Basic Life Support is not only important in the acute healthcare setting, but it can be life-saving anywhere: at the grocery store, at your kid’s soccer game, on the side of the road, etc. I fortunately have never had to perform CPR outside of the hospital setting; however, when I was in nursing school, my friend and I had a history class together. We had just been learning about strokes in our ACLS class. Our professor was lecturing and all of a sudden it was as if he couldn’t get his words out. He was trying to read the PowerPoint and gibberish was coming out. We looked at each other and mouthed “is he having a stroke?” I immediately left the class to call 9-1-1. It turns out, our professor did have a transient ischemic attack. He thanked us the next time he was back in class for recognizing the signs. Luckily, we felt confident in our training as nursing students and we able to help our professor.

This leads me to my best advice for healthcare providers and students entering the healthcare world: be confident in yourself and your training. As healthcare providers we all learn BLS and CPR because it is the most basic thing we can do to help save a life in the event of cardiac or respiratory arrest. As stressful as this situation can be, if you are mentally and physically prepared it will be a much smoother process. You only have to get re-certified in BLS every two years. I would recommend that you review the guidelines on a monthly basis, put together a mock code for you unit, and make sure people are prepared for a real-life situation. Being educated on how to perform BLS and CPR is especially important for healthcare workers as you could be the patient’s only chance between life and death.