ACLS, PALS and Beer

I've just knocked out the didactic and written exam portions of both ACLS and PALS. After all these years, I've landed upon an amazing truth: Emergency cardiac care education is so much better if you have an ice cold Pearl in one hand. Impossible, you say?

Utilitizing the AHA's HeartCode courses, I was able to get through all but the final portions of both classes right in my humble abode. The PALS content is delivered by CD and the ACLS course is available via online download. After successfully getting through both, here's what I think about them.

The Good:

You can stay in your house. And fast forward through a few things. And drink beer. It's even relatively inexpensive. PALS ran me just over $100, not including the skills check that I'll arrange soon with a training center. The course is mostly scenario-based, with realistic scenarios and menus that allow (require) the learner to direct each assessment and intervention.

The Bad:

While HeartCode courses are not specifically recert courses, I wouldn't recommend them for the starter ACLS or PALS student. There is enough of a challenge inherent in the computer format of the scenarios. If you don't take enough time playing with the menus during the orientation period, you could easily find yourself screaming "Chest tube!" at your laptop, all the while having no idea where to go to actually insert one. You really need to know the algorithms going into the course to minimize further difficulties.

The Ugly:

The PALS Team Concept Video. What in the world? When they hired the cast of characters to simulate an actual pediatric resuscitation, someone forgot to tell these guys that, in general, emergency providers should be the ones to bring calm to a crisis situation. I can forgive the fact that each participant has perfect hair, presumably in the middle of a busy shift, but must our speech be clipped and hurried, a la ER?

Overall, these courses were winners for me. I was able to efficiently work through them, to avoid wasting as much time on areas where I felt very comfortable, and to learn new things. Thumbs up!

The First Call-In

So I hate calling in sick to work. I also dislike people who insist on coming to work with frank toxic manifestations of infectious disease. I guess I've just been lucky in my nursing career so far and haven't had to call in often at all.

I was unlucky - oh so unlucky - earlier this week. I had a stressful weekend, complete with a funeral for friend's child, so if I felt a little off as I left work on Monday morning, I chalked it up to fatigue. Within a couple of hours of getting home, it became evident that this was a little more than just fatigue. It was poisoning. Or possibly Ebola.

At any rate, before long I knew that I would be in no shape to safely return to work that night. I wasn't looking forward to the phone call. After all, I'm still fairly new and it did seem shady. I had just left the place a short time ago appearing just fine.

"Charge nurse."

"Hi. This is EJ. I work nights and I'm going to have to call in sick for tonight."

"No problem, sir. I've got you down."

"Well, see, I--"

"No sweat, man. Feel better, okay?"

"I just hate to--"

"No biggie. Thanks for calling early. Just get to feeling better."

That was it. No questions asked. No inquisition about my symptoms. No mention of whether I had taken my temperature. No bartering about possibly coming in and just wearing a mask. Ahhh... this is the way it should be.

Over a month?

I know I need to sit down and write. It's been too long. I finished orientation at the new place and it's absolutely great. I probably run into material just about every day that would make a great blog post, but for the moment I've run into a little bit of a blogging rut.

As I said, the job is fantastic. I feel like there's constantly something new and exciting to see. There are resources at this place like I've never known before. But despite all efforts to the contrary, I trudged through orientation in a frame of mind that was... um, less than ideal.

I'll spare you the depressing details, but let's just say that I've learned a lot about surviving shifts with critical patients when my mind was anywhere but at the hospital. I know I've written about working while fatigued, but working while pathetically consumed by relationship stress can be the most dangerous of all.

But fear not... I'm now looking forward and not backward. I have a new focus on faithful friends, supportive family and a great job. I no longer "do" hot-and-cold, off-and-on, or wishy-washy. And I'll be back to write some more, just as soon as I come up with a unique perspective on something that strikes me.