Well I bet that got your attention!

I don’t really mean it. They’re obviously a lovely association and do all kinds of good things and create all kinds of awarenesses.

But one of their most recent recommendations has me and a few of my colleagues a bit angry with them.

We in CCU are required to be certified in Advanced Cardiac Life Support (ACLS). ACLS is more or less a set of algorithms to follow in certain scenarios – stroke, respiratory arrest, heart going too fast, heart going too slow, heart stopping, etc. The original class is a 2 day long affair, and you have to pass a test, and then you’re good to go. Those with this certification must renew every 2 years with a 5 hour renewal class and another test.

Our renewal class is divided up into stations. There’s a mega-code station (cardiac arrest), a respiratory station, tachycardia, bradycardia, PEA, etc. These stations provide a review of what to do in these situations, what drugs to give, interventions to perform, and most importantly they provide education regarding changes to the recommendations that we learned 2 years prior. I have never been to a renewal class that did not teach updated guidelines, because it seems like they change all the time. An example – 9 years ago (when I first took ACLS) Lidocaine was indicated for Vtach/Vfib, and then Amiodarone came on the scene and they changed the guidelines for Vtach/Vfib to include Amiodarone. (Although to digress – I renewed last May. The new guidelines weren’t going to go into effect until June 1st. So although research had shown that the new guidelines were more effective, the training center told us that they would not begin teaching them until June 1st. So we were recertified for the next 2 years on old guidelines. I’m sure this was mostly administrative – having to revamp the books, tests, etc, but it still struck me as very odd.)

Every nurse in a hospital needs to be certified in BLS – Basic Life Support. This is where we learn how to do chest compressions, rescue breathing, and the Heimlich Manuever for adults, babies and children. We have to recertify in this every 2 years as well. If you do ACLS, BLS was automatically included, and you took 2 tests at the end and got 2 separate cards.

As of June 1st, the AHA has directed that BLS no longer be included with ACLS. That it should be a separate course. The nurses I know view ACLS/BLS renewal as a necessary evil. No one likes doing it, it’s a long and boring day, you’re put on the spot by instructors, there’s a test, etc. Mention having to renew ACLS at the nursing station and you’re guaranteed to garner a few sympathetic groans. At least we got to kill two birds with one stone. Now we have to take a separate renewal course for BLS. Interestingly, I cannot find any information about this on the internet or AHA’s website. We were informed of this change through work e-mail. I have not been able to find any explanation for this change.

It used to be that JCAHO made life harder for nurses. Is the AHA following suit? I don’t even know why BLS needed to be cut out anyway – there always seems to be enough time to finish everything. What extra information are they going to give us to make up for losing BLS? How much longer are they going to make the BLS recertification process to justify making it a separate certificate? Right now it’s about 45 minutes. Maybe I would feel better about it if the change had been presented along with some convincing information on why they decided to do so.

Not a huge deal in the grand scheme of things, but it’s just one more thing we have to take care of piled on top of a bunch of other little things. And that seems to fit my blogging theme of the week.

UPDATE: I just got a letter from work. We can do a BLS/CPR course on campus and the AHA has increased the renewal course to 8.5 hours! Yippee… more time to watch the goofy stroke video and practice intubating a dummy! (I ALWAYS intubate the stomach. Always. They’ve totally given up on me.)