What every new nurse or nursing student needs to know about ACLS and certification

I have taught ACLS and related skills since 1980. click here to see me teaching this material in Nepal.

Okay, so this is just my opinion, but on the other hand, I have been around. Recently, a senior nursing student told me she was looking for a job on The Mainland, maybe in ICU. I asked her if she was comfortable with ACLS, and she replied “What is that, anyway?”

Welcome to the world of Initials!

On the right hand column of this blog is a link with the title “Did you ever wonder what PHTLS stands for?”   and I guess the first thing for me to say is, on that site you can find a guide to all the possible initials and credentials for critical care, that have ever been invented. Your nursing education is not over just because you graduated from nursing school, and if you want to work in something really high-tech, it is inevitable that you get some kind of qualification to do so. The Nurse’s Guide to Alphabet Soup is a great resource and introduction to all of this.

If you have to ask, it is not a good sign

I was glad she asked me before she applied for the job. When you apply for a job, the employer expects that the applicant be familiar with the requirements. If the job requires ACLS and the applicant were to give that answer, the interview is over. it will stop right there.

TIP about reading job ads

For a lot of job ads, they will list a very specific picture as to what they are looking for. If the job to which you are applying has a list, in bullet-points, of skills and qualifications, it is a good idea for your response to go right down the list of bullet-points and provide concrete evidence that you meet each one.

Back to ACLS

Not too long ago in clinical, there was an emergency involving a patient who was not “one of ours” – i.e., not assigned to one of our students. I had listened to morning report on the person, (I always listen to all the report) and there had been nothing to tip us off that he was about to have a problem.  It was nearing the end of the clinical time and we were doing our charting when the staff nurses rushed into the nurse station to get the Crash Cart. I knew what that meant, so I jumped up off the chair and followed them. The man in question was having a respiratory arrest. The staff nurses called for the Code Team to arrive, and in the meantime I took his carotid pulse, while the staff nurse got oxygen going and started bagging. Then I helped hook up the chest leads for the heart monitor, get the hard surface under him, get an IV started, etc.

Some students had trailed me into the room and stood in the corner, watching this unfold. The man survived and was transferred to ICU.

Naturally, the post-conference was dominated by discussion of this  event. One student said; “I want to know how to get a nursing job where I do that?”

Oh, to be young again…..

Be prepared for a pearl of wisdom

Here it is: the goal is to not do ACLS if you can avoid it. Act before the person has a cardiac arrest. The goal is to identify in advance, every situation that might deteriorate in to an arrest situation, and to convene the Rapid Response Team to address the issues before the patient’s breathing stops. The more clever you are at this, the better the nurse you will be.

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The fact is, we are conditioned by medical TV shows to think of the dramatic aspects of health care, the high tech response that salvages somebody who is right at the very Brink of Death, staring into the precipice of Doom. The TV shows emphasize the heroic nature of this work, and the rest of us overlook the depersonalization that comes with high tech medicine. It’s exciting and glamorous.  Most of health care is not actually like that, though, and the dramatic events are followed by a long recovery in which attention to detail is needed and progress may be slow.

For that reason, when nursing students ask my advice about doing critical care, I usually try to gauge their ability to make and use a Nurse’s brain, and to perform diligent physical examination, along with their maturity level. Excessive enthusiasm about using ACLS skills, as if it is the only thing that happens in critical care, is actually a sign of inexperience.

Oh, and by the way, the man at clinical did just fine and was discharged from ICU after a day or two.

What do you think? I promise to answer any questions related to this topic…… fire away!








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8 responses to “What every new nurse or nursing student needs to know about ACLS and certification

  1. Future Nurse

    I suppose ACLS simulation in nursing school really does get the “glamour and glitz” reputation. We get to practice our reaction to high stress situations with a random team, playing novel roles. On one hand we get to apply what we have been taught. On the other hand, we see that the most valuable skills cannot be taught. However, one’s dreadful performance to these situations does not necessarily doom us for a future in such roles. A wise woman once told me that we all “freeze.” At one time or more, she said, it will happen to you. With that said, having the motivation to get up, keep going and put a lesson in your pocket to be a little more effective next time is key.

    As is stated in the blog it is true that prevention of ACLS situations is the ultimate goal. While some healthcare workers may be fascinated with playing with a new life saving toy/procedure, or love the rush of the crisis to wake them up from a dull day or distract them from their personal lives, we do need to remember that the patient is someone’s family, whether a child, parent, brother, sister, etc. The nurse with a watchful eye often does not get the credit that the person doing CPR gets, even though they both save lives…. One just does it while maintaining intact ribs.

    • precisely and exactly.

      you “get it”

      to the un-initiated, it looks like the persons doing the arrest procedures are really brilliant. They are not ( okay well, sometimes they are…) but what they *have* done is to practice the scenarios over and over. go to my YouTube nd you can see how I taught this same material in Nepal.

      and, in simulation, you CAN”T KILL THE PERSON, which is a trememndous advantage of that mode of learning….. ( why can’t you kill them? becasue they are NOT REAL, that’s why!)

  2. Justin

    I’ve heard from two different nurse managers that having my ACLS certification before I start job hunting will improve my marketability. I’ve already signed up for basic EKG and will sign up for the ACLS pharmacology course here in a few days, both pre-reqs for the ACLS course at the large local hospital here.

    I get that the goal is to not let your patients reach the point of needing ACLS. But from the point of view of a soon to be grad and entering the desperate to find a job category, I need any and all initials I can get.

    That’s my 2 cents. FWIW.

    • I will give you credit for knowing what ACLS is, at least.

      And now, Grasshopper?

      There are only six rhythms.

      It’s true.


      Your ecg guru

    • okay. You want to be able to show that you are motivated to learn above and beyond.

      Here is my pitch about ekg: some courses are waaaay better than others. check the ratio of lecture versus guided practice. if the teache rmainly lectures but you only get to interpret a strip on the quizzes, that is not a good course. if they teach and model the six step method, then the thought process, the critical thinking of ecg, becomes front and center. if you have a good thought process as to how to appraoch ecg, you can still glean valuable info about the underlysing physiology even if thee are parts of the strip that are troublematic.

  3. FutureRN

    This is a great article. I recently had a conversation with a nurse manager who said she loves seeing that list of initials on new graduates resumes – BLS, ACLS, PALS. She said the first thing it tells her is that this person recognizes that their nursing education isn’t limited to their school classrooms or clinicals. The education doesn’t end when at graduation. It continues with advanced training, certifications, CEU’s and so on. She was quick to point out something that hadn’t crossed my mind. The cost factor. We prefer to focus on the patient care aspect of medicine – not medicine as a business but we know in many ways it is. She said at times the resume has to get past the people working in HR before it lands on her desk. For some hospitals, when they see those credentials it’s one less certification the hospital has to pay for or reimburse with this new hire.

    One of the biggest things I took away from ACLS was the importance of teamwork. We talk about it, we know what it is but putting it into practice isn’t always a smooth process. Having seen an ICU code where everything was chaotic, people were fumbling for items and everyone seemed to want to direct the code but no one had a BVM ready, it really brought home that message of team work. Our instructors were great at focusing us on both the things we as nurses can do on our own before that crash cart arrives/emergency team responds but also how you function in a group of people. Who’s leading the code, having things prepped so it’s ready when they need it and making sure that you’re working in a role which you have the skills and are prepared to work within.

    • I absolutely agree with the idea of teamwork, so glad that was your takeaway lesson.

      You don’t have to save the teamwork for an arrest situation. Us it all thew time. I think I may write a future blog on this subject. It’s already been a theme but it can benefit from more

      thank you for commenting


  4. Pingback: Nursing student advice – are you an adrenaline junkie? | Nursing in Hawaii

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