What Studying For and Taking the ACLS Exam is Really Like

By Ashley Prince, Nursing Student and MidlevelU Contributor

As a nursing student, I recently had to take an ACLS (Advanced Cardiac Life Support) course which proved to be a learning experience. The ACLS certification exam was a whole other challenge. While the material was overwhelming, I also realized it is essential to prepare me for my future role. Even though epi is usually the answer in an ACLS situation, I can't really rely on that, right? Sliding by without an understanding of the content could leave me in a precarious position as a nurse, unprepared to handle critical situations. So, I dove in. Here's a look at my experience. 

Studying for ACLS

-12 weeks away from test, learning EKG strips for first time:

“Wait, what’s the difference between bradycardia and tachycardia again?”. “That’s A fib?!”. “Longer, longer drop Wenckebach… which is a 3rd degree block…right?”. “What do you mean someone can have a rhythm without a pulse? What kind of sorcery is this?!”.

-8 weeks away from test, learning Megacode algorithms for the first time:

“Push…that one A drug-atropine? Amiodarone? Adenosine…ADENOSINE! Yeah that one”. “Shock him! Wait I can’t shock this one? That’s dumb…”. “Give ‘em atropine! They’re not symptomatic? Who cares!”. “Give epi. Why? Because epi usually is the answer”.

-2 weeks away from test, reviewing Megacode algorithms:

“Geez this code is a mess! GAWD Cristina don’t you know that you have to give epi every 3-5 minutes, not 3-5 seconds? And you don’t stop compressions while the defibrillator is charging? No wonder they call it Seattle Grace Mercy Death” (you really feel like you’ve made it when you can criticize Cristina Yang on Grey’s Anatomy, not gonna lie).

Taking the ACLS certification

-As part of the exam, you need to be the “team leader” of a Megacode:

“Crap…first one is VTach with a pulse and I didn’t study that one… um….”. “Give 600 mg of adenosine! I just killed my patient? But that was the right drug! Oh 6 mg, I really meant 6”. “Push epi! What do you mean he doesn’t have an IV? I need to say put in an IV?”. “So… that’s a bad rhythm… I forget the name… um… a little help here guys…”. “What to do next… anyone got some good ideas?”.

The Summary

ACLS is hard but despite some mistakes, all of my classmates and I passed! It does take a lot of studying and preparation though, and you really should study and prepare up until the point where you’re thinking “OF COURSE I would give 300mg amiodarone, what else would I do next, dummy?!” If not, one day you’ll be standing up as the team leader in a code, pooping your pants because you’ve done this in your head a hundred times before but just this once you can’t think of what to do. Meanwhile, the person relentlessly doing compressions is thinking “GEEZ give him 300mg amio already and tell me to switch out!”. Don't be that nurse!



Wow. This is....eye opening, and not in a good way. I can't believe the lack of knowledge and lack of understanding so proud on display.


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