Thursday, June 4, 2009

CPR Recert

Every year or two (depending on where I'm working and what the rules are) all nurses have to recertify CPR (more accurately BLS, basic life support). This is a something I have done every year since CPR was invented and it became illegal to allow people to die a natural and dignified death without pounding their chest and breaking a few ribs. Something to think about when you have decisions to make about familiy members, I can tell you.
Back in the early 70's, things were sometimes a little unclear as to who got CPR and who didn't, but we all learned it anyway. I worked as a nurses aide (now called LNA's or licensed nursing assistants) for a year out of high school before I went to nursing school, but that is a story for another day. Anyway I think the first CPR class I attended was in 1972 or '73. That's a helluva long time to be poundin' away on the dummy every year or so. It was a lot more complicated then, now it's pretty streamlined.
The first time a patient died on my watch was when I was a puppy nurse, out of school less than a year. I was the 3-11 charge nurse on a 40 bed rehab floor, although they were mostly chronics; brain injured individuals without much rehab potential and things like that. It was kind of a nursing home floor really. I was the only licensed individual, but oddly my 3 year diploma program which people are so condescending about prepared me for a leadership position 3 months out of school when the average ADN and BSN students were still in orientation. That's not a slam, just a statement of truth.
I was feeding an elderly woman, I'll never forget it, mashed potatoes. Some of it dropped onto her lap and I had lost the napkin. I stepped out of the room to the kitchenette across the hall and returned in about 20 seconds. She was gone, sitting bolt upright and holding onto her spoon as if she planned to continue using it. I did have to do post-mortem care with the policy book propped open on the bedside table. One of those life experiences I guess. But CPR? It was a rarity at that place.
I taught CPR for about 15 years later on and got pretty well burnt out doing it. I taught scouts, dental offices, teachers (they are the worst for performance anxiety), business offices, restaurants, EMS, and the usual hospital inhabitants of nurses, respiratory therapists, lab and xray, unit secretaries, EKG techs and doctors of course. Doctors were the worst because most of them a)sucked at it and b) just weren't interested in doing it right at all. I guess that was OK, during a code you would much rather have a doc who knew their ACLS (advanced cardiac life support) shit than BLS. Nurses and EMT's mostly did CPR anyway; Call me crazy, but I thought it was important for the docs to know proper technique so that they could evaluate CPR in progress for effectiveness since they are the ones running the codes.
I don't mind jumping through hoops as long as they are reasonable. I'm not a young woman anymore, and the knees just won't tolerate being on the floor slaving over a hot CPR dummy. The education team had kindly provided cushy mats to ease the stress. The child and infant mannequins were on tables for our convenience, also a plus. As far as I know we were all nurses, EMT's, paramedics. The last thing we want is someone who has never performed one minute of CPR in their lifetime on a living person nit picking the depth of compressions. You always know who they are because it goes something like this:

"You need to make a tighter seal" or "You need to compress faster" or "You didn't yell help" or "You forgot to blah blah blah blah".

Sigh. It was the same today, there is always one yutz in the pack who pecks away at every minuscule detail and holds up the entire line.
I'm happy to tell you she had nothing to nit-pick with me (smug expression).
I waited for my turn behind a new EMT, young, probably about 11 years old judging by the look of him; they get younger every year for some reason. The poor kid had to perform after he became completely unnerved by the young woman in front of him.
The very attractive young lady had on white capri's made out of some interestingly rather sheer material; unfortunately she was obviously wearing a thong (blue).

Picture this; if you have never seen CPR performed, go to Youtube and try to imagine what this poor young EMT had to witness. Think about this attractive young woman with her back to us, kneeling next to the mannequin in her see-through white capri's, pumping (yes, pumping) from the shoulders and bending at the waist. Up, down. Up, down. Up, down.
Are you getting a mental image? Good, because that was likely the only image in the EMT's head as he fumbled through his demonstration. He left rather quickly afterward.


So that's CPR for this year, now I'm all set.