Portland Community College | Portland, Oregon

A Class That Comes From the Heart

Photos and story by James Hill

by James HillAn anxious nurse hovers over the patient. He reads the defibrillator. The vital signs are dangerously low. He decides to give the patient oxygen and begins to identify rhythms on the display panel. Medication is needed, but suddenly the patient appears on the verge of cardiac arrest.Quickly grabbing the defibrillator handles, the nurse begins a series of shocks to the patient’s chest. Soon, the vital signs regain normal levels. Wiping his brow, the nurse breathes a large sigh of relief. Welcome to the megacode evaluation of the Advanced Cardiac Life Support provider course (ACLS). The nurse is Jon Van Horn, a Good Samaritan Hospital critical-care professional, and the patient is a plastic dummy hooked to a computer posing as a real-life defibrillator. What Van Horn experienced wasn’t life or death, but "successfully complete" or "not successfully complete" for the course. He was in an evaluation he must take to be certified to handle critical care through the American Heart Association (AHA). Nurses and health-care professionals from around the state converge at PCC’s Central Portland Workforce Training Center to either take the provider course (for newcomers), or renewal class for veterans to get two-year certificates. Offered by Portland Community College’s Institute for Health Professionals, the course is contracted through Providence Health Systems, Oregon Health Sciences University and Legacy Health Systems."It’s challenging," Van Horn said. "It used to be a lot harder, but you need to know your algorithms. The megacode is the most difficult part of the evaluation because you are given all types of rhythms and you must know the drug dosages, and how to shock."Megacode is only a small part of the entire ACLS evaluation. For example, the half-day renewal class features an introduction lecture by instructor Nancy Taft (registered nurse) on ACLS algorithms before students are whisked away to nine different case-based scenarios. After a brief break, the professionals come back for two more scenarios and two pressure-packed megacode evaluations.In megacode, an instructor sits near the makeshift cardiac testing area and devises scenarios for each person in his or her group of six or seven health-care professionals. Two other students help the individual being tested, aiding the person on patient monitoring."It is essential for health-care professionals who actually help the patient directly," said Joe Stevens, an ACLS instructor since 1981 and full-time respiratory therapist. "They can save a life with a simple act of defibrillation in a critical-care environment. Some professionals come annually to keep their job where they’re in a position to save a life. They must know how to act and save a life. But others have been here in the past and just need a refresher."At the conclusion of the day, the students are given a written examination and a CPR-D test. If the American Heart Association-trained instructors from PCC approve, the health-care professionals will get a seal of approval and can resume their critical care service for their health-care employer with renewed confidence in their knowledge and abilities."It’s easy access and provides education in ACLS, meeting the standards that many hospitals require for their staff," said Paula Derr, clinical education and emergency shared services manager for Providence. "There are critical care units that require their staff to be ACLS-certified to do their job."Wes Harwood, education coordinator for the Institute for Health Professionals and on the regional faculty for the American Heart Association, says the course is designed for paramedics, nurses, respiratory therapists, physicians and pharmacists. "It has been really wonderful to have the classes here," Harwood said. "Whether the students are from The Dalles, or wherever, we assist them with their training needs. The critical and emergency care people especially benefit from ACLS."The total number of health-care professionals in the program during winter term of 1999 rose to 307, up by 64 from last year at the same time. An average of 32 students take part in any one ACLS class; no more than 40 are allowed in to insure an adequate instructor-to-student ratio."We focus on a topic and make it as realistic as possible for them," Harwood said. "It’s relating to their interest. You always learn better by relating to what you already know."