Last Call.

I am now officially certified by the American Heart Association and the American Academy of Pediatrics to intervene with advanced life support should your child, or any child, show up in our ER. Or just pass out in the street.

It's not really a big deal - okay, maybe it is - but these little milestones, certifications and whatnot, are inching me ever closer to eventually becoming a CEN (Certified Emergency Nurse), and that excites me. I've never been one for little pieces of paper; it's the documented proof that I have at least a small clue as to what I'm doing that gets my motor humming. Lifelong learning, indeed. And it's a great prep for ACLS (Advanced Critical Life Support). All these "a" and "d" drugs get my panties all in a bundle: amiodarone, atropine, adenosine, dopamine, dobutamine... In real life, we're always consulting with each other, with online and written resources (evidence-based, of course ;) ), but it'll be nice when I can just rattle off weight-based dosages and drip rates like it's old hat. All in due time...

In the meantime, passing PALS (Pediatric Advanced Life Support) today required the successful coding of two (imaginary) kids (and the passing of a written exam). My instructor/tester was a woman I work with in the ED, so I was doubly conscious of her assessment of me, wondering whether or not she would, after my testing, feel confident coding a kid with me in the ER. My first "kid" was a baby in asystole. CPR: check. Oxygen, monitor, IV: check. Shocked him once. Nothing. CPR. Gave epinephrine. No change. Continued CPR. Shocked him again. No change. CPR. Epi. CPR. No change. At this point, she tells me I've passed. "....but.... he's dead...." "Yes. He is."

And, ya know? I was so grateful she did that. I needed that experience - even imaginary - to show me that sometimes, no matter what you do, they're gonna die. It still didn't stop me from wanting to do more - and in the real world, this cycle would have gone on much longer - but it still drove the point home. And I needed that.

So thanks, Z. For ever so gently busting my chops and reassuring me that life is life, death is death, and sometimes our machines and drugs just won't cut it. And at the same time, making sure I know what to do to try my damnedest before we make that call.

"So, how do you feel after passing?"
"Well, how do you feel about working next to me in a peds code?"
"Fantastic. Good job."

From a colleague, a "seasoned" nurse, a CEN... that's all the affirmation I need. Rock on.