by erin01

ok so i am reading all the good info thats on here..cause i am a dork I start my orintation on 6/8 on ccu step down and want to read and study as much as i can so i have an idea what's going on=) now in school we did a little on ekg but not much, and this stuff feels so over my head. I am reading it as well as i can but i am not sure how i will ever really grasp it. Is this normal, its so complicated. I get the basics ..i think, i know st depressions are not a good sign but other than that...i am lost. What else can i do ? i do well when someone teaches and i read up on it later. But this is tuff and i am starting to worry that i will be lost and dumb. Any adv

Re: ok ekg?????

You are not expected to come outof school a fully fledged cardiac nurse-that is what orientation is for. You will be taught EKG's, pacemakers, drips, and all the related CCU competencies during that time. For now, begin by being able to recognize basic rhythms and how to ID NSR from VT, atrial fib and so on. EKG interpretation is something that takes alot of practice-and there are nurses that after years and years still have difficulty with 12 lead EKG's.

Good luck!

Re: ok ekg?????

I'm thinking that part of your orientation will be a basic dysrhythmia course? From there you will learn all the need-to-know rhythms. I worked on a tele floor for a year and got to know a good bit in that time, however there is still a lot I don't know, and I run across new stuff all the time! Will there be monitor techs in your unit? If so, I've found the monitor techs are always willing to explain things, as well as the other nurses you will be working with. You can never know it all, and we are always running things by one another at work, getting second opinions on things. Never stop asking questions!!!

Re: ok ekg?????

If you haven't done ACLS yet, I would recommend doing it as soon as you can. I learned a lot of heart rhythms with causes and tx's by taking ACLS about 1 week before I started my orientation...

Re: ok ekg?????

Originally Posted by libbyjeanne

If you haven't done ACLS yet, I would recommend doing it as soon as you can. I learned a lot of heart rhythms with causes and tx's by taking ACLS about 1 week before I started my orientation...

Good point! ACLS is a great way to learn algorithms-it doesn't explain the pathophys though, so try to follow it up with that...always nice to know WHY you're doing something-not just following a flowchart. Hang in there--you'll get it

Re: ok ekg?????

Typically ST depression is indicative of myocardial injury, the myocardium is not getting enough oxygen due to blocked arteries, vasospasm, poor cardiac output and on and on. Yes, it's not a good thing, usually. Although you can have pseudo depression due to lead placement, body habitus and other factors.

Hopefully you'll get a good dysrhythmia class and at least a basic run though on 12-leads, especially how to identify ischemia, injury and infarct. The others above are correct, no one will expect you to be ready to go right out of the gate! IFit means all that much to you, I would suggest taking ACLS and picking up a used copy of "Rapid Identification of EKGs" by Dale Dubin. It's an easy basic read if you feel the need to have a head-start.

Good luck though!
Tom

Re: ok ekg?????

http://www.skillstat.com/Flash/ECGSim531.html
Great site to help get you started.
Works best with IE...not so well with firefox for some reason.

Re: ok ekg?????

I took a basic arrhythmias course during nursing school which really helped- it was online and the book was mostly like a workbook-I think if you got the book and went through it, it would really help you! The author is Walraven and you can get it on amazon.com for $64. I recommend getting the book new so nobody else has written in it-bc you will write in it-a little repetitive but will drill in the normal values for PRI, QRS, etc for each rhythm. You start off by learning the basics- normal sinus rhythm, and build up from there (where to start when reading a rhythm etc). Hope this helps!

Re: ok ekg?????

I guess it all about Practice- I don't know about any of u but I got squat-for-training in school on cardiac!!! And don't be one of those arrogant little nurses that think just because you know 5 arrythmias that u know anything at all. I study constantly- and thought that if I understood basic arrythmias I could read a 12 lead EKG??? YEAH RIGHT!!! They are so complicated! They are like trying to do the Rubics cube (anyone remeber those?) I'm gonna need 3 years in full time study to actually interpret one well>

Re: ok ekg?????

Originally Posted by c_beshore_rn

I guess it all about Practice- I don't know about any of u but I got squat-for-training in school on cardiac!!! And don't be one of those arrogant little nurses that think just because you know 5 arrythmias that u know anything at all. I study constantly- and thought that if I understood basic arrythmias I could read a 12 lead EKG??? YEAH RIGHT!!! They are so complicated! They are like trying to do the Rubics cube (anyone remeber those?) I'm gonna need 3 years in full time study to actually interpret one well>

Yep, you've got it. Practice until you see strips in your dreams (uh, I wouldn't know anything about that...). Ask questions of more experienced nurses, bug the tele tech (if you have one) and if you hear that someone is doing something funky, check it out if you can.

Starting you may not be able to differentiate between "intermittent high-grade AV block with junctional escape beats", but you'll be able to know that, "hey, that doesn't look good, maybe I should look at my patient." And the second part is the key. Technology is great, but getting our eyeballs on the patient is much better!

Cheers,
Tom