Is it really necessary to learn to read an ekg? anyone really use it? - page 2

by northmississippi 6,634 Views | 44 Comments

Do any of you actually know how to read and use the telemetry monitor when it comes to watching the heart beat pattern (p wave, etc). Would it be worth my time to spend the summer learning to really read one? Thanks.... Read More


  1. 0
    Quote from KaLynRN
    My last med-surg job had tele patients, and the nurses watched the tele rhythms, and we were also responsible for documenting per shift a rhythm strip. Plus, if there are any changes, you should catch that and call the MD for orders. It's part of your assessment/monitoring job duties. So yes, if you are with tele pts
    It's like this at my job as well. We don't have telemetry techs watching the monitors. I attended a week long 40 hour brutal telemetry class that ended with a killer of a test to prove your competency. And to be honest, it wasn't something I was able to determine if it was a needed skill...attendance was mandatory, and successful completion was necessary if I wanted to stay employed.
  2. 0
    Totally!! I gets sort of fun after a while, measuring the intervals and deciphering the rhythm. I mean, it's not fun when you're already swamped and one of your patients have ST changes, but otherwise I enjoy studying rhythm strips and EKGs. Also can I just add that if I was a patient I would feel very nervous if my nurse didn't have at least baseline competency in EKG interpretation. If you need help understanding try icufaqs.com. I really like the way he explains things.
  3. 7
    Of course you need to know how to read basic rhythms. How are you going to review your patient's chart if you don't understand what you are looking at? I can't believe this is a serious question. I am choosing to believe you are yanking our chain.
    GrnTea, Hygiene Queen, payitforward, and 4 others like this.
  4. 0
    Yea, you should have a basic knowledge. I mean I understand if you can't distinguish between all the different arrhythmia, but knowing that it isn't a normal rhythm is essential for all nurses, IMO. More extensive knowledge if you work anywhere where your pts are on tele.
  5. 1
    Funny you mention this.

    I went through nursing school with a boy who is a telemetry monitor person. In school, I recall him not being really great at reading them. Ironically, I know for a fact that our hospital hasn't put him through any extra training. However, I'm theoretically supposed to call him when I want a telemetry reading myself, lol.

    I learned to read three lead years ago, and it's pretty straightforward. Now, 12 lead I don't know about, and I concede that. I really don't care either. When I want to know what's on the monitor I look and chart it. I've had more than one occasion where someone watching it called about something that was obviously incorrect. I called them once to see how long a patient had been experiencing bigeminal PVCs. The RN kid watching, who had been doing that for nearly a year, said exactly, "Nah, man, I think I've been seeing a lot of artifact though." I hung up. Stupid.
    GrnTea likes this.
  6. 0
    In my hospital (large teaching hospital) every floor is a tele floor meaning that any patient could be on tele at any time. While all of the floors have techs (that are located in one large room on a different floor) to watch the monitors and call with any issues it is the responsibility of the nurses to read/interpret at least one tele strip per shift and if the techs report anything it is up to us to see if it was real/artifact/ or whatever else it may be (interference from electronics etc.). We (all hospital RN's) are tested on this yearly and if we do not pass the test have to go to remediation.
    As for ekg's we are just responsible to do them, notify the MD when they are done and if there is anything abnormal on them. Then the MD usually takes them and another MD comes by and orders another one.
  7. 0
    ...not to mention you are going to need to read rhythms if you want to get ACLS certification.
  8. 0
    In short, yes it is very necessary for you to least gain a basic understanding of how to read an EKG.

    Learning how to read a basic EKG strip is really not that hard. With ACLS, you only have to learn something like ten rhythms. They also introduce other concepts, like how to recognize myocardial infarction, but for the most part, they're basically teaching you to look for some fairly basic rhythms.

    As you go through the rhythms, you will kind of see how the heart is electromechanically working. The reason I say electromechanically is because the electrical conduction system of the heart is what makes the rest of the heart mechanically contract. Most of the time, what happens electrically is fairly close coupled to what happens mechanically. So problems in the electrical side of things can make the mechanical not function as it should.

    Reading a 12 lead EKG is an art in and of itself. I am not all that good at reading 12 lead EKG's, but I can certainly recognize an infarct when I see it. Reading a 12 lead EKG builds upon learning to read a basic EKG, and once you know the basic rhythms, adding on the other stuff is a little bit easier.

    The other reason for learning to read EKGs, a regular strip or a 12 lead, is that although the computer can do some interpretation for you, sometimes it gets the interpretation way off from what it really is. I do not trust the computer to recognize EKG rhythms or interpret 12 leads, so I do it myself instead. Sometimes the machine agrees with me.

    As others have stated, sometimes telemetry patients have a technician who watches all of the patients. If something goes wrong with the EKG, that technician may assume that they are seeing artifact or that someone took the patient off of the telle box for a few minutes, instead of recognizing that the patient has in fact gone asystolic. What that means is that you, now knowing the rhythms and such yourself, can look at the telemetry monitor and see what the rhythm is and do your own interpretation in real time and catch the problems as they occur.

    Learning to do this can only help you.
  9. 0
    Having a progressive care (telemetry) background, reading monitors was absolutely vital to my job. Okay, this person suddenly went in atrial fib with RVR. WHY? Are they stable or unstable? And now you have to call the doc. And they're going to ask you what the rhythm is. So yes, you need to know.

    I cannot read a 12-lead at an expert level, but I can still identify rhythms and know how to localize injury/infarction.

    We were expected to look at the monitors and document the cardiac rhythm at minimum Q4H. We have monitor techs, but half of the time they aren't paying attention to the monitors and simple just click the boxes to silence the alarms.
  10. 0
    We have 3 med surg floors that have tele. Pretty soon all our units will probably have tele. I think it will be time well spent though it is a skill you have to use to get good at.


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