EKG on female patients

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How do all of you do EKGs on female pts? I've been using a towel folded longwise to cover their breasts. My big concern is placing electrodes and connecting the leads when they are large and a bit saggy. Do you ask them to lift themselves? I work in an ER and many times I simply cannot get a female to do the EKG in a reasonable time frame.

Heck! This sounds like the most painless RN duty I've heard yet.

Sounds like a field I need to investigate further with my soft, warm, accurate, and gentle-touch hands.

Thanks Guys!!

1 Votes

I'm not doing EKGs in a hospital (currently still a paramedic), so most of the female pts have a bra on and I don't make them remove it. And yes, you can a clear reading if that's what you mean, but it makes it a lot trickier to get the 'trodes located correctly. I still have to lift the bottom edge of the bra and stick it underneath, otherwise at least V4 is much too low. V3 also has to normally go underneath the bra. Ultimately, you're not touching the pt any less, but the fact that the bra is still there I think provides a mental barrier for both pt and provider. However, if you want a true quality EKG, no bra.

1 Votes
Specializes in icu/er.
Psqrd said:
My only problem with getting females to do your 12 leads is that by constantly pushing your work onto females it encourages those who believe that men should not be in the nursing profession.

I have say that I feel that you might be setting us back a few places as far as men in nursing, as men we may be scrutinized more closesly for these particular procedures but we should maintain our professionalism as we forge ahead with accomplishing our job by utilizing good proper technique to stay ahead of those that will question.

I bet if you ask those females that you have to ask to do that work I'll bet you'll find that they don't like the fact that you ask them to do that all the time.

P2

you'll cahnge your tune once you get a complaint from some freak saying you made her feel "uncomfortable". now you think it wont happen to me cause i'm to professional, i used to be that way when i first got out of school but over the yrs the things i've seen happen to fellow co-workers have changeed my view and made me much more wiser. as far as pushing the male rn back a few yrs, spare me please, if you are in a unit you'll be pulling more patients and poking more iv's and dropping ngt's for your fellow coworkers to more than make up for "pushing your work on them". and by looking at your profile it shows you are a nsg student, well good, have'nt they taught you yet that you will have to work as at team in a unit in order to survive. and of course you need to take the bra off *** well as any necklace and any ankle jewlry for limb leads. unless you want to "half *** it". non-emergent ekg on female, nope not me unless with female staff memeber in room, and no caths. don't want the h/a.

1 Votes
Specializes in LTC, ER.

I think it is good to wear gloves while doing the ekg. although i'm a woman, i still feel weird about having to touch their boobs. Also another good reason to wear the gloves is that i have encountered so many large breasted women that have alot of moisture going on under there- it smells like they are baking yeast rolls- and i definitely do not want to be touching that. i absolutely tell women to hold their boob up to get the leads on. i feel like the breast has got to be pulled up, i'd rather they do it themselves. i feel really bad now though hearing how well you guys work on keeping the patient draped during an ekg. my main goal is that the curtain is pulled, i never drape.

1 Votes
Specializes in Tele, M/S, Psych.

I love this post...I think many of us have had this experience! I must say, professionalism is a must. I work on a Tele floor so most patients have had an EKG and understand what that entails, so when I come in and tell them what I am doing, they know.

I do feel that keeping the patient comfortable is at most up most importance. We have the gowns that unbutton at the shoulder so I always start with the right side of the patient placing V1 and V2. Then I cover the right side back up and place V3, V4, V5 , and V6. I always tell them that I may need to lift their breast up. I always cover them up completely before verifying lead placement on the screen and capturing the EKG.

I've never run into a problem with a patient with EKGs (granted, again, I work on Tele), but I did have a long time Cardiac patient tell me, "Are you embarassed?" when hooking them up to the 5 lead monitor. When I replied no, she said, "Well lets get over modesty, I've done this before." And took her gown off.

We both laughed and I proceeded. She was one of my favorite patients I've ever taken care of (and not because of her immodesty but she was truly a wonderful person and so appreciative of her care).

I do believe the patient comes first. Whatever we can do as Health Care Professionals to make them comfortable, then we should do it. If a patient doesn't want me to do the EKG and would prefer a female (unless they spontaneously go into 3rd degree HB and are bradycardic and need the EKG STAT) then I have no problem making them more comfortable and getting a female to do the EKG.

1 Votes
Specializes in Cardiac/ED.

Well as I see you agree with me or do I agree with you?? As RN1980 pointed out in may I was a nursing student at the time of that posting...I am now an RN and perform EKG's all the time as I am on a Cardiovascular intervention unit and it is standard that when patients return from the Cath lab that they get an EKG. At the time of my post my only experience with EKG's was as a phlebotomist where it was part of our responsibility to perform them on out-patients so over approximately 5 years this was something I did every day and many times a day at that. I stand by my earlier comment. I recently had an opportunity to sit down with author and instructor Chad E. O'Lynn PHD, RN. of the Univ of Portland. He and Russell E. Tranbarger wrote "Men in Nursing...history, challenges, and opportunities" this book should be a must read for all men in health care. All men in health care have a responsibility to uphold the professional standard, we men are just as good and caring as our female counterparts. If this cycle continues...gay men who are nurses won't be able to care for male patients out of fear of a complaint or gay female nurses be able to render care for female patients. This has to stop and it stops with us...as we men set the standard not just for yourself but for all male nurses.

P2 RN.

I am a NURSE and I am here to stay! "this where a trumpet would blast or a rim shot on the drums" hehe!

1 Votes
Specializes in Tele, M/S, Psych.
Psqrd said:
Well as I see you agree with me or do I agree with you?? As RN1980 pointed out in may I was a nursing student at the time of that posting...I am now an RN and perform EKG's all the time as I am on a Cardiovascular intervention unit and it is standard that when patients return from the Cath lab that they get an EKG. At the time of my post my only experience with EKG's was as a phlebotomist where it was part of our responsibility to perform them on out-patients so over approximately 5 years this was something I did every day and many times a day at that. I stand by my earlier comment. I recently had an opportunity to sit down with author and instructor Chad E. O'Lynn PHD, RN. of the Univ of Portland. He and Russell E. Tranbarger wrote "Men in Nursing...history, challenges, and opportunities" this book should be a must read for all men in health care. All men in health care have a responsibility to uphold the professional standard, we men are just as good and caring as our female counterparts. If this cycle continues...gay men who are nurses won't be able to care for male patients out of fear of a complaint or gay female nurses be able to render care for female patients. This has to stop and it stops with us...as we men set the standard not just for yourself but for all male nurses.

P2 RN.

I am a NURSE and I am here to stay! "this where a trumpet would blast or a rim shot on the drums" hehe!

As far as maintaining professionalism Psqrd, I absolutely agree with you. I can't say I've experienced anyone "pawning" off anything on me (except foleys on males). I also agree as a nurse we must set the standard. Not just for male nurses, but I believe as nurses we must set the expectation for each other and continue to raise the bar higher so not only the continuity of care is greater but also the STANDARD of care.

I don't want to solely represent nursing as a male (though will until I die) but want to represent nursing as a whole!

Psqrd, a very exciting congrats to your graduation:yeah: and I must find this book you speak of and read it!

1 Votes
Specializes in Cardiac/ED.

You said it well...

that book- ISBN 978-082610221-8

Chad O'Lynn is an amazing speaker...I had to honor to meet him at the first annual Male Nursing Symposium in Monterey California. He was one of many inspirational speakers over the 2 days of this conference that was also was attended by Ruth Ann Terry MPH RN Executive Officer of the California Board of Registered Nursing. She talked about one of the earliest Registered Male nurses in California...his license number was like 68 I forget what year it was but she said that at last report he was still alive in Southern California...what a treat it would be to talk to him!

Live long and prosper.

P2

And thanks for the congrats! I know that I have the best job in the world.

1 Votes
Specializes in district nurse, ccu, geriatric.
1776patriot said:
Is it possible for the female patient to leave her bra on during the EKG and still get a good reading?
SteveRN21 said:
nope..... because you have to basically place 75% of the leads where the bra covers....

Sorry to disagree SteveRN21, I actually found it easier with a bra, because the saggy boobs are already out of the way, and I just adjusted the bra slightly underneath the breast to accommodate the electrodes.

1 Votes

You all are so respectful. Thank you for that. I am not a nurse but a patient. I have seen EKGs done on other women, and have had them done on me. The best was by a young man who used the woman's gown (open to the front) to cover her breast while he did his job. It worked out well, she was never exposed. The worst, a female nurse who wanted to train a couple of N.A.s She just came in with the two guys, never introduced them or said a word, told me what she wanted to do and stood there waiting for me uncover. I just looked at the two guys. I had no idea what they were there for; she then explained they were there to watch and asked if I minded. I said, YES!!! She asked them to leave. She then proceeded with the EKG, and just took the top down and exposed the entire chest area. Which given she was same sex is ok, but I would not have liked her to do it that way had they men been in the room.

1 Votes
Specializes in Cardiac/ED.

To expose a patient like that is extremely unprofessional!! It does not matter if you are the same sex as a patient or not. I am male and would never just walk into a patient's room throw back the covers to check a patient or perform a procedure no matter what the sex of the patient...to do so demonstrates a huge lack of respect for the patient and their privacy.

I'm sorry you had such a bad experience with this tech...it does not reflect well on the profession.

P2

1 Votes
Psqrd said:
To expose a patient like that is extremely unprofessional!! It does not matter if you are the same sex as a patient or not. I am male and would never just walk into a patient's room throw back the covers to check a patient or perform a procedure no matter what the sex of the patient...to do so demonstrates a huge lack of respect for the patient and their privacy.

I'm sorry you had such a bad experience with this tech...it does not reflect well on the profession.

P2

Sad thing is if the V.A. were better at respecting patients, if she had asked and explained that she would use min. exposue techniques and wanted to teach them the same, I would never have kicked them out.

1 Votes
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