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Hello all, I was hoping someone had some good suggestions for EKG resources??? I will be starting my first NP job in a few months, which is a Cardiology clinic position. My program did not require me to learn how to read EKG. I have a few mo months so I am wanting to prepare. I have ACLS and i have taken an arrhythmia course in the past, so I have basic understanding of some things; however, i want to be more prepared than what i feel now, Thanks!
Everyone in the medical field has some paramedic friends. I'd hook up with them- some of em are brilliant with quick accurate interpretation. One of the local FD's has a class for medics and they invite us ED Rn's to go. The small nuances they go over is well worth the time. Each dept, or station depending on the size, has 1 EKG guru that is always spot on and I have never found one that wasn't enthused about helping others.
There is a youtuber I cannot recommend enough. He has some videos that will definitely help you. Go to this channel.
A good place to start rhythm interpretation is right about here:
Now, in my opinon don't stop there. Move on to the 12-lead vids, read all you can, keep learning. After all, being able to read a strip and say, "it's this rhythm" is not the same as a conceptual understanding of what's going on with an ECG. Understanding how ECG traces are electrical vectors, knowing Einthoven's triangle, remembering the hexaxial system and leads, things like that are important because they form a conceptual foundation that will change how you see the traces. Rather than a buncha squiggly lines you will start to see that each lead's tracing is actually a picture...no an animation...of what's going on in the heart.
Best wishes, and congratulations on your new position! :)
Sorry about the broken "Go to this channel" link above, I can't edit my post to fix it...but this is the channel I meant for you to visit: http://https//www.youtube.com/user/32bravo711/videos
Also I reread your initial post today and it sounds like you've probably taken the same sort of advanced interpretation course I have. It is called advanced, but really it is quite basic because it covers only lead II. Advanced or basic depends on one's perspective.
I will get to the point: be sure to watch his 12-lead videos. Start here:
Then when you do whatever training you are gonna undoubtedly have at your new position it'll be more like a review/refresher.
Thank you so much for your helpful response! That was exactly the type of answer I was looking for. When I was doing clinical in the office, the cardiologist was going over 12-leads with me, and I knew I had some deeper learning to do that was beyond the basics that I am use to. Thanks again!
Hi OP,
I was a tele nurse for 6-7 years and am a FNP now, I went to a highly rated school and graduated with a 4.0, despite this I was still not prepared for advanced EKG reading with my new job in electrophysiology (and honestly, this is a better attitude to have than to pretend you know everything). I can understand where you are coming from. Even if I had an understanding of basic to intermediate EKGs, I wanted to be better, and I still do! I work closely with an EP who will often be perplexed by EKGs, I've corrected him and hes corrected me as well, we've also read EKGs differently than various cardiologists or primary care MDs as well, nothing is textbook! So I don't quite understand the reaction you got earlier in the thread, pretty narrow minded IMO.
I think the best place to start is Dubin's book, it is simple, to the point and a very easy read. It is just the basics. Then there is "The only EKG book you will ever need" which is also a good reference. And another is "The complete guide to ECGs". Keep practicing. If you can get a stack of EKGs and blind your self to the interpretation and just go through those and practice, it helps!
OP I would recommend looking into a CE course near you. A lot of people that I know speak highly of them (my facility incorporates several Rapid Response RN positions and many have done a variety of 2 day courses. They all talk highly about them in terms of bizarre rhythms that aren't traditional and are subtle.) You might even be able to work it into your compensation package. Hopefully that's useful and gets this post back to the point. Oh, and I'm sure your practice will know that no one is proficient at EKGs starting out and can give you some more "seasoned" resources. Best of luck and congratulations on your position!
My NP program did not cover EKGs at all, that I remember. That it is rated number one in the country. I had been a tele and critical care nurse so have training from that experience.
I have worked in several fields as an NP with no prior experience, including urology, G.I., and orthopedics. No one is prepared on their first day. Almost every NP I have spoken to will tell me about being thrown into situations way over their head when they first started a job. And every MD will stay the same. That is how we learn.
I have read post from Boston FNP for years and they are generally helpful and non-judgemental. Not sure why he/she now feels he is in a position to judge competence.
I know this is an old post; however, I'd like to thank those of you who had helpful and encouraging things to say. After being in Cardiology as an APRN for the past 6 months, I'd like to share how everything has turned out. Ya know, since I didn't have any experience with advanced EKG interpretation (gasp!). So, I started back in October 2017 and shadowed my main collaborating physician a ton, as well as some of the other physicians I work with. Having gone through a family NP program, there is so much that goes with this specialty, that I never learned. Rightfully so. Being able to shadow them for a while really helped be get an idea of the most common chronic CV conditions I would be dealing with, as well as common medications, diagnostic testing, etc. that I would be ordering for these patients. Every single one of the cardiologists that I work with are helpful and open to teaching. I frequently go to them while in clinic, when I am dealing with complex patients and need some reassurance or direction. They are okay with this! And they make me feel that it is okay to not know everything! This is a learning process, and knowing where my weakness lie, and what I could do better, really helps keep me in check and makes me a better provider. One of the cardiologists I work with told me that 12-lead EKGs are hard. He said that. He's been doing this for 30 years probably. He says it takes several YEARS of reading them to truly get comfortable. With that being said, I feel as thought I have truly excelled in this specialty, and my starting lack of competence with 12-leads has not held be back one single bit. I started seeing patients on December 14, 2017. It was scary at first and I've had to ask a lot of questions. I am now finally getting more comfortable and having to ask less questions, but I don't hesitate to ask for help when I need it. I see patients in clinic 4 days a week, and mostly deal with ischemic heart disease, cardiomyopathies and heart failure, PAF, valvular heart disease, and some resistant hypertension. We have an EP and EP NP that deal most with most of the EP stuff. I love knowing a lot about a given specialty vs. knowing a little about everything. I absolutely love this specialty and I have a knack for it. So glad I didn't let the negativity bring me down.
MJC2118, APRN
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You don't need to know my perspective or opinion on why this position is a good fit for me, in order to recommend me some resources, which by the way, was the original intent of the post.