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Discussion

EKG training and ACLS

Hey all!

I'm a recent grad, passed boards, and hired into an SICU. The training program seems a bit backward. I'm working with my preceptor for 3 month, which means I'll be on my own in August. The hospital isn't planning to put me into EKG training until August and won't ACLS certify me or put me in a critical care course for a year. Totally flipping backwards right?!

Anyway I was wondering if anyone had done an online EKG course? If so, which one and would you recommend it? How about ACLS?

Many thanks!!!!!

I want to cover my butt since I have a license to protect. If my hospital won't train me in a timely fashion, I'll find a way to do it myself!!

Thanks again!

Misty Dawn

Featured Replies

I think you could learn basic rhythms from an on line class.

ACLS is only a two day class but you need to know your rhythms first. You have to demonstrate competency. Call the AHA.

Mark has a great site:

http://www.icufaqs.org/

They're sure backwards. Maybe they want you to learn on your own.

How can they allow you to work in SICU without ACLS?

  • Author

Tell me about it!! I talked to my educator about it at work and she just sort of brushed things off and said that's the way it is here. The funny thing is there is an EKG class scheduled in August that I can attend, and there is an ACLS class in October, but they don't want to put me in ACLS for a year!!!! How can I competently work in an ICU without rhythms and ACLS?

Anyway, thanks for letting me vent. I'm looking for an online EKG course.

Thanks!

I self-taught rhythms.... they are pretty simple. I am slowly learning the ACLS algorhythms. I think that they don't want to overwhelm you as ACLS is actually, as far as my experience goes, a small portion of the job. I will be attending codes to help my learning but will not take a lead role until I have taken and passed ACLS.

This is so funny I just posted a thread on the CCU board complaining about this very thing. My manager just hired 4 more new grads and we have a similar police re:not ACLS certified for one yeat, not IABP certified for one year.

I agree it should be changed. I'm not saying you should be running house codes, but what's the harm in going to the class?

tell me about it!! i talked to my educator about it at work and she just sort of brushed things off and said that's the way it is here. the funny thing is there is an ekg class scheduled in august that i can attend, and there is an acls class in october, but they don't want to put me in acls for a year!!!! how can i competently work in an icu without rhythms and acls?

anyway, thanks for letting me vent. i'm looking for an online ekg course.

thanks!

mistydawn,

how in the world can they expect you to work in an icu without ekg certification? legally, you should not be documenting strips without the certification. jcaho would flip over something like this and a lawyer would have a field day with it. can you imagine this coming up in court.......can you explain why you documented this strip as sinus tachycardia when it is clearly supraventricular tachycardia? why was the doctor not notified?

answer........uhhhhhhh i thought it was sinus tachycardia? :uhoh3: this is a serious problem, and after all the years of being a critical care nurse.....when in doubt about a strip or anything else i always ask someone else for their opinion.

as for the one year before acls, to me i think that is reasonable. it will take you at least that long to become comfortable with medications, rhythms, and code situations. acls can be difficult the first time around. no need to rush things, observe codes, pick brains and study, study, study.

you can do it!!!!!!:pumpiron:

I wouldn't want to work in a unit like that. There are many other places out there who will better prepare you. Or, you can get on the stick yourself and by some books or take the AACN ciritical care cours on line (ECCO I bleieve its called). I have never heard of such ridiculousness of not even a critical care course for a year. Even if you want to teach yourself, a unit that doesn't conssider that knowledge a priority is likely to ba a scary place.

I completely understand the frustration, as I'm in the same boat! I started as a new grad in an SICU last July and am STILL not ACLS certified. I did EKG about 90 days into orientation and they wanted to wait about six months for us new grads to do ACLS, which would have been in January. Apparently classes have been "all full" and here it is a full year later and I am not ACLS certified! I feel incompetent as an ICU nurse! It's disconcerting to be transporting an unstable patient to Radiology, etc. and not know what to do if they code right there in the elevator. This is only the beginning of quality problems at my hospital, which is why I'm scoping out new hospitals. Ugh.

Hi Everyone,

I am a new grad RN, just passed the boards. My husband is an ICU RN and the 6week orientation included ACLS AND CCRN course. I hope the hospital I plan on working ICU at will do the same for me, ya'all got me wondering. My husband works at Kaiser(awsome), I on the other hand am trying to stay close to home 10 mins away, for emergency's we have a 4 and 5 year old. Anyway, buy yourself a ACLS book and take the darn class yourself, to heck with the hospital, this is YOUR butt on the line! Boy, I sure know what i'll be asking in the next interview, THANK YOU for the heads up.

Here is an awsome websit I found while craming for the boards,

www.skillstat.com/flash/ecgsim531.html I know it helped me alot to read and understand ekg's and I know I'll be working with it alot more now!

Take care,

April :)

hey misty.. my two cents - -

some units/hospitals do their training differently blah blah blah.. perhaps u might have know this upon interview?.. or whatever.. doesn't matter.. basic rhythms (v-fib/v-tach are the most important ones), and recognizing ectopy is important.. a-fib and flutter too.. when u get comfortable, know the acls logs.. that will give u all u need to know.. i wouldn't worry about it.. take it into ur own hands if u have to.. i am of the same thinking that i can't wait for others.. be prepared.. so, when it comes time for class, all will look to u for help.. and that's a great feeling.. take an online as well, but remember, immediate feedback and clarification is sometimes difficult.. you can also find all kinds of rhythyms and examples online without paying for anything.. check out any ekg/ecg website.. for example : http://medlib.med.utah.edu/kw/ecg/

u'll do fine.. just practice, practice, practice, and impress ur bosses.. they may advance ur training after such..

enjoy - -

  • Experts

some of my links have already been posted for you, but my links have different portals. can't remember why i found different entryways to the sites. also, i didn't have a chance to check to see if all links are still good, so forgive me if any are no longer working.

http://www.kauaicc.hawaii.edu/nursing/ekg/tutorial/tutorial.htm ekg interpretation for healthcare professionals from kaua'i community college nursing school

http://www.kauaicc.hawaii.edu/nursing/ekg/tutorial/lytes.htm - electrolyte and medications: effect on ekgs from kaua'i community college nursing school is just one section from the above site

http://rnbob.tripod.com/#section_3_cardiology_in_critical_care - section 3 of this website, nurse bob's micu/ccu survival guide http://rnbob.tripod.com/ , will help you identify all whole bunch of different rhythms and arrhythmias. nice clear rhythm strips are posted here. the site also covers a host of icu procedures, an extensive section on critical medications organized by categories, fluids and electrolytes, shock, and more!

http://www-medlib.med.utah.edu/kw/ecg/index.html - an excellent online tutorial with diagrams on everything you want to know about ekg interpretation from the university of utah school of medicine. also has quizzes! geared for physicians, but nurses can get information from this also.

this is the link i have for the skillstat ekg tutorial: http://www.skillstat.com/ecg_sim_demo.html - an online simulator that will show and explain what 25 of the most common cardiac rhythms look like on a monitor. you can stop the strips so you can study the tracings. there is also a little game you can play with the simulator.

http://md-do.org/files/physical/ekg.doc - from medical students. more than you'd ever want to know about ekgs and reading strips

http://students.med.nyu.edu/erclub/ekgexpl0.html - here is a short tutorial on how to read an ekg. click on the arrows at the bottom of each page to continue through the tutorial.

http://www.ccmtutorials.com/ - critical care medicine tutorials for medical students. some of the information here is very scholarly. topics include introduction to critical care, problem orientated approach, respiratory failure, shock, renal failure and sepsis. there is a great deal of information at this site. you have to surf around, especially using the links to see what is there if you don't want to read what is on the entire site. these are links into overviews of some of the topics that might interest you. there is much more specific information on these topics at this site.

http://enw.org/can'tbreathe.htm (part 1)

http://enw.org/can'tbreatheii.htm (part 2) - "i can't breathe!" 38 respiratory problems in the er. the links are for part 1 and part 2 of this very educational article. scenarios with focus on the problem solving of respiratory problems. each case will tell you what is going on, what needs to be done for the patient immediately and why. (emergency nursing)

http://enw.org/airwaycommandments.htm - the 10 commandments of airway management

http://enw.org/airwayhell.htm - difficult airway management: action-plan for airway problems from hell! more for emergency situations, but good to know what you need to have ready if you're not the one doing the intubating!

http://enw.org/maskventilation.htm - optimizing mask ventilation. what you need to know about ventilating a patient using a mask

http://enw.org/electrolytes.htm - "maintaining the internal seas in harmony: common electrolyte disturbances in the ed" good discussion of dehydration and sodium and potassium electrolyte disturbances. includes discussion of how they occur, signs and symptoms, labs, as well as nursing actions

http://www.trauma.org/resus/moulage/moulage.html - from trauma.org this is a fun interactive site of patient scenarios where you get to test your trauma treatment skills! your adventure begins with this: "a call breaks the quiet of the early morning trauma room. the on scene paramedics inform you that they are with a 26 year old male who was the restrained driver (no airbag) of a saloon car that had an argument (at 50mph / 80kph) with a telegraph pole and lost. the driver has been trapped in the car for around 30 minutes but is now free and has an open leg wound that is bleeding copiously and he is somewhat aggressive (glasgow coma score 14 - e4v4m6. they will be with you in ten minutes." from thereon you are presented with choices of actions to take. as i deliberated chose the wrong actions i laughed and laughed at the responses that came up on the screen. talk about learning priorities . . .

http://classes.kumc.edu/son/nurs420/unit4/hemomon.html - a tutorial on hemodynamic monitoring from the university of kansas school of nursing

http://www.healthsystem.virginia.edu/internet/anesthesiology-elective/cardiac/cvcphys.cfm - the physiology of central venous catheter from the university of virginia school of medicine. check the site index for videos of procedures

https://nursing.advanceweb.com/common/ce/content.aspx?courseid=362&creditid=1&cc=48817&sid=1390 - hemodynamic monitoring: techniques and troubleshooting, an update continuing education article from advance for nurses.

http://www.pacep.org/pages/start/ref.html?xin=sccm - this is a free online tutorial on how to use the pulmonary artery catheter in the clinical environment. includes pre and post tests and photographs. information will load much faster if you have dsl. you have to register to access this tutorial, but it is free.

Are there any EKG online certification you can take for Las Vegas, NV? I am taking beginning classes for rn to get certified for ekg. All help is appreciated.

I guess I am fortunate because I am a new grad working in the SICU. I will be out of orientation on April 4th. I have already had the EKG class and become ACLS certified. Both classes really helped my understanding of what to do in certain situations.

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