EKGs.....I think I'm screwed!

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Specializes in Med-Surg/Oncology/Telemetry/ICU.

i honestly hate them! it really stinks since i work on a med-surg floor that is also tele so there's always the possibility of having at least one tele pt. i mean, i passed the ekg test after taking the class, but my boss just sent me an e-mail saying she wants to talk with me about a couple strips i did last week.

she didn't in any way sound threatening or anything and the rational part of my brain knows that she just wants to chat and make sure i'm at least "getting there" with strips and analyzing them, i'm just terrified! :( since i've only been a nurse for 4 months, i know there's a huge learning curve, but i tend to take everything so personally and think i'll get fired for any little thing.

i'm supposed to take acls next month and i just don't know if it'll even sink in!:trout:

okay, i just need to breathe..........

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Specializes in Med-Surg/Oncology/Telemetry/ICU.

okay, had a chat with the nurse who actually told my boss about my "issues" and since i never see my boss (i work nights) we worked it out and i learned a lot!

whew! :p

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Specializes in Nephrology, Cardiology, ER, ICU.

Don't beat yourself up about this. Gosh - for only being a nurse for 4 months - you're doing fine! Relax. You WILL get comfortable with EKGs, I promise.

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Specializes in Travel Nursing, ICU, tele, etc.

I agree, you have to give yourself a huge break...it will all start making sense, but it takes time. I would give yourself a good year to feel competent and then you will still have the odd rhythm that you will want to check out with other people, we all do. That is what is so great about working with a team of people, you never have to figure it out alone.

By the way, you will LOVE ACLS!! I am NOT kidding. You will learn so much, you won't believe it and you will gain a huge boost in your confidence by going through it, I promise. You will be stepped through the process in such a way, that you will get it, (again) I promise!

Relax, don't worry so much. You can do it!!

:yeah::yeah::yeah:

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Specializes in Cardiac, med-surge, orthopedic, and ICU.
i honestly hate them! it really stinks since i work on a med-surg floor that is also tele so there's always the possibility of having at least one tele pt. i mean, i passed the ekg test after taking the class, but my boss just sent me an e-mail saying she wants to talk with me about a couple strips i did last week.

she didn't in any way sound threatening or anything and the rational part of my brain knows that she just wants to chat and make sure i'm at least "getting there" with strips and analyzing them, i'm just terrified! :( since i've only been a nurse for 4 months, i know there's a huge learning curve, but i tend to take everything so personally and think i'll get fired for any little thing.

i'm supposed to take acls next month and i just don't know if it'll even sink in!:trout:

okay, i just need to breathe..........

believe it or not ekg's can be very fun to read when you know what you are looking at. i have been a telemetry step-down nurse for 71/2 years and i love it. i think that all pt's should have on telemetry, reason being that you can tell that they are alive. have you evey walked into a room and your pt was dead as a door nail and there was nothing that you could do even if they were a full code.

take your managers input as a learning experience and let that help you to better understand ekg's. if there is someone on your unit that is good at reading strips let them teach you, i learn something everyday. :balloons:

hope everything goes well for you.

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interpretation of a strip. Is a brief period of time in the care of a patient. You are looking for critical landmarks, you are not treating, that is for the physician> One thing I practice in look at your strip in the beginning of your shift and then note changes throughout the day(lengthening PR int./q wave present/ flipped bundles) then assess the patient for changes in their dynamics. Start slow and you will get comfortable. Good luck. When in doubt get a 12-lead

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Specializes in Cardiac/Telemetry, Hospice, Home Health.

nursekatie, I too tend to take things personally. I am starting on a surgical PCU with cardiac observation in several weeks (my first RN position) and I am so nervous. I am afraid I will say dumb things and not know as much as I should. I am worried that perhaps I am not as prepared as I should be... all those anxieties. Sigh.

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Specializes in Cardiac Telemetry/PCU, SNF.

Reading EKGs is both art and science. The best thin you can do is practice, practice and practice some more until you literally dream strips. It just takes time.

As you do this here's a couple of hints: know your normal rhythms, that way you can at least spot when something is awry. Know the basics, SR, SB, ST, AFib/Aflutter, SVT, PVCs, PACs, VTach, VFib. More importantly know what to treat with each one, the monitor or the patient. Then start worrying about the complex stuff, AV blocks, pacemakers, 12-leads. You don't need to know that the rhythm is "idiopathic wide-complex tachycardia with ectopic beats from the ventricular outflow tract" thats for the docs (yes, I made that one up), unless they're symptomatic with it. Know your basics, learn ACLS and you'll start to get comfortable. ACLS is fun, enjoy it!

Relax, it's only 4 months in. It takes time. Like another poster said above, if you;ve got someone onthe unit who is a whiz at strips utilize them. How about a tele tech? They usually are sharp as heck with strips. You the resources available on your unit.

Good luck!

Tom

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Specializes in Emergency.

Hi there!

I am a new grad on a telemetry unit. I took the classes during orientation for EKG interpretation, but still have a long way to go before I feel comfortable interpreting. The one most important thing I can say to you is this: Have a really good relationship with the telemetry techs. They are your lifeline. If I am in doubt, I always call them for their assessment, since they are trained to do telemetry exclusively. Also, I never ignore a tele techs call for an alarm, or change in rhythm. I go assess the pt, and let them know what's going on. They are your eyes and ears, since as a nurse, you cannot sit and watch everyone's tele all the time. I print out strips at the start of my shift, and periodically look at the monitor for any changes, but they watch all the time, and have way more training than me in what to look for. I know some of our hospitals tele techs think I am a pain, but some are great at teaching me about the rhythms. I always tell them I am a new nurse and still learning.

The second most important thing for you to know is this: Know your fatal heart arrhythmias! SVT (supraventricular tachycardia, not really fatal, but can do damage to the heart muscle), PVC's ( a real warning that the heart is diseased, and can quickly dteriorate into a fatal rhythm), R on T phenomenon (the Twave blends into the Pwave) which is a lethal rhythm, idioventricular rhythm (hr less than 40bpm) a code is imminent, Vtach (most common cause is MI) call a code, torsades de pointes (must defib), V fib (always defib Vfib), and asystole (pt is dying).

As you can see most of these are ventricular arrhythmias.

Know them, and know what to do for them. There are several books out there to help you learn, or just go spend time with your hospitals tele monitor...Mine were great...They even quizzed me!

Amy

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I am a cardiac monitor tech, and it does take some time to get used to reading rhythms. When I started working there, we all needed to take the course and pass with a minimum of an 80. But if we got a 96 and one of the lethal rhytms wrong, we failed. In the class was both nurses new to the floor and CMTs like myself. The advantage that we as CMTs have is that is our primary responsibility...sitting and watching the monitors. I thinkit would definitely be in the best interest of all new nurses to spend a couple of shifts with a preceptor looking at just the monitors.

It does take some time, and as some of the posters have stated...know your normals.

Kris

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Specializes in Med-Surg/Oncology/Telemetry/ICU.

i haven't really been back here since i posted this but i'm glad i got some input. i took acls this past week and it was great! the guys who taught it were medics who do this sort of thing all the time and most of us were m/s, onc, med, surg nurses so they didn't expect us to know it all by heart.

we learned so much because they didn't make it stressful for us. i heard the year before that the people who taught it were awful and were almost trying to fail people. things actually started making sense and no longer will i ever b**** about having to renew my cpr card!!! ;)

i'd heard from people that it should take a year to be comfortable as a nurse, but i didn't really think of it taking a year to be good at strip reading too! :( i've recently discovered the tele floor though, and those peeps are great!!

thanks a lot for all the positive talk and i'll just keep studying! :D

gotta go to work now!

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Specializes in rehab, ortho, cardiac.

take it easy. ekgs will come with practice. just remember the rules

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