feeling inadequate

I have been an RN now for a little over a year. I know what you're feeling! I still feel that way sometimes. You will soon learn that when you walk out the door from work, your shift is over. I'm not saying you shouldn't care...I'm saying that you cannot let what happens at work rule your entire life. Bad things and good things will happen. When in doubt, ASK someone. I still have to ask my co-workers for help sometimes, and at times they ask for my opinion. That's what great co-workers do for each other. Things will get better...

Take a deep breath.

Don't second guess yourself. "Asymptomatic" arrhythmias are seldom treated unless they are an acute change that indicates something worse is coming along.... increasing PVCs, new brady, etc.

But - always make sure you do a complete assessment to make sure that the patient is truly asymptomatic.. did you check for postural hypotension? BP in both arms? Apical rate only? Check the HX to make sure this is not an acute change? Rule out brady as a reaction to meds? No change in mentation? Document all your findings? Then you're golden because your documentation shows that you were exercising professional nursing judgement based on critical thinking, not just heresay and assumptions.