Doctors...scary!

Nurses General Nursing

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I will be working on a Telemetry floor cross training to CCU as a new grad. I know I have a lot to learn, but at the same time I feel like I know my stuff okay. But when a doctor is standing outside your patients room at the chart box there is nothing I would rather do than go hide and read what they wrote after their gone! How long until I feel confident confronting the doctor and telling them what I see going on with their patients and reading those telemetry strips?

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It's probably different for everyone, but one of the things I was most nervous about when starting in ICU was rhythm interpretation-- until the day I disagreed with an intern and I knew I was right.

He tried to order me to give lido to someone in a-fib, insisting it was V-tach. I was actually still in my critical care residency at the time, not even a full-fledged ICU nurse yet--but I held my ground and said, "I'm not giving lido until you can convince me this isn't afib. Look: narrow complex, irregularly irregular--" He ran off to talk to his resident, then sheepishly came back and asked me to give Digoxin instead. I teased him a little ("Say I was right! Say it!") and he jokingly bowed to me and said he bowed before my superior knowledge. But he never questioned my clinical judgement again after that. :)

Like any other skill, EKG interpretation gets better with time and lots of practice. Nobody expects you to be an expert right off the bat--and there are lots of books, classes, and tutorials on the web, as well. Walk through each strip logically, breaking it down--measure the P-R, the QRS, the QT--rate, rhythm, ectopics--and if you still don't know what you're looking at, ask a fellow nurse. If the doc has "stumped" you, ask him/her to walk you through the strip and explain what s/he's seeing. Most cardiologists loooove to teach, and they'll respect you for actively trying to learn.

Have fun! There is so much to learn and it's all keeeewwwl! :cool:

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Specializes in Everything except surgery.
Originally posted by Stargazer

It's probably different for everyone, but one of the things I was most nervous about when starting in ICU was rhythm interpretation-- until the day I disagreed with an intern and I knew I was right.

He tried to order me to give lido to someone in a-fib, insisting it was V-tach. I was actually still in my critical care residency at the time, not even a full-fledged ICU nurse yet--but I held my ground and said, "I'm not giving lido until you can convince me this isn't afib. Look: narrow complex, irregularly irregular--" He ran off to talk to his resident, then sheepishly came back and asked me to give Digoxin instead. I teased him a little ("Say I was right! Say it!") and he jokingly bowed to me and said he bowed before my superior knowledge. But he never questioned my clinical judgement again after that. :)

Stargazer...I love this story...Bravo!

Most cardiologists loooove to teach, and they'll respect you for actively trying to learn.

And you're absolutely correct...cardiologists do LOVE to teach!! But... getting them to shut up..... will be the problem...:chuckle!!

Amyi...as Stargazer posted there are some excellent sites online ...but unfortunately I couldn't find them today....but will try tomorrow for you. Thought I had them in my favs...but must have deleted. But check this one out. It's just the basics...but it does present some questions also...and you can take the test for CEUs if you would like or need it. But you don't have to pay a thing unless you go for the credit for ceus....otherwise you can view and print out the material! It even has a ekg crosswood puzzle!

http://www.rnceus.com/course_frame.asp?exam_id=16&directory=ekg

Also check out some of the links....some go nowhere...but many do ...and here is one:

http://www.rnceus.com/course_frame.asp?exam_id=16&directory=ekg. This one covers hemodynamics also...but still is a good site to familiarize yourself with different strips.

Good Luck...:cool:

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Specializes in Med-Surg, Long Term Care.

I'm not a telemetry nurse, but I bookmarked a site that looked interesting that I found on this bb at some point-- (Our Med/Surg floor may be getting some telemetry beds in the future and I wanted to be prepared!)

http://www-medlib.med.utah.edu/kw/ecg/index.html

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Specializes in Everything except surgery.
Originally posted by RN-PA

I'm not a telemetry nurse, but I bookmarked a site that looked interesting that I found on this bb at some point-- (Our Med/Surg floor may be getting some telemetry beds in the future and I wanted to be prepared!)

http://www-medlib.med.utah.edu/kw/ecg/index.html

GREAT site RN-PA....Thanks....in fact...it's probably one of the best I have seen online! :cool:

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Specializes in Med-Surg, Long Term Care.

Thanks, brownie-- Glad you like it and hope it can be of help to someone. It looks like a fabulous site, brimming with information and very user-friendly, too! :specs:

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Specializes in Everything except surgery.
Originally posted by RN-PA

Thanks, brownie-- Glad you like it and hope it can be of help to someone. It looks like a fabulous site, brimming with information and very user-friendly, too! :specs:

You're welcome RN-PA....I just browsed it a little...but it has a lot great stuff on there...in fact..."I" can't wait to get another day off....so I can really delve into it..myself..:cool: But now have to go work...:o...CYA soon...:)

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