How confident are you with reading tele

Grobyc82 · Feb 18, 2018

Yes. For the most part the cardiologists that I work with have rapport with me so I'm never afraid to ask them their opinions. But yes I would not ask them the difference between sinus rhythm and afib or something else like that. Heart blocks can be challenging (not first degree) but sometimes differentiating between them is not a snappy decision to me as say...sinus rhythm and afib haha.

vintage_RN, BSN, RN · Feb 18, 2018

I've always wanted to learn and I've taken several workshops on interpretation but I find it's a very hard skill to master unless you're doing it every day. I am in critical care, but NICU....generally we aren't interpreting rhythms in the NICU unless the kid has a specific cardiac thing going on...but babies generally don't have arrhythmias, and if they do than they go to Peds CCU. I wish it was a skill we did and learned more often because I'm really interested in it!

Been there,done that, ASN, RN · Feb 18, 2018

I've always wanted to learn and I've taken several workshops on interpretation but I find it's a very hard skill to master unless you're doing it every day. I am in critical care, but NICU....generally we aren't interpreting rhythms in the NICU unless the kid has a specific cardiac thing going on...but babies generally don't have arrhythmias, and if they do than they go to Peds CCU. I wish it was a skill we did and learned more often because I'm really interested in it!

It's a great skill to learn. Just, be aware... you would not just be calling the rhythm, you will be responsible for instituting the correct treatment.. STAT.

Simonesays, BSN, RN · Feb 19, 2018

You might be beyond this site (in terms of your EKG skills) but it's kind of fun: Free ECG Simulator! - SkillSTAT

Workitinurfava, BSN, RN · Feb 19, 2018

You could ask a telemetry tech if you have one on your floor. Since it is their primary job, they know the rhythms inside and out. It will take time for you to learn it completely.

RotorRunner · Feb 19, 2018

Yes, quite comfortable. I've been a flight nurse/critical care transport nurse for a few years now and it is an essential skill. Would recommend a book called "Rapid Interpretation of EKGs" by Dale Durbin as a resource.

PCnurse88 · Feb 19, 2018

The blocks are not that hard to learn. You should not have to remediate your teaching alone. I would NEVER ask a cardiologist to teach me on the fly. They expect us to know our stuff. They are way too busy to teach nurses.

I disagree. The blocks can be challenging at first, and there are plenty of things (not necessarily tele) that I go home and look up. We cannot possibly know everything about the medical field, especially when we are new or when it is something we do not do all the time.

Depending on your unit/hospital's culture, asking the cardiologist can be a great idea. Our cardiologists LOVE teaching us, and will actually go out of their way to bring interesting EKGs or tele strips to us to show us things. They encourage questions, especially when we're new to nursing and/or the field.Of course, if this isn't the culture of your hospital, you may find that they don't want to or don't have time to teach you- your educator can be helpful at a time like this. In fact, that's pretty much their job.

3peas · Feb 19, 2018

I have a critical care background. Not great at it, I kept trying, but learned my limitations and in critical situations gave it to the gifted readers. I mean we can't be good at everything right? Luckily that's not part of my job anymore.

Rocknurse, MSN, APRN, NP · Feb 19, 2018

I'm very comfortable because I worked in cardiac ICU for a long while, but if you're not there are plenty of online resources to learn from, and lots of books. YouTube is a great resource too, if you want to learn about blocks.

Guest805836 · Feb 19, 2018

I am pretty durn confident withing the margins of my scope of practice in France not permitting me to initiate treatment on my sole decision. However, where there times where I called the guy on call saying "I believe patient X is in afib, would you like me to give amiodarone ? I did an EKG for you to look over" and the EKG would wait until much later, if the doctor on the other side of the phone knew me, knew my experience level and told me to just go ahead and initiate treatment. If I had a weird rythm I wasn't comfortable with (some weird block, or a Wolf Parkinson White re-entry thing... or like an atrial flutter with 1:1 conduction can seem a bit like sinus tachycardia sometimes), I always insisted the EKG be looked at anyway.

allnurses Guide · Feb 20, 2018

I am sure this will be unpopular. It always makes me nervous when nurses say they are perfectly proficient with reading tele strips. This is something that falls within nursing scope but is often far above the training an expertise of the nurses. This is true also at the provider level.

Spiva, L., Johnson, K., Robertson, B., Barrett, D. T., Jarrell, N. M., Hunter, D., & Mendoza, I. (2012). The effectiveness of nurses' ability to interpret basic electrocardiogram strips accurately using different learning modalities. The Journal of Continuing Education in Nursing, 43(2), 81-89.

Zhang, H., & Hsu, L. L. (2013). The effectiveness of an education program on nurses' knowledge of electrocardiogram interpretation. International emergency nursing, 21(4), 247-251.

Salerno, S. M., Alguire, P. C., & Waxman, H. S. (2003). Competency in interpretation of 12-lead electrocardiograms: a summary and appraisal of published evidence. Annals of Internal Medicine, 138(9), 751-760.

Cat365 · Feb 20, 2018

ER nurse here and I openly admit I bite at it. I've read books on it, taken classes, and I still pretty much bite at it. All of the studying has only taught me to interpret when I have a printed rhythm strip, time, and calipers. At work this is never. Best I can do at work is "crap that's bad" and opps that's worse. Maybe I need to work in a tele unit for awhile. Luckily in an ER the Dr, PA, or a nurse that isn't rhythmically challenged is always around.