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ICU Critical Care! Is this a normal BSN class? Texas?

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by tracey350z tracey350z (New) New

Hello all,

I'm seeking information about Texas nursing school programs (or any others, really) who have an entire course in ICU. Our school requires ICU after med surge and this is the class that usually flunks students out of nursing school! :banghead:

In this class, we are tested on hemodynamic monitoring, all forms of shock to include what the shock is doing to hemodynamics: svr, preload, afterload, PAP, PAWP, etc. We are also tested on 12 lead EKGs, and dysrythmias other than the common ones like; junctional escape, supraventricular tach, etc. The Nursing board states that content requirements should include: Med surge, Peds, OB, and mental health (all of which we also have). Need some input from this great community to let me know if this content is a bit "advanced" or if I'm just not smart enough to grasp this as "basic" nursing elements?

Just need to get a feel for what's out there and determine if this class should not determine graduation.

Many thanks! :bow:

locolorenzo22, BSN, RN

Specializes in Ortho, Neuro, Detox, Tele.

Hello all,

I'm seeking information about Texas nursing school programs (or any others, really) who have an entire course in ICU. Our school requires ICU after med surge and this is the class that usually flunks students out of nursing school! :banghead:

In this class, we are tested on hemodynamic monitoring, all forms of shock to include what the shock is doing to hemodynamics: svr, preload, afterload, PAP, PAWP, etc. We are also tested on 12 lead EKGs, and dysrythmias other than the common ones like; junctional escape, supraventricular tach, etc. The Nursing board states that content requirements should include: Med surge, Peds, OB, and mental health (all of which we also have). Need some input from this great community to let me know if this content is a bit "advanced" or if I'm just not smart enough to grasp this as "basic" nursing elements?

Just need to get a feel for what's out there and determine if this class should not determine graduation.

Many thanks! :bow:

I'm in IL, and this theory class covered most/all of the requirements you mention here....it's possibly not quite as advanced...but the concepts remain the same. We had 2 weeks of class over hemodynamic monitoring, a week over shock, 2 weeks over heart stuff, etc...ABG's

It was a tough semester, but I feel that if you study and get to know the basic stuff you should be ok....just go in positive, and that's half the battle.....

hypocaffeinemia, BSN, RN

Specializes in Critical Care.

Hello all,

I'm seeking information about Texas nursing school programs (or any others, really) who have an entire course in ICU. Our school requires ICU after med surge and this is the class that usually flunks students out of nursing school! :banghead:

In this class, we are tested on hemodynamic monitoring, all forms of shock to include what the shock is doing to hemodynamics: svr, preload, afterload, PAP, PAWP, etc. We are also tested on 12 lead EKGs, and dysrythmias other than the common ones like; junctional escape, supraventricular tach, etc. The Nursing board states that content requirements should include: Med surge, Peds, OB, and mental health (all of which we also have). Need some input from this great community to let me know if this content is a bit "advanced" or if I'm just not smart enough to grasp this as "basic" nursing elements?

Just need to get a feel for what's out there and determine if this class should not determine graduation.

Many thanks! :bow:

Our entire third semester in my ADN program is "critical care", with clinical rotations to the ICU, ER, and NICU.

I seriously doubt they want you to become experts at critical care but even if you plan to work in med surg you better know what afterload/preload is and other hemodynamics.

Additionally, you should know the importance of 12 lead EKGs and what is being looked for on each of them, and as for "uncommon dysrhythmias" you sure as heck better know what SVT is. This is an incredibly common dysrhythmia anywhere in the hospital and you should be familiar with its implications to your patient and common treatments. You don't have to be ACLS or have the algorhythms memorized, but this stuff like SVT is so basic we covered it in our second semester (was on our last test).

I'm in TX and will be done with my BSN in a few weeks (hopefully). We have a class that is exactly what you describe.

We covered a lot of dysrhythmias (not junctional escape, but definitely SVT). We also covered hemodynamic monitoring in a good amount of detail. It's important to know proper interventions and the rationales for that...since if you ever find yourself in a critical care area that info's pretty vital.

The only thing that you talked about that we didn't cover (although I wish we had) was 12 lead EKGs. I think our instructor thought it would be too much, and hospitals will generally pay for you to take the 12 lead class if you're in an area that requires you to be able to interpret them.

I'm in FL, and the class is just called med surg II, but our entire clinical rotation is in ICUs. We are expected to learn everything you mentioned. The NCLEX tests us all on the same material, so most schools cover the same general stuff. We all have to take ICU, Peds, OB, and Psych, regardless of where we actually want to work when we graduate.

I wish my NS had something like that! If we get placed in ICU its random according to the spots available...I would love to have a class like that

Sterren, BSN, RN

Specializes in L&D.

My program doesn't have that (you do get a clinical rotation in ICU though) but I sure wish they did. It sounds like you are going to learn a ton in that class.

and FWIW, I think all nursing classes determine graduation. If you fail a class, whether it was an easy class or a hard class, you don't get to graduate, right?

futurecnm

Specializes in ED.

I'm in an AD program and we have a series of lectures (coming up next week) on critical care, ICU, etc (all the stuff you described) and we get tested on it. I'd love a course just on this info, more in depth. You are lucky!!!

:yeah:Thanks for all the replies. I guess I was not very clear when I described the "common dysrhythmias". The ones I noted were the basics that I would assume everyone would hope to learn.

We do have Med surge I & II in addition to Critical care. Just curious where the ADN student attends that had an entire ICU course? :D

Thanks again.

hypocaffeinemia, BSN, RN

Specializes in Critical Care.

:yeah:Thanks for all the replies. I guess I was not very clear when I described the "common dysrhythmias". The ones I noted were the basics that I would assume everyone would hope to learn.

We do have Med surge I & II in addition to Critical care. Just curious where the ADN student attends that had an entire ICU course? :D

Thanks again.

I'm the ADN student that misread your line regarding common dysrhythmias. I've been a monitor tech for years, so it's a bit of a sore spot dealing with nurses that don't know their rhythms. :p

I'm also the one with a "full semester" of critical care.

This isn't entirely accurate: We're one of the few integrated (versus block) curriculum programs out there, so we touch on each and every system the first three semesters, going into more detail and more complexity each time. The third semester we cover the "extremely sick" angle from each system and this is when we get into all the critical care interventions that address each system. We typically have two systems a test, and 7-8 tests, with about 8 hours of lecture per test. The fourth semester is more focused on getting us graduated, however, we do cover other topics like public health, and organize a health fair.

Our entire third semester in my ADN program is "critical care", with clinical rotations to the ICU, ER, and NICU.

I seriously doubt they want you to become experts at critical care but even if you plan to work in med surg you better know what afterload/preload is and other hemodynamics.

Additionally, you should know the importance of 12 lead EKGs and what is being looked for on each of them, and as for "uncommon dysrhythmias" you sure as heck better know what SVT is. This is an incredibly common dysrhythmia anywhere in the hospital and you should be familiar with its implications to your patient and common treatments. You don't have to be ACLS or have the algorhythms memorized, but this stuff like SVT is so basic we covered it in our second semester (was on our last test).

I saw your post on the cath lab question; with your background in telemetry, I can certainly see how my question might have seemed elementry. I might not have presented my information accurately. In regards to hyper & hypo dynamic stages of shock, naturally pre and afterload is quite basic but is it "basic" NS content to apply with a high degree of understanding how these factors effect SVR, RAP, PAP, PAWP etc.

In regards to 12 leads...of course it's important. Was just curious how many people were given an actual 12 lead print out on a test and were required to interpret it? My research shows this to be an advanced EKG course usually offered for nurses through their employers.

Thanks for your reply:up:

I'm the ADN student that misread your line regarding common dysrhythmias. I've been a monitor tech for years, so it's a bit of a sore spot dealing with nurses that don't know their rhythms. :p

I'm also the one with a "full semester" of critical care.

This isn't entirely accurate: We're one of the few integrated (versus block) curriculum programs out there, so we touch on each and every system the first three semesters, going into more detail and more complexity each time. The third semester we cover the "extremely sick" angle from each system and this is when we get into all the critical care interventions that address each system. We typically have two systems a test, and 7-8 tests, with about 8 hours of lecture per test. The fourth semester is more focused on getting us graduated, however, we do cover other topics like public health, and organize a health fair.

Ahh! we must both be typing away. I totally understand where you're coming from with the "lack of knowledge" about rhythms on the units. I've watched a pt going into Vtach and the RN getting frustrated that the monitor was in malfunction....won't get into that, but quite frustrating!

Thanks for the updated message. Would love to pick your brains some more!

hypocaffeinemia, BSN, RN

Specializes in Critical Care.

I saw your post on the cath lab question; with your background in telemetry, I can certainly see how my question might have seemed elementry. I might not have presented my information accurately. In regards to hyper & hypo dynamic stages of shock, naturally pre and afterload is quite basic but is it "basic" NS content to apply with a high degree of understanding how these factors effect SVR, RAP, PAP, PAWP etc.

I don't know the details of how high a degree of understanding your program requires, but we have to be proficient with critically thinking through shock and applying and analyzing all of the above.

In regards to 12 leads...of course it's important. Was just curious how many people were given an actual 12 lead print out on a test and were required to interpret it? My research shows this to be an advanced EKG course usually offered for nurses through their employers.

Thanks for your reply:up:

If your program requires 12 lead interpretation, you're likely the only program in the country to do that. We have to know what's on a 12 lead, and the obvious lead parings: II, III, AVF; I & AVL, V1/V2 and V5/V6, etc. and how to basically analyze rate+rhythm ST seg/T wave/Q wave abnormalities, but that's the extent of the training.

Additionally, I've worked in several hospitals over the years and it has always been the physicians' jobs to interpret twelve leads. Sure, it is incredibly helpful to learn to read the EKG (ignore the auto-generated reading, often very wrong), but even in rapid response situations were the ICU charge nurse responds and sees "tombstones" on a patient's EKG, we still have to take the EKG down to the ER MD in order to confirm diagnosis.

What I'm getting at is that it would be highly irregular to expect something from nursing students that even highly seasoned staff nurses such as the ICU charge are not expected of.

I don't know the details of how high a degree of understanding your program requires, but we have to be proficient with critically thinking through shock and applying and analyzing all of the above.

If your program requires 12 lead interpretation, you're likely the only program in the country to do that. We have to know what's on a 12 lead, and the obvious lead parings: II, III, AVF; I & AVL, V1/V2 and V5/V6, etc. and how to basically analyze rate+rhythm ST seg/T wave/Q wave abnormalities, but that's the extent of the training.

Additionally, I've worked in several hospitals over the years and it has always been the physicians' jobs to interpret twelve leads. Sure, it is incredibly helpful to learn to read the EKG (ignore the auto-generated reading, often very wrong), but even in rapid response situations were the ICU charge nurse responds and sees "tombstones" on a patient's EKG, we still have to take the EKG down to the ER MD in order to confirm diagnosis.

What I'm getting at is that it would be highly irregular to expect something from nursing students that even highly seasoned staff nurses such as the ICU charge are not expected of.

Thanks a million! Yes, we were given an actual 12 lead EKG on the last exam with one word; "interpretation"? In clinicals, the professor will look at the 12 lead and ask us to go through each lead and interpret it on the fly (and it will impact our clinical grade). Don't get me wrong, I love the knowledge however, nursing school is hard enough and I would prefer this higher level of knowledge be an added bonus to my education and not something I must divert my long hours of study towards for an exam.

I searched online to get more visual education on this since I knew we would be tested on it. The sites that offered instruction were med schools.

Do ya know of a place where I can find EB rationale that 12 lead interpretation is to be done by physicians?

hypocaffeinemia, BSN, RN

Specializes in Critical Care.

Thanks a million! Yes, we were given an actual 12 lead EKG on the last exam with one word; "interpretation"? In clinicals, the professor will look at the 12 lead and ask us to go through each lead and interpret it on the fly (and it will impact our clinical grade). Don't get me wrong, I love the knowledge however, nursing school is hard enough and I would prefer this higher level of knowledge be an added bonus to my education and not something I must divert my long hours of study towards for an exam.

I searched online to get more visual education on this since I knew we would be tested on it. The sites that offered instruction were med schools.

Do ya know of a place where I can find EB rationale that 12 lead interpretation is to be done by physicians?

No. This is more than likely a scope of practice issue. We can interpret it all we want as (future) nurses, but using it as a springboard for treatment requires making a medical diagnosis. To the best of my knowledge, there's no nursing interventions that consider abnormal EKGs- the best you could hope for is like "risk for decreased cardiac output R/T abnormal EKG, but if you interpret any more than that, you're diagnosing. EKGs are a fine line because as a monitor tech I technically make borderline medical diagnoses all day long interpreting strips, but while RNs are responsible for knowing their rhythms, the docs have the ultimate interpretation.

My diploma program included everything you mentioned, including 12-lead interpretation (not every last nuance of EKG interpretation, but all the common and "panic" rhythms, and, yes, we had to interpret strips on exams -- a lot of them, not just one).

hypocaffeinemia, BSN, RN

Specializes in Critical Care.

Interesting. I obviously haven't started my third semester yet, so I have no idea how in depth we go into EKGs. I'd love to have 12 leads as I help teach the class at my hospital so it's an area I know I'd ace, but I was just speculating based on the fact that the majority of med surg and even tele nurses I interact with on a daily basis seem quite...lacking with even basic EKGs. I'll call and tell them there's new ST elevation in the inferior leads and they'll ask me what that means and what they should do (call the doctor, 12 lead, CE, and MONA if applicable).

Once I graduate and have a bit more leverage in my system, I will try to advocate increased knowledge of EKGs for the med/surg nurses, as any given shift 2/3s of med/surg are on a tele pack in my facility.

Italia13 RN

Specializes in ER.

I am in a BSN program and "Critical Care" is our last rotation. I thought the course was pretty easy. It is kind of like the "ah-hah" class, since you pretty much learned everything, now it is just more acute and you actually start to put the pieces of the puzzle together with everything you have learned thoughout nursing school and it starts to really make sense. This class was alot of studying and work, but what nursing class isn't, but I loved going to this class because you learn so much and it was never a boring moment! Goood Luck!

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