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!
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.
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?
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).
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.
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!
I am in a BSN program as well and we have a class very similar called Advanced Tech. class. This is the class where he are required to learn ventilators, shock and the cascade, hemodynamics, CVP, PAP, 12 lead EKG's and interpretation along with the medications that are given. We are also tested on 12 lead ekg's along with 6 sec. strips that we must identify the rythum and what meds are to be given. I have to admit though that I learned so much in this class and studied so hard and I hated it at the time but I am thankful I took it.
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).
Wow! your school tested you on "a lot" of 12 leads? (the 8.5X11 inch full sheet that is ordered by MD like this: http://www.ecglibrary.com/elec_alt.html)!? We have been tested on lead II 6 inch strips since Med surge I with all the "panic" rhythms and then some. What school do you attend, just curious. Thanks for the response :bowingpur
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.
Methylene; sounds like you are going to make a big difference out there! Good for you! Advocating a higher degree of EKG understanding is ultimately acting as an advocate for the patients and your obvious strength in this area will serve you well as a springboard. Best wishes to you! Save the cath lab for later; I think your drive is needed pre and post cath lab You'll do well wherever you end up.
Yea my school doesnt really teach anything EKG related...our profs have told us that once we graduate we can take classes on this stuff. We do have an advanced health/acute nursing care class that we have the CHANCE to be randomly placed in our last year but it depends on how many people have signed up or who want it...I signed up and am hoping to get it!!! I think it would help so much
We had a semester long and very intensive and FUN Critical Care/ICU class in my BSN program as well. I LOVED it!! It was the best class I had in nursing school :) We learned 12 leads, basic ECGs, vents, hemodynamic monitoring, drugs, etc. etc. etc
THe clinicals were fun to, went spend a lot of time in the ICU (two 12 hour shifts a week) and the ER, cath lab, etc. Good times! I loved every second of it.
We also were expected to know 12 lead interpretation backwards and forwards.
Im in CA in a BSN program. Our critical care class isnt until 5th semester (6 semester program) and yes, the entire class is about critical care and all the clinicals are in ICU..
Wow! your school tested you on "a lot" of 12 leads? (the 8.5X11 inch full sheet that is ordered by MD like this: 
Save the cath lab for later; I think your drive is needed pre and post cath lab
hypocaffeinemia, BSN, RN
1,381 Posts
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.