Is it really necessary to learn to read an ekg? anyone really use it?

[northmississippi]

Do any of you actually know how to read and use the telemetry monitor when it comes to watching the heart beat pattern (p wave, etc). Would it be worth my time to spend the summer learning to really read one? Thanks.

[Tait, MSN, RN]

I worked a cardiac telemetry unit and it was absolutely vital to my career to read the monitors. We had techs in a war room that would watch them, but often it was the nurses on the floor that caught arrhythmia and issues earlier. I would highly recommend having this skill.

[rncat2000]

I think if you are planning on working on a telemetry floor it would be good for you to. I work on a cardiac step down unit with telemetry and it has been to my advantage to know how to read the telemetry. Even tho we have tech that their whole job is to watch the telemetry they still miss things.

[Do-over, ASN, RN]

We are required to analyze the telemetry for our patients.

Can I expertly interpret a 12-lead? Not even close, but we have to know enough to know when to consult the doc.

[Morainey, BSN, RN]

I think it's very useful to at least learn your common rhythms. Any patient on my floor who is on telemetry is being watched on a monitor by a tech, and the strips get read by a designated telemetry RN, but I like to be able to took a look at the monitor and have a clue.

[Misskala]

My last med-surg job had tele patients, and the nurses watched the tele rhythms, and we were also responsible for documenting per shift a rhythm strip. Plus, if there are any changes, you should catch that and call the MD for orders. It's part of your assessment/monitoring job duties. So yes, if you are with tele pts

[applewhitern, BSN, RN]

Yes, learn to read them. You will need this in ACLS, plus you might have a test on them when applying for a job. I have had a telemetry test in job situations many times; not during an interview, but during orientation. Any skills you have is a plus. I also don't always trust the telemetry "tech" who reads them; I like to look at my own. Don't worry too much about reading 12-leads right now, but at least learn to read a basic lead 2 rhythm strip.

[HouTx, BSN, MSN, EdD]

PPs are all correct. It's not enough to be able to identify various cardiac rhythms, you need to be able to connect the dots. You need to understand the underlying physiology behind the arrhythmia - and what it means. Is it due to low perfusion? Med reaction? Stress? Is it true or reactie (vaso-vagal) bradycardia? You also need to be able to recognize various modes of pacemaker tracings.. in order to troubleshoot for problems associated with new insertions or malfunctions.

Proficient critical care nurses should also be able to interpret/analyze 12 leads because this is frequently part of the protocol for acute changes in a cardiac patient... you have to be able to communicate effectively with the physician and anticipate orders.

So - Yeah, you need to learn this. But don't be discouraged at first. Based on my decades of teaching it - most nurses don't really get that fundamental "aha" until they take the basic class for the 3rd time. (srsly) Goes like this:

Class #1= Oh, I can measure all that stuff and tell you what it is, IF I use my reminder notes.

Class #2 = Oh, yeah I remember that.. that arryhthmia means that the patient is ________ and needs to have _____ med/treatment

Class #3 = Oh no! T-waves are spiked, what's the K+ level? 1st degree is lengthening, I think he's extending his MI - better call the doc. Uh Oh, looks like Wenckebach.. Is that TPN here yet? Let's salvage some myocardium!

And so it goes . . .

[nurseprnRN, BSN, RN]

And besides, even if for some reason you can't read one right off the top of your head (and honestly? it's really not that hard, really) you still need to know what it means when someone charts a rhythm or you have to read the report on an EKG. Yes, you work in tele? You need to know this.

Remember too that rhythm strips are NOT the same as diagnostic 12-leads. I worked in open heart surgery for years-- we used rhythm strips all the time, but nobody's 12-lead is normal after OHS, so we never got good at those and I didn't even try to learn them until years later.

[beckster_01, BSN, RN]

Learning basic arrhythmias is absolutely essential, regardless of where you work. EKG monitoring is basically telling you what a person's heart is mechanically doing. If you don't understand arrhythmias do you truly understand cardiac physiology? And if you don't understand cardiac physiology will you really be able to take care of a cardiac patient? And lets face it- almost every patient is going to have a cardiac history. If you don't understand heart rhythms you won't understand what happens with fluid and electrolyte changes. When you look at a set of labs, why would you care what a potassium, mag, or calcium level is if you don't know what effect that can have on cardiac function? And as GrnTea pointed out, it really isn't that hard. There is also a plethora of resources online.

Now a 12-lead EKG is a different story. I would learn enough to know the difference between a new/old MI, however determining the location/severity of the MI is beyond my scope of practice. Sure, it is great to know how to read a 12-lead, but the physician- specifically a cardiologist- is the one responsible for the read.

[proud nurse, BSN, RN]

My last med-surg job had tele patients, and the nurses watched the tele rhythms, and we were also responsible for documenting per shift a rhythm strip. Plus, if there are any changes, you should catch that and call the MD for orders. It's part of your assessment/monitoring job duties. So yes, if you are with tele pts

It's like this at my job as well. We don't have telemetry techs watching the monitors. I attended a week long 40 hour brutal telemetry class that ended with a killer of a test to prove your competency. And to be honest, it wasn't something I was able to determine if it was a needed skill...attendance was mandatory, and successful completion was necessary if I wanted to stay employed.

[SwansonRN]

Totally!! I gets sort of fun after a while, measuring the intervals and deciphering the rhythm. I mean, it's not fun when you're already swamped and one of your patients have ST changes, but otherwise I enjoy studying rhythm strips and EKGs. Also can I just add that if I was a patient I would feel very nervous if my nurse didn't have at least baseline competency in EKG interpretation. If you need help understanding try icufaqs.com. I really like the way he explains things.