New Job... been off for a while...

pagandeva2000, LPN · Apr 15, 2007

Please keep us updated on how this job is doing. I just completed an EKG course for continuing education, and I really loved it. It will take time for me to actually interpet the strips, but I do continue to practice at my leisure. I would like to know what I can do with this additional skill, so, I am grateful to know how you are doing. Good luck!

OY!!! Ok, so I haven't been around for a while, have been dealing with a couple of different issues lately, #1 being stupid earthlink. We switched over to their phone service along with their DSL, and ever since that time internet hasn't worked right.
Anyhow, went to renew my ACLS, figured ok, it's been almost 2 years it's time to renew. Up till that point i'd been accepting BS jobs that are part time at best and not really fully using my capabilities as a nurse since september. So I start talking to my old friend Jackie, who is an MSN and teaches a bunch of continuing education for medical advancement center in los alamitos. (and for those of you in the so. cal. area she offers alot of different courses that'll get you continuing ed) So she asks what i'm up to, where i'm working etc etc. I tell her i'm not working and that's part of the problem. Apparently, there had been an opening in a cardiology practice for a pacer tech/nurse where she goes for her pacemaker. The current tech is going back to school to do her RN and BSN and they'd been looking for someone for months to replace her when she leaves at the end of may and NO ONE had responded to their ad in the papers. So I figure, yeah right ok they're not going to hire me... ((snickers)) they did!! I've been there two weeks, and although it's alot to learn, i'm loving it!
Funny thing is, I started on my birthday, accepted the job the day before. I'd also interviewed with a hospital for a tele unit position as a float like two weeks before that, and had been told i'd be offered the position, two weeks later, nothing, this job gets offered, so I took it. The first day on the job I get an email from the hospital extending the offer of employment. Duh. So I had to graciously back out of that position to keep my pacemaker clinic that i'm inheriting here at the end of may. Once i'm fully trained, i'll be interrogating 4 brands of pacemakers and ICD's (medtronic, guidant, st. jude and a few elas), reprogramming and testing them and have full reign of the office that I will be running. I'll be the only person in the Cardiology office that's capable and knows how to do it. (job security) It truely is who you know for a decent not run of the mill position. Although it's really a technical job, everyone's been saying how quickly i'm learning it all. Just yesterday I interrogated my first ICD without my trainer standing over my shoulder. God I love this job!!!!
My friend Jackie has told me that this job will lead me in a direction both career wise and $ wise that i'd never dreamed.
Anyhow gang, sorry to have been gone for a while, but internet problems still persist, still in school, and now working on top of that, and possibly going to start a fri/sat night shift in ER again to make some extra cash while i'm training at my lower rate of pay for the day job.
Wayne.

postmortem_cowboy · Apr 15, 2007

Heya' pagan! yeah this job is a wee bit different as far as EKG's are concerned. I took have taken a basic, advanced and 12 Interpretation courses, but this isn't quite like that. Each lead into the heart from the pacer has or gets it's own EKG. So you actually see the skin leads you put on with everything together, then you see everything split apart with the myocardial leads as well, one for atrial, and one for ventricular... it's really weird. I'm learnin'... but it's alot of information, have to do thresholds to see where the heart captures for each lead and set the pacer based on those thresholds, you have to do P and R wave sensing so that the pacer will actually see the waves, have to do impedances which are nothing more than resistance to the leads, but can tell you if you have a broken lead or too much scar tissue formed around the lead in the heart... etc etc etc... alot to know... alot to learn... but i'm getting there.

And that's only one portion of my job, there's phone checks that you do an EKG over the phone to check the pacers battery status, there's event monitors, holters (which i'm not reading at the moment) scheduling, editing pacer results from interrogation in the computer... oy...

The one good thing everyone keeps telling me is, that if/when i get comfortable doing it, and have been doing it for a while, I can move over to one of the device companies and do implants in the OR with the docs, and i guess those guys make the big bucks due to the degree of speciality and not very many of them around. May 31st is when I inherit this clinic all to myself and i'm basically on my own, so after that point... hopefully i've learned enough to get myself by and do a good job.

Wayne.

pagandeva2000, LPN · Apr 15, 2007

Where did you find an Advanced EKG interpetation class? It may take time for me to decide to take such a class at this moment since I really need practice with the current course I just took. I will be taking the 12 lead class next month, but it is only for one day, the previous one was for three days. I do believe that I would benefit from sitting in an actual class for a more extended period of time, where I would have time to go step by step rather than the crash course I received, but I did walk away with a great deal of information that I never knew before, so, it was worth the money. We did go over pacemaker rhythms, but it was very BASIC, taking all of 5 minutes. This course did strike a cord with me and I do wish to learn and practice more.

What you are doing seems to be extremely interesting and I look forward to more posts from you sharing your experiences. Thanks for sharing. It is interesting that people can share something that someone else may wish to do themselves.

Heya' pagan! yeah this job is a wee bit different as far as EKG's are concerned. I took have taken a basic, advanced and 12 Interpretation courses, but this isn't quite like that. Each lead into the heart from the pacer has or gets it's own EKG. So you actually see the skin leads you put on with everything together, then you see everything split apart with the myocardial leads as well, one for atrial, and one for ventricular... it's really weird. I'm learnin'... but it's alot of information, have to do thresholds to see where the heart captures for each lead and set the pacer based on those thresholds, you have to do P and R wave sensing so that the pacer will actually see the waves, have to do impedances which are nothing more than resistance to the leads, but can tell you if you have a broken lead or too much scar tissue formed around the lead in the heart... etc etc etc... alot to know... alot to learn... but i'm getting there.
And that's only one portion of my job, there's phone checks that you do an EKG over the phone to check the pacers battery status, there's event monitors, holters (which i'm not reading at the moment) scheduling, editing pacer results from interrogation in the computer... oy...
The one good thing everyone keeps telling me is, that if/when i get comfortable doing it, and have been doing it for a while, I can move over to one of the device companies and do implants in the OR with the docs, and i guess those guys make the big bucks due to the degree of speciality and not very many of them around. May 31st is when I inherit this clinic all to myself and i'm basically on my own, so after that point... hopefully i've learned enough to get myself by and do a good job.
Wayne.

postmortem_cowboy · Apr 15, 2007

Yeah... well the place I go, medical advancement center is here in california, it's own by my friend Jackie Fritz, she teaches all kinds of stuff, PICC placement courses, NCLEX reviews, IV/Phleb classes (which i'm helping on the supervision day of it for the weekend class) and a whole slew of other courses, go look her up on the internet, might find it as "MAC" or "Medical Advancement Center" She has an EKG basic interpretation that goes up to but doesn't cover all the blocks, mostly just the atrial and normal rythms, then the advanced covers all the ventricular, blocks and death promoting rythms. Then the 12 lead goes over MI interpretation, how to hook one up etc etc etc... It's quite in depth. the basic EKG course ran what i think 3 days, same with advanced, and 12 lead if i remember was a 2 day course.

This is way different, you hook up skin leads and place the programming head over the device, and retrieve information off the pacer/ICD, can program in just about anything you want or can think of... from AV delay to PVARP, PVAB... way technical... that and you can run thresholds to see when the heart looses capture from the pacer spikes and decriment from voltage and miliseconds to get a pulse curve to optimize the battery life. ICD's will store EKG's when they shock, you can see those when you interrogate the device, and watch the device as it tries to anti-tachy pace the heart out of whatever rythm it's in before it shocks, then you can see it deliver the shock, i had one the other day i interrogated on my own, anti-tachy paced twice, didn't do anything, then it shocked... two hours later same damn thing... lol.... so it's way fricken technical... but i'm learnin' it..

Wayne.

TheCommuter, BSN, RN · Apr 17, 2007

OY!!! Ok, so I haven't been around for a while

It's nice to see you back, Wayne. I had been wondering where you had disappeared off to...

Anyhow, congratulations on the amazing luck with finding a good job!

postmortem_cowboy · Apr 17, 2007

Thanks commuter!!

Wayne.