jo1828

I work on a cardiac step-down unit, and was teaching as student the other day about pacer spikes. I told her that sometimes there are three pacer spikes--one before the P wave, and two close together right before the QRS complex. I had seen this occur just once or twice, and had been told it was from biventricular pacing. My charge nurse corrected me and said this was just artifact. I assumed she was right, but when I researched it online, I found several sources that talked about 2 ventricular spikes showing up on the EKG. Any thoughts would be appreciated!

I work on a cardiac stepdown floor and am almost 4 months off orientation now (can't believe that!) and went through feeling incompetent, worrying about not being able to see the "big picture," worrying about asking stupid questions...and there are still good and bad days. A very experienced nurse told me it takes 2 years to start feeling comfortable (although you should never feel TOO comfortable) so i remind myself of that. Also, it is helpful to think in any given situation, "what would a prudent nurse do right now?" Floor nursing is different than nursing school, and the only way to get good at it is experience. Experienced nurses make mistakes too, i have seen it firsthand. It is just part of the job, part of being human. It is a relief knowing others are feeling the same things--i know we all feel isolated in our incompetence sometimes, but if you are ever unsure of anything, just ASK, people will respect you for knowing your limits and being safe.

I was going through the same thing in nursing school...i threatened to quit about every other day. I felt like nursing didn't come naturally, felt inadequate, had other interests...but now, almost 6 months out as an RN on a tele floor at a major teaching hospital, i LOVE my job. There's still awful days where i go home and cry...but for me, being a nurse is soooo much better than being in nursing school...and looking back, it was all the precious little moments connecting with patients that made me keep on going. So, no one can make the decision for you...but know that being a nurse is a TON different from being a student.

I'm a new RN as well, and i often wonder about the same things :) On my tele floor we do K over 10meq/hr (20 if central line) and 1gm Mag over 30 min, 2 over 1 hour.