Carlinrnprof

I agree. It will come back to you. Keep those patho and assessment notes handy and review content as it comes up in the new courses. If you always ask "why" and look up the answers you will do great.

Awesome job advocating for this patient! To answer some of your questions:Yes it is possible for these patients to have abnormal ECGs like you described and not be infarcting. You said that it was non STEMI, but the machine read acute. Usually this is due to pathologic Q waves or R wave progression-can be acute or old. You can almost never rely on the machine's interpretation. Without see the actual ECG I could not definitively say. Yes! This patient should have been seen upon arrival to the floor! Minimally within the first 1/2 hour.The patient's cardiologist should have been consulted from the ED and transferred to a more acute setting. Beyond an MI this patient could also have had a PE or tamponade. Unless he was a good actor or I'm missing something he should have been in ICU over night.

Have you ever asked the manager if you could shadow on the unit? We allow nurses from the step-down and m/s units to come in a shadow a nurse for a shift. If you make an impression the staff tends to push for you to get a position on the unit. (we tend to be rather vocal).Also see if you can float or sign up on their needs list. We currently have a staffing and bed shortage. Telemetry nurses are being pre-assigned to our CICU to take the patients with transfer orders that can't be moved or are used as helping hands when there is a high acuity. We have hired several of these nurses. Just a few ideas outside the box.