Why do I have to take the EKG arrhythmia test if I took it 8 months ago??

[Nurse Beth, MSN]

Dear Test Anxiety,

 I don't have access to specific policies or regulations of Kaiser Permanente or AMN, but I can provide some general guidance based on standard practices in the healthcare industry.

It's not uncommon for healthcare organizations to require employees, including travel nurses, to complete specific competencies and tests periodically to ensure they are up-to-date on the necessary skills and knowledge. These requirements help maintain a high standard of patient care and safety.

While it may seem redundant or frustrating to retake a test you have already completed, it's important to remember that organizations like Kaiser Permanente have policies and procedures in place. They may require specific competencies to be completed during in-person orientations regardless of previous experience or testing history.

Additionally, sometimes educators will take a one-size fits all approach to structuring orientation for expediency. If you are newly contracted for a monitored area, you can be expected to test along with the other new hires.

While it is possible to contact HR to dispute the decision, it may not be the most advisable approach. As a travel nurse or new employee, it is generally expected to remain adaptable and avoid causing disruptions.

Remember that testing anxiety is a common challenge, and many individuals in healthcare have faced similar feelings. There are various techniques and strategies to manage test anxiety, such as deep breathing exercises, mindfulness techniques, and visualization. If your anxiety significantly impacts your ability to perform at work, you may also consider seeking support from a healthcare professional or counselor who can manage anxiety.

You can also discuss your feelings with your nurse manager or the nurse educator at Kaiser Permanente. They may be able to provide additional support or accommodations to help you manage your anxiety during the testing process.

Study to reduce anxiety. You could ask your educator if they have a textbook on arrhythmia that you can borrow or if they can provide you with a study guide for the upcoming test.

Regarding the arrhythmia exam, the strips will be straightforward and are not intended to be tricky or ambiguous. Don't overthink.

Anticipate one or more questions on each arrhythmia. Here are a couple of things to know for sure:

• Identify and differentiate v-tach and v-fib. 
• Identify and differentiate SVT and Afib. SVT is regular, Afib is irregular (R-R), and there's no discernable P wave (there may be undulations but no discernable and regular P waves).
• Be prepared for a first-degree block, a second-degree block, and a third-degree block.
• Recognize asystole (yes, people do confuse it with vfib. Asystole is not a perfectly straight line but does not have the unorganized waves vfib has).

Remember that the organization wants you to succeed. They know your work ethic, they want you back, and they've already invested time and paperwork to re-hire you. It's highly likely that they'll work with you if you don't pass the first time.

Experienced educators do not judge nurses who don't pass their arrhythmia competency. They try to discover the underlying reason and help you get to where you need to be.

Overall, I understand that retaking a test you've already completed can be frustrating. Still, it's essential to comply with the organization's policies and work towards providing safe and high-quality patient care. You can do this.

Wishing you the best in your nursing career; I hope you can find ways to manage your anxiety and thrive as a travel nurse.

Sincerely,

Nurse Beth