Elec-Trocardiograms: ECG Interpretation

When I did my own EKG lab testing I used the following materials: BIOPAC electrode lead set (SS2L), BIOPAC disposable vinyl electrodes (EL503), Cot, BIOPAC electrodes, Computer Sytem, BIOPAC Student Lab software v3.0 or greater, and BIOPAC acquisition unit (MP30). When all these materials are available the computer was turned on and three of the electrodes were placed on the body of my teammate. Two electrodes were positioned on the medial surface of each leg just above the ankle, and the last electrode was on the right anterior forearm at her wrist. When these were attached the subject was asked to lie down on the cot and relax. We then attached her to the EKG machine with three colored cables. The white cable was placed on the electrode on the right forearm, the black cable was placed on right leg and the red cable was attached to the electrode on the left leg.

the trying times within this field. Through my experience as a nurse tech at the

This Friday, September 29th, I had my second clinical observation experience in the Cardiac Cath Lab. I was there from 7:00 a.m. till noon, viewing the flow and duties of the nursing staff on the unit, learning about the procedures done on this specialized unit. Throughout most of the morning I followed Sara, an RN, who had been in the unit for eight years. It was an impressive experience that broadened my previously limited knowledge of the roles and experience of a Cath Lab nurse.

As I prepare for my first classes in nursing school, I recognize my unique position to examine the values that I will bring into my nursing career. Without any experience, my values remain relatively unshaped regarding healthcare. In contrast, the values of nurses who have already accumulated a variety of experiences tend to be more nuanced and informed. For this exercise, I met with one of these experienced nurses—CC, a cardiac-catheterization laboratory nurse who just welcomed her third child. Together, CC and I explored the differences in our upbringings, how we were each sucked into nursing, and how our values have changed throughout different life experiences. Above all, I intended to delve into the story of her fifteen-year career in order to discover how an experienced nurse philosophizes patient care.

After completing my bachelor’s degree at Florida State University in the fall of 1997, I began my career at a small hospital in Largo, Florida. I started on a thirty eight bed cardiac/telemetry unit. I had the fortunate opportunity to orient with a seasoned nurse who loved her career in nursing. She was an enthusiastic preceptor that not only educated me on the tasks of nursing but inspired and introduced me to critical care and critical thinking. I spent the next three years at this hospital working in the Coronary Care Unit until deciding to become a travel nurse and see the country. I began travel nursing with my best friend and we worked in Florida, Washington D.C., New York and Denver. At all of these locations we worked in the intensive care unit. Each experience provided a different population and vast new experiences.

On September 28, when we went to Tripler Army Medical Center, I was placed in the Cardiac Ward. At that time, I was able to learn so many diagnosis dealing with the patients. The nurse had briefly explained what was going on with each individual patient and the type of treatments they are doing to help. She had also neatly clarified each medication she was giving them and told me exactly what it was used for. I was able to get an experience of hands on by taking a patient’s temperature. I had shadowed as she did so many things to make the patient feel comfortable and did everything to the best of her ability to make them happy. She had taught me how to record every piece of information about the patients on the computer by showing me what

A combination of these experiences and his educational background of a Diploma in Nursing, a Bachelor’s degree in Health Care Management and a Masters in Corporate and Public Communication inspired my curiosity on understanding what sparked Amber’s will to be such an all-around person in the nursing profession. Amber said “to grow, one has to be willing to work hard. Nursing is beyond a gentle touch.” This phrase gave me the understanding that nursing requires considerate exposure to all the life aspects. With that understanding, one can treat patients and fellow medical professionals well. One gets to understand everything that affects their professional life, and life outside the workspace.

For this interview I had the opportunity to speak to Vicky Ronald, RN, BSN, OCN. She has been working as a nurse for 20 years now and stated that she loves what she does because it is a gift and a blessing to contribute in healing patients. This interview is a brief history and description of how Vicky made it to the top of the Nursing ladder, her roles, past experience and how she integrates HIPAA to maintain patient confidentiality.

One of the nurses beside me begins to speak. “Look at the screen,” she said, pointing to a monitor. “Right now, we're doing a coronary angiogram. Basically, we're inserting a dye and using an x-ray to spot any abnormalities in the arteries of the patient's heart…”

Acute care nursing is by far the most interesting and exciting field I have yet to encounter. There are a couple areas for improvement, and there a couple areas that I have exceeded in. With that being said, the first area of improvement is knowledge of the pathophysiology of the most common diseases seen in the emergency department. The second area of nursing that needs improvement is the titration of intensive care unit medications. Two strengths that I can identify are as follows: patient safety, such as hygiene, and patient safe communication. I enjoyed being in the forefront of the hospital, it was truly an excellent learning experience. I am very thankful to the staff in the emergency department at Las Palmas Hospital, they facilitated

Cardiovascular disease has long been the leading cause of death in the United States and is predicted to affect forty percent of the population by 2030 (Narang et al., 2016). Moreover, research states the cardiovascular workforce is inadequate to meet the rising demands of our aging population (Narang et al., 2016). Nurses caring for patients in the cardiac catheterization laboratory are key members of the cardiovascular workforce. While there is research to support the development of nurses working in the pre- and post-cardiac catheterization laboratory settings; current literature reveals little information about the development of nurses working in the cardiac catheterization laboratory (Currey, White, Rolley, Oldland, & Driscoll, 2015).

Cardiovascular diseases have long been the leading cause of death in the United States (Narang et al., 2016). Research predicts the progression of cardiovascular disease will affect forty percent of our population by the year, 2030 (Narang et al., 2016). Furthermore, research shows that the cardiovascular workforce is inadequate to meet the rising demands of this patient population (Narang et al., 2016). In particular, a subset of cardiac nurses, a cardiac catheterization laboratory nurse is a key member of this cardiovascular workforce.

her future practice. As the DNP Essential VI document denotes, the DNP graduates are well positioned to function as collaborators with members of the other professions (AACN, 2006). As an example, this writer has taken a step forward and collaborated with the local American Heart Association to provide basic lifesaving education to non- clinical members of the team. This was well received by the management team and has attracted potential clinic customers in the process. Looking at the big picture, this writer will apply principles learned to achieve high patient quality outcomes, emphasize evidence-based practice and deliver the highest level of nursing

1. What does an electrocardiogram measure and what do the P-wave, QRS-complex, and T-wave represent?

Several of the roles which I observed this morning were expected: the nurses took vitals for incoming patients, performed focused assessments, and were the main communicators between family, the patient, and the physician. I realized when the first patient came in around 10:00 am, the RN’s role in assessments, gathering blood work, and carrying out all the necessary steps to situate and stabilize the patient as soon as possible. It was incredible seeing the nurses work together, in sync, in those first moments when the patient was brought in. And though expected, I appreciated seeing just how much communication was held and information was gathered from the patient or family members by the nurse. Jessica asked the right questions from both parties, while still showing incredible empathy and not making the whole situation seem rushed and flustering. I understood this as another essential role of the nurse in the ED; he or she must maintain even in such a fast-paced environment empathy and focus in each interaction.