Elec-Trocardiograms: ECG Interpretation

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.

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 EKG is read by a doctor or specialist, such as an internist, family medicine doctor, electrophysiologist, cardiologist, anesthesiologist, or surgeon. The doctor will look at the pattern of spikes and dips on your EKG to check the electrical activity in different parts of your heart. The spikes and dips are grouped into different sections that show how your heart is working

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

De-prescribing is, therefore, a complex process that is required for the safe and effective cessation of inappropriate medications to improve the quality of life (Hasler, Senn, Rosemann, & Neuner-Jehle, 2015). Page et al. (2016) suggested a five-step approach for safe and successful de-prescribing: (1) consider all medications currently taken and the indication for each medication, (2) evaluate the overall risk of medication-induced harm in an individual, (3) assess each medication for its potential to be de-prescribed, (4) sort medications by the order of priority to de-prescribe, (5) implement and monitor de-prescribing regimen. While de-prescribing appears feasible and relatively safe to reduce the impact of polypharmacy in older adults,

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.

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 a qualified Certified Nursing Assistant and a student who will be attending a four-year university this fall to pursue a career in medicine, the position as a Nursing Assistant within the Heart Center Cardiology Clinic at Seattle Children’s is an ideal fit for me. I am confident that the patient care and customer service skills I have developed through caring for residents within geriatric facilities will make me successful in this position.

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…”

Reading the story of Macbeth, Lady Macbeth takes control and understands his state of mind. Lady Macbeth could not understand how Macbeth could fail, as he brings the daggers back with him. She had a plan, and prepared for the murder as well as set the daggers by the guards herself. She claimed that she would have killed the king herself, yet Lady Macbeth also states, "Had he not resembled My father as he slept, I had done 't." Lady Macbeth refuses to commit this murder being that she sees a resemblance between King Duncan and her father, which causes her to not be able to do the killing of Duncan.

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?

Demonstrate how your prescribed text and ONE other related text of your own choosing represent this interpretation of belonging.

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.

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.