Asystole Is The Most Stable Rhythm

It was my Skills III final scenario test.  A scenario test is slightly different than a skills test in that during a scenario test, you have to nurse a mannequin that talks, has pulses, and breathes, while the teacher (and the grad student for some reason) watches you.  It's pretty intense.


We students were paired up.  And we got to choose our partners for once, PTL.


Right before this test we learned how to read rhythm strips of the heart.  (This is hard.  No lie.  I don't like it.  And I will be spending time this summer going over it.)


Since the heart seemed sooooo important to the "patient", I studied how to care for a heart attack patient and tried to understand the rhythm strips for heart attack patients.


I knew MONA.  Morphine.  Oxygen.  Nitroglycerin.  Aspirin.  (Not in that order though.)


None of that mattered.


Side note, 10 minutes before the scenario test, the director of the Skills classes comes into our classroom to tell our teacher that the mannequin's blood pressure hasn't been working right lately.  Oh great.  Taking BP on a person is hard enough, but on a mannequin, torture.


The "patient" kept telling us to leave him alone and to get out of his bedroom.


Uh, the other part of this test was that we needed to use therapeutic communication.


Me: You're not in your home, sir.  You are in the hospital.
"Patient": Leave me alone.  I just want to go to sleep.
Me: *hold/pat mannequin's hand*  It's okay, you are in the hospital.  We're going to take care of you.
"Patient": OOOOOOOHHHHHHHH, my chest hurrrrrrrtttttts.


We take the vital signs.  I take the BP and tell it to the teacher.


Teacher: Are you sure?
Me: Uhh, yes.
Teacher:  Okay then.


Panic, panic, panic.


Was that BP right?  Are we going to give him medicine related to his BP when I don't know his BP!?


"Patient": OOhhhh, my chest.  Get out of my room!
Me: You're in the hospital, sir.


Move along.  We put the EKG on the patient and get a rhythm strip.  Now we have to interpret it and call the doctor and tell him what the strip says.


This is what the strip looked like:

We told the teacher (who pretended she was the doctor on the phone) it was atrial flutter.


Me: This is Katie in room 227, with Mr. Smith.  We just got his EKG, atrial flutter.
Teacher/Doctor: Oh really?  That's not what I see on the EKG you sent me.


(We sent him an EKG!?) (And why are our pretend doctors always men?)


Me: Okay.  What do you see then?  (I thought this was a great question!!)


Teacher/Out-of-doctor-character:  Are you kidding me?  A doctor would have hung up on you.
Me: Uhhhhh.  (A doctor would have hung up on me when there is a patient who is dying?)


Needless to say we got the rhythm strip wrong.  The strip above is atrial tachycardia.


This is atrial flutter:

Yeah.

This means that the patient was not having a heart attack.  But some lung problem, I don't know, I didn't study what to do in the chance of a lung problem.  I guess this teaches me to only study for one thing.


Anyway, we passed.  And now its a funny.


The moral of the story:  Get your strips straight!


Ahhhh, the life of a student nurse.


"Consider the work of God: for who can make that straight, which he hath made crooked?" Ecclesiastes 7:13