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Thursday, June 08, 2006

Telemetry This

It really comes as no surprise to me that I, Ms-Looking-For-Love, work on a cardiac floor. Hearts are our specialty, and rightly so. We live eat and breathe the many facets of the heart. Of all the organs in the body, it is this one that we are most educated on. And really I wouldn't have it any other way. Being the center of the body, without the workings of that single mass of muscle, our entire being would cease to exist. The brain, the kidneys, the lungs. They're all vitally important. But without the heart, forget about it.

Tuesday night I found myself suffering from one of those completely debilitating headaches, the ones that I always used to boast that I never get. Things were about to pick up again, being that it was going on 3:00 AM, so I decided to catch a break before attempting to push my agony aside and get to work.

Sometimes I just like to listen to my own heart, and for whatever reason this was one of those moments. Perhaps I just wanted some reassurance that I was still alive despite all the pain. I leaned back in the chair and closed my eyes. I placed the ends of my stethoscope in my ears and fell hypnotized by the rhythmic lubb dubb of my own heart beat.

Of course this was not the first time that I had done this. But for whatever reason, this time was different. I was overcome with the most powerful sense of awe. Almost a reverence all its own.


I'd never realized how complex the heart was until I studied it in school, and then took the dysrhythmia course at the hospital. Even the slightest electrical glitch could cost you your life. Unfortunately, being a telemetry nurse, we see this all the time. Depending on the occasion the outcome can go either way, and last night was no exception.


The phone rang and I answered with my usual salutation. I'm never surprised when the monitor room calls, and so really this was just another call. The monitor tech informed me that the patient in room 186 had just had a 9 beat run of V-tach. I thanked them for calling, hung up the phone, and spun around in my chair in what seemed like one smooth, continuous movement. Behind me sat Sharon. This was her patient. I relayed the message to which she groaned and hopped up to go and check on the patient. Before leaving the nurse's station she flipped through the patient's chart looking at some previously recorded EKG strips. Apparently the patient had done this sort of thing before, permitting Sharon to simply assess the patient, and inform the doctor in the AM, as opposed to calling him at 2:30 in the morning. Yet she seemed hesitant, and called my attention to the strips. The patient's cardiologist had already evaluated the strips and concluded that in fact it was not V-tach but just some "noise" that the heart monitors pick up from bodily movements. I could only wholehearted agree with the doctor, looking down at the paper covered with erratic scribbles. We were both curious to know if this most recent run of V-tach proved to be only noise as well. I asked Sharon to go get the strip from the monitor for me to take a look at it.

One look and I knew without a doubt. This was definite, textbook V-tach. 9 wide, clean peaks followed by descending waves that climbed into a peak once more, essentially a very neatly drawn zig zag over the horizontal Y axis. Unfortunately this meant that Sharon would have to make that call to the doctor after all.
After that I just sat for awhile and stared at the strip, wondering what the patient felt as their heart threw out a signal like that.

EKG's are kind of like snowflakes. No two are alike. You could have two completely different patients, both with a run of V-tach, and still they would be unique in and of themselves. It makes me wonder if somehow a person's character somehow shows through on their EKG. Some patients have perfectly rounded waves while others look jagged and worn.


They can teach you a lot in school. They taught me a lot at Southern. They taught me a lot at the hospital. They both specifically taught me about the heart. But what do I really know? I can tell you about the many components of the heart. But the block stops there. That's all. I can't tell you what's really in the heart.


So tell me this, what does your EKG look like?

1 Comments:

Blogger lady be good said...

Telemetry Me! You artist you!

5:02 AM  

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