Mid-January we started our second lab block which meant I got to see a bunch of my classmates in person once again which I was super excited about! Labs have given us the opportunity to get to know one another outside the online environment and develop friendships throughout the Maritimes. This lab block consisted of us mastering Exercise Stress testing and Phlebotomy with an introduction into Holter Monitoring. The courses that accompanied the lab were short courses and were back in December so I was astonished by how much I remembered and new stuff I learned in our 2 ½ week lab. Back when I was looking into this program I thought that the stress testing course would be much longer; however, the great thing about this program is its curriculum layout which carries over previous course content into the next so as you get further into the program there is less new stuff to learn and more old content you use.
The first day at lab we learned how to take each other’s blood pressure which meant we finally got to use our stethoscopes! Taking BP is an essential part of stress testing which seems simple to do but it was very hard to learn at first. People have different heart beat volumes (some loud, some very quiet), and have different BP ranges which may be normal for them but would be abnormal to another individual. That night we also performed our first exercise stress test on each other which was needless to say…super poor quality. Over the 2 ½ week period taking BP got easier and our stress tests improved in quality but more challenges were given to us as the lab progressed.
The second day was centered around phlebotomy (orientation, meeting our phlebotomy teachers, and learning how to draw blood) which brought out nerves in most of us. Prior to lab we had completed our phlebotomy course so we knew most of our theory but putting this into practice was easier said than done. Luckily our instructors were some of the nicest people I have met in my life and were super encouraging, kind, patient, and helpful. I think it took me 3 whole days before I didn’t have to re-tie my tourniquet twice because the first time it wasn’t tight enough. We practiced how to properly and safety draw blood using a straight needle and a butterfly needle on our fake arms for a day or two before we started practicing on each other and on volunteers. I frequently donate blood so giving blood does not scare me but taking blood from someone else made me very nervous. Eventually my confidence grew and I got my 20 successful blood draws signed off with a passed exam. I could draw blood again if I had to but I won’t lie that I am not thankful that RCTs in Nova Scotia are not required to draw blood.
As the lab progressed, the scenarios became more challenging in stress testing and required us to pull more information from the knowledge we had learned in previous courses. This lab really helped me get a better grasp on some of the medication names I have always struggled with and a better understanding on how to connect health issues with cardiac pathologies. I quickly became aware of how much multitasking an RCT has to do when performing a stress test and how we must be prepared for anything to happen. When performing an exercise stress test we need to get a thorough history from the patient including their health, habits, family history, activity level, respiratory issues, and medications as they are not given to us prior. Once we have this information we have to be able to relate their history/medications to their resting heart rhythm and their heart’s response to exercise. We are also required to know the relative/absolute contraindications for the test and decide if the test protocol is appropriate as well as the relative/absolute termination time for testing. Monitoring the patients overall look, described symptoms, blood pressure, and heart rate are all to be done simultaneously to watching and analyzing the patient’s heart on the ECG monitor. A doctor is always nearby or in the room when performing stress tests to ensure if a medical emergency was to happen, assistance would be there quickly. For this lab we only practiced exercise stress testing but we did thoroughly discuss nuclear stress tests (when they are performed and what we would do in certain scenarios).
The final part of this 2 ½ week lab block was spent on learning how to use the holter monitoring software. The next course we were entering was holter monitoring which was laid out different than any other course we had previously taken. This course requires us to analyze holter scans using software that can be difficult and frustrating to use at times. Our lab instructor Jenn showed us some tips and tricks on how to use the program efficiently and effectively before we started the course. We also learned how to hook up a holter monitor and a loop monitor which differs slightly in how they collect information and the period of time they are worn. I won’t get into too much detail about these event monitors as I plan to write a blog about this course in the upcoming future.