The Year: 1997
The Place: Cooley Dickinson Hospital
The Subject: Yours truly
The Setting: Cardiac Rehabilitation Center
I was about to graduate with a degree in Kinesiology from Springfield College (go Pride!) but first, I had to fulfill my internship hours. As a young student armed with a lot of theoretical knowledge but not much else, I was excited to finally get a chance to actually do something other than sit in a classroom and take notes. Having studied such areas as anatomy and physiology, EKG interpretation and medical terminology, I was sure this whole internship thing would be a breeze… until my first week there.
My primary role was to walk around take blood pressures of the patients while they walked on treadmills or rode stationary bikes. The more involved stuff like reading and interpreting EKG strips was left to the nurses that supervised the unit (and for good reason, as you’ll learn below).
I had learned in my studies all about fast heart rates (tachycardia), slow heart rates (bradycardia), as well as various types of heart arrhythmias such as ventricular fibrillation, or v-fib for short. So while I wasn’t quite ready to perform heart surgery, in my young and foolish mind, I was more than qualified to work at a cardiac rehab unit.
I was taking a patients blood pressure when I heard the EKG monitor alarm go off and when I glanced at the monitor, it was clear that the patient who was associated with the EKG was in all sorts of trouble. I wasn’t exactly sure what v-fib looked like on a real monitor, but I was pretty sure this was it!
Upon looking around, the room, I realized that there were no nurses or doctors available and despite the patient who was in ‘v-fib,’ talking to the guy next to him, I was pretty sure I had to do something. That something was to more or less to tackle the patient off his treadmill and in the process, scare the living hell out of him.
Hearing the alarm, the nurse came in and upon witnessing me with the patient, she calmly walked over the EKG machine and with a swift hit to it, the alarm turned off and the patients sinus rhythm went back to normal.
Needless to say, I was embarrassed to say the least. Turns out the EKG machine was old and occasionally would have it’s own sort of arrhythmia with alarms blaring and the EKG going off the charts. Amazingly, the patient didn’t have a heart attack from my actions and after everyone was calmed down, the nurse sat me down for a talk.
“What was Gary doing when the alarm went off?” she asked.
‘Talking to Sam,” I answered.
“This is a great teachable moment for you.” she said. “ALWAYS monitor the patient first and the machine second. More often than not, observing a patient will tell you more than the machine will.”
APPLICATION TO COACHING
There are near limitless metrics out there. Some are product-driven while others are physiological in nature.
Heart rate, power output, cadence, lactate threshold, VO2 Max, speed/pace, elevation gain/loss… just to name a few.
Now don’t get me wrong, these metrics have tremendous value when used properly and usually in correlation with one another. However, they should NEVER take the place of the athlete as a whole. Therefore, questions such as, “How are you feeling?” or “How did the race or training session go?” are so valuable. This is often why Rate of Perceived Exertion (RPE) is one of the best assessment tools, as it is subjective and takes the whole athlete into consideration.
While paying too much attention to metrics vs the athlete as a whole might not be as damaging as tackling an 89 yr old cardiac patient off a treadmill, it is still ill-advised.
Place the overwhelming focus on the athlete and their feedback and let that guide your use of tracking metrics and data.
Rick Prince is the founder/director of United Endurance Sports Coaching Academy (UESCA), a science-based endurance sports education company. UESCA educates and certifies running and triathlon coaches (cycling and ultrarunning coming soon!) worldwide on a 100% online platform.
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