A Day in the life of a Telemetry Nurse? - page 3
Hello, I'm considering applying for a job on a tele unit and am interested in learning more about telemetry. If anyone could answer these questions, it would be much appreciated! What is a... Read More
Sep 18, '12 by GrinchyRNOh, so true! Aides/techs can absolutely make or break you. Unfortunately, on my 30 bed tele unit, we are usually short staffed and 50% of the time, work with no techs. Oh, how I hate those nights!
Sep 18, '12 by annatuesdayI am a telemetry nurse working nights. Nowadays with the new federal healthcare reimbursement and the tight budget, we do not get CNAs at night anymore. At first I was miserable but now I am used to taking my own vitals, turning and cleaning my own patients, calling the doctor re a new Vtach, calming down a confused non compliant patient, accepting a new admission, and whatever else coming my way. Q insulin drip can wipe you out. Sometimes I wonder how I made it through the night. Yes working days can be crazy, but there is help, like CNAs and unencumbered charge nurses. There is also that sleepy thing at night. Nothing is perfect either way. All I know is that I love telemetry and am still learning everyday. It is ultra interesting and never boring, that's for sure.
Sep 21, '12 by Drew3175As a new grad I worked ortho/neuro, and got bored with it. I worked telemetry for 4 years before progressing to progressive care, which is the step-down open heart unit of my hospital. I love it. My patents come up from our CVICU with chest tubes and pacer wires. I was uncomfortable at first, but not anymore. Are my days busy-yes, hectic-yes, rewarding-yes. Am I bored as a progressive care nurse no way! I learn something new almost every day. I say go for it, the more knowledge the better. Good Luck!
Sep 15, '15 by ivyleaf, ASN, RNI just re-read this post, and I think it's one of my top favorite on allnurses ever. Are you still doing cardiac? Do you still feel that way?
I am again contemplating cardiac nursing (or ED) as my next career move... i just passed ACLS and am considering doing a 12 lead ekg course, although not sure if it's worth the $$.
How would you compare the population to your general med/surg floor (older vs younger, more/less obsese, more/less ambulatory/independent, more/less frail)?
Sep 15, '15 by ivyleaf, ASN, RNSorry, forgot to quote simonemyheart's post-- the one I was referring too
Quote from simonemyheartI get to work about 6:45, get my pt assignment for the day. I look up the H&P, consults, order's, labs, VS hx - to not trend or change.
I go and look in on my pt's rooms to make sure no one is in distress and assess who is the most critical.
I get report on my pt's during walking rounds, I check IV sites, IV tubing, rates of drips. Who's on a drip, who's getting antibiotic or other IV fluids, who's on maintenance fluids. Is there any out of date tubing, IV's, is everything labeled.
I only really write down in report info that I have not looked up and all the nurses know that I do this so it's no longer a problem.
We do not have doctors in our hospital at all times so I like to call the MD's in the AM regarding orders I may need - pt in pain -need pain meds, low H&H as compared to previous labs, a decline of of pt's condition, Dr. So and So has cleared this pt can they be DC'ed, clarify meds, etc.
I like to it this way b/c our floor gets crazy busy and it's easier to do whatever I can earlier.
I pull my meds, grab supplies, and to my morning assessments. I make sure I focus on lung sounds - with IV fluids I hate fluid overload, pulses, perfusion, O2 sat, VS, heart sounds, LOC, all that good stuff.
In between all this Im being called away for phone calls, pt in pain, pt has nausea, demanding family members who want to know why my grandpa who just had a stroke is NPO, critical labs coming in, some pt's heart rate is in the 30's, Im getting a new admit when I already have 6 pt's...........
After all this maybe I have time to sit down and chart, while Im charting the unit director wants to know why I'm charting when I could be the room talking to my pt about there life - BECAUSE I AM TRYING TO SAVE THEIR LIFE AND IF I DON'T CHART YOU WILL BE ASKING ME WHY HAVEN'T I CHARTED YET.
Then their are random people who want to know if grandma can have more vanilla ice cream but can I make it look like a sundae and mix it with chocolate pudding with crushed graham crackers on top. And of course I have to jump up and do it because we have to keep those HCAP scores up and my favorite thing to do is play waitress.
Pt X spent all his time asking me questions about anything and everything and I answer but not to his satisfaction and then the doctor comes in and gives him the same answer but he forgets the rest of his questions and is on the call light wanting to know more answers when he could have asked to the doctor 30 seconds ago but he tells me that he doesn't want to bother the doctor because he is too busy. Yeah, like I'm not.
That's my day or at least the first 3 hours, the other 9 are just as bad.
Nov 10, '15 by AlissaO, BSN, RNAt my hospital there are 3 tele units- one of them takes post CABG/valves and LVADs but my floor and the other just get your typical cardiac patients. Usually they're in from the ER for cp/sob or if they're tachy they may need cardiac monitoring (i.e. infection/GI bleed... not really cardiac related but it's another thing to learn about!) or if they have a history of afib they'll be on our floor no matter what they come in with or sometimes we get medical overflow. We also get transfers down from the ICUs- often after they've stabilized after a aneurysm or something. My floor has mostly semi-private rooms so we don't get too many isolation patients (yay for no c.diff!) but we end up having plenty of roommate problems, sometimes we're moving patients in the middle of the night to get them closer to the nurses station or with-it vs. extremely confused/impulsive patients out of the same room.
I work nights- I usually get there right at 6:53 to clock in and quick write down my assignment and the patients' meds. I don't look them all up unless I have extra time because you can generally tell what their history is by what they're taking (and make sure all the day shift meds got addressed before getting report plus when I go see the patient I know what I'll be bringing them if they ask and know which PRNs are available to them or what I would need to get an order for). Then we have huddle at 7, then bedside shift report (plus all the extra goodies we talk about in the hallway away from the patients/families). By 7:45 I'm usually doing my first set of vitals/assessment (we have techs that do toileting etc. and take our blood sugars, we do our own vitals which is fine by me- I don't want to have to stalk my PCA down to find out their pressure before giving my meds, it's bad enough waiting for sugars some nights). Then I try pass all my meds before 10. If I can take my midnight assessment at 11 and let my patients get some sleep while I do my charting/note reading/write the report sheet for the new day/give report to the charge nurse until 5am when I can do my 4am assessment and pass my 6am meds at the same time and then give report at 7:15.
Sounds simple but it never actually happens that way. Usually I don't have the chance to sit down until after 11 and then I may as well make my midnight assessment and chart them both at the same time. The evening can be a lot of paging doctors to get whatever orders you may need/want before they get too crabby, going to get your patient ice water and then going back because they only wanted ice and then going back because 'an orange juice sounds good' and then going back because 'oh I really prefer grape juice' but then again 'it's been almost 5 hours since my last BM so I'd better have a prune juice instead because I'm practically constipated', then you get cornered by a family member who wants to make sure you know their entire family's medical history and about the argument that went down 10 years ago between Aunt Sally and Grandma Ruth and how that somehow relates to the patient's diverticulosis and how (even though they've been in the hospital for 5 days) at 10pm on a weekend is a good time to bring up that their ear itches and don't you have a medicated cream for it RIGHT NOW? And one of your patients you don't know much about because they're discharged and their ride should be here any minute but then you end up spending an hour getting their ride coordinated and them out the door while you admit your new patient down the hall. Then the telemetry tech is calling you that one of your patients leads are off and they can't get ahold of your PCA and then they call that the person they just cardioverted is back in afib and your other patient just had 10 beats of VT and then a bed alarm goes off for the 5th time in 5 minutes. Or you walk into a rapid response or every single patient you go to assess also needs you to take them to the bathroom right then.
It's almost always hectic but it's almost always fun. Certainly never boring and your coworkers and your patients will get you through because they're awesome. You will have short-staffed days with 6 patients, most of them heavy when you keep running out of flushes or alcohol swabs in your pocket. You will also (hopefully) have staffed days with 4 patients and be able to have conversations with your patients and get to know them and let them know they're important and maybe feel awesome for passing your meds early or be able to do something extra for them they've been too afraid to ask for. Many of the nurses on my floor are relatively new (<2 years) but there are also a handful who have been there 25+ years. Definitely a great great place to learn and if you like the fast pace then stick with it because there will always be new grads around on a tele floor needing more experienced nurses to work with and there's more to learn every single shift.