Cardiac stepdown vs. telemetry

  1. Hey guys...

    Sorry if this is a stupid question, but...what is the difference between a cardiac step-down unit vs a telemetry unit? I did a very short stent on a tele unit almost a year ago and found it to be much like a typical floor (where you run a lot), just with tele. Is there a lot of 'running' on a cardiac stepdown unit like this or is it a little more focused like an ICU (but obviously not quite as intensely focused)?

    Thanx!
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  2. 12 Comments

  3. by   CaLLaCoDe
    I agree, a telemetry unit is more scatter brained like med - surge but very fun indeed when this occurs, multi teared thoughts and actions lol

    Your thoughts on a cardiac SDU are quite correct; and I just don't care for the very sick, just too many threads to keep balanced!
    Last edit by CaLLaCoDe on Feb 4, '07
  4. by   NurseCherlove
    Quote from TeleRNer
    I agree, a telemetry unit is more scatter brained like med - surge but very fun indeed when this occurs, multi teared thoughs and actions lol

    Your thoughts on a cardiac SDU are quite correct; and I just don't care for the very sick, just too many threads to keep balanced!

    Thank you for responding TeleRNer....at least this gives me some idea as to what to expect. I guess I'm just a little tired of the floor thing and I need to get some substantial cardio experience so the cardiac intermediate care thing may just work out for me.
  5. by   NurseCherlove
    Anyone else?? I'm really trying to find out if a cardiac stepdown unit is a little less chaotic than tele - more 'organized chaos' if you will?
  6. by   SEOBowhntr
    I am an asst manager on a Cardiac Step-Down Unit, and it is a lot of fun. I have time to spend with my patients, however, I also have the unit with the second sickest patients in the hospital. We are the people who catch patients falling, and keep them from hitting bottom lots of the time. Myself and my staff avert a great many of codes and bad outcomes through rapid recognition of problems. During the past 6 1/2 yrs on this unit, I've only called a code 3 times, but have made rapid intervention, at least once or twice a month, averted the need to call a code. The accuity is a bit higher, but the rewards are a bit better sometimes also. I've worked a variety of areas, including TELE, and ICU, and like step-down best because my patients have the potential to crash and burn, and I have the challenge of keeping them on the up side of the ground.
  7. by   pcunurse111
    I work in a small hospital. The unit I work in is considered a stepdown unit but also a telemety unit. Which means sometimes we have a mix of med/surg that need tele and higher acuity patients. The problem with our unit is that we have alot of movement in and out of the unit.
  8. by   elemschoolnurse
    I was just offered a position on a step-down unit and the response by SEO makes me more confident in accepting the position. The ratio will be 1:5.
  9. by   pcunurse111
    Our ratio is 1:3, but many times we are 1:4 without and nursing assistants. It is not unusual for us to start with 3 pts have 3 different pt by the end of the shift.
  10. by   CaLLaCoDe
    Quote from pcunurse111
    I work in a small hospital. The unit I work in is considered a stepdown unit but also a telemety unit. Which means sometimes we have a mix of med/surg that need tele and higher acuity patients. The problem with our unit is that we have alot of movement in and out of the unit.
    I agree with the frequency of movement in a stepdown unit! Many times 3 patients would leave stepdown early in the shift and 3 would be admitted from ICU. Pretty manic at times. Once we even sent some of our patients to the floor and the rest of our patients down to ICU and closed step down since there were not enough nurses that night to cover the step down unit; we went home early! LOL
  11. by   elemschoolnurse
    I accepted the position on the step-down unit today. The ratio is 1:5, but there is an assistant. I feel good about the decision. I think most of the patients will be cardiac or renal. I'm getting excited. Just nervous about learning to read the monitors. I hope it comes easy to me.
  12. by   cappucino
    i worked in an intermediate care unit where all pts were on the bedside monitor and we carried beepers for any arrhythmias or desats. I have also worked the pcu unit and the med-tele. The difference to me is clear. The med-tele's were the most stable and were about to be discharged. Pcu is more of the acute cases fresh from the e.r. or i.c.u. The i.m.c. was about the most intense. Many probably should have been icu, but since there were never enough i.c.u. beds we had the overflow. There were usually a code a week or every other week. That was a 3-4 pt ratio. Breaks were scarce.
  13. by   loriann
    I work on a tele floor which is also the CCU stepdown unit. Our ratio is generally 1:4 and have had 5 patients on occasion. We do get the med/surg-type patients who require tele monitoring and many times you can discharge 2-3 patients and end up with 2 new ones by the end of shift. The floor can be pretty manic, but I like the movement and the shift goes by fast!!
  14. by   All_Smiles_RN
    Quote from cappucino
    The med-tele's were the most stable and were about to be discharged. Pcu is more of the acute cases fresh from the e.r. or i.c.u. The i.m.c. was about the most intense. Many probably should have been icu, but since there were never enough i.c.u. beds we had the overflow. There were usually a code a week or every other week. That was a 3-4 pt ratio. Breaks were scarce.
    I agree with cappucino.

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