does this sound extremely unsafe or is this typical??

UnbrokenRN09, BSN · Mar 7, 2014

I know this is like 3 months old, but this is just nuts and totally unsafe. What is the point in monitoring pt's on tele if no one is going to actually monitor it? You won't be able to, because you're going to be doing nursing duties for 7 patients as well as the CNA duties, transport duties...totally insane. It takes a good hour or two to prep a CABG if you're also responsible for the clipping, pre-op meds, EKG, paperwork, labwork, teaching, IS instruction, large bore IV insertion, IV fluids, etc. What if someone goes into VT while you're stuck in a room prepping a CABG and everyone else is drowning too....meaning no one is by the monitor. Someone is going to die on that floor and it's not a matter of "if" it's "when".

I work at a facility where we monitor our own tele, but it's not a traditional hospital set-up with long hallways, it's sections or "pods". We have a good central monitor set up at the nurse's station that is close enough to pt rooms to hear alarms. The pt's also have bedside monitors if they're on a gtt or just not very stable. The other facility I work at is a traditional hospital setting with tele techs in addition to the bedside monitors and central monitor station. So no, I would say this is not "typical" and anyone that thinks it is has sadly never had the priviledge to work in a safe environment. Even if it is night shift, that doesn't automatically mean it's not busy. I have worked both....dayshift is generally busier, but it just takes a couple things to go wrong with a patient to make night shift awful. You need techs/support staff at night just as you do during the day.

delphine22 · Apr 11, 2014

Unfortunately, all I can say is time to leave. Once management decides to go one way, no amount of begging or pleading (or poor outcomes or tragedies) can convince them to hire more staff.

CardiacKittyRN · Apr 11, 2014

I'm on a progressive cardiac unit... we have no techs, day or night shift, but we do have a monitor RN on our floor 24/7. We try to have any procedure that can be done at bedside, there, but transports to tests or cath.. just depends. Sometimes there is a transporter avaliable, sometime as take them down the cath lab ourselves.

ashleigh_0804 · Apr 12, 2014

Is it unsafe, yes. Does it happen everywhere, yes. That's what makes nurses so important. We have to deal with cutbacks firsthand and learn how to adapt. So while it's unsafe...it's a hard reality.

PedsRNCVICU · Jun 24, 2014

We have 2 monitor techs at all times covering our ICU and step down unit. Its hit and miss as far as having a CA or unit sec but our CAs don't get to do much hands on with pts anyway

ProgressiveActivist, BSN, RN · Jun 25, 2014

It sounds extremely unsafe. If youre busy it could be hours before you notice a change in rhythm, ectopy aberrancy or new RBBB or long qtc.

What happens is people just turn off the alarms and the printer. No one notices when the pt is off the monitor and then he's found dead on the floor. (true story)

SubSippi · Jun 30, 2014

I might be the odd one out, but I don't think it's particularly unsafe. I've worked in places both with and without tele techs, and I prefer to interpret my own strips and be responsible for that aspect of patient care.

While there are definitely some downsides, the tele techs became way more of a bother than anything else. I would get more than a dozen phone calls telling me that my patient has a noisy signal when I know they're just up to the bathroom, or that the patient's leads are off when I know they're getting a bath. Or when a patient will brady down to the high 40s every so often while they're sleeping.

I found that letting the techs be the ones primarily responsible for monitoring rhythms, nurses end up not ever actually looking at or analyzing a strip. This can be a problem, for example, when nurses need to be aware of a patient's QT interval when giving certain meds, or when a patient has an infarct or partial blockage in a certain area of the heart. A tele tech doesn't know the patient's history, and therefore doesn't know which lead they need to have displayed on the monitor.

I know it's a pain in the butt, and it is always overwhelming when a new task is put on a nurse's plate (especially in the name of the almighty budget). I just feel that rhythm interpretation and monitoring is something an RN should be doing. Instead of inventing a tele tech, hospitals should have hired more CNAs to give the RNs more time.

On a side note, in a hospital where I did clinicals had a tele tech on each floor behind the nurse's station monitoring rhythms, instead of a couple people in a room on a different floor. I think this is the best of both worlds because the tech knew what was happening on that floor, and the nurses also had easy access to the monitors, and were therefore kept more in the loop. But...that was a couple years ago, and that hospital has probably gotten rid of that since then!

SRDAVIS · Jul 28, 2014

Where are u located?

stablesystole · Aug 5, 2014

I'd phrase it as less safe than it could be, as opposed to calling it unsafe. Having worked as a tele tech before I graduated I can say for definite that having a dedicated analyst on the monitors does enhance safety due to the ability to spot subtle changes minutes or even hours before an event would occur. That said, labor costs are the number one driver of healthcare costs so it is not surprising that such a job is a natural target for slashing.The elimination of night shift techs is more worrisome to me. I know that it's a tempting target for budget purposes but they are such an asset for the nighttime management of patients, especially the confused and fall prone and so forth.