Nervous about new tele job!

  1. I am an RN with two years of correctional nursing experience.. I was just offered a position on a tele unit :heartbeat in a nearby hospital. Of course I am elated at this oppurtunity and cannot wait to get started. However, I am very nervous because this is my first hospital position and want to do very well. I want to be overly prepared and was hoping for any pointers that may be out there!! I have my ACLS and I have basic knowledge about EKGs and rhythms..Wish me luck!
    •  
  2. 11 Comments

  3. by   izziebi
    Remember it is all about cardiac output. EKGs are no big thing if the patient is perfusing. Treat the patient not the EKG. If the patient is decompensating it is because they are not circulating oxygen so put the nasal canula on at 4 liters, lower head of bed and call for help if a situation arises.

    XOXOXO
  4. by   fsh1986
    I am a new grad and starting tele soon... why would you lower the HOB?
  5. by   Been there,done that
    Confusing response. You would lower the head of the bed if the b/p dropped.. raise the head of the bed of shortness of breath is the issue.
    Either way.. the issue is significant enough to call for help.

    Good luck.
  6. by   brainkandy87
    Don't blindly give medications just because they're scheduled. When I worked a tele floor, I don't know how many times I had a pt hypotensive or bradycardic because the day nurse had given a beta blocker without bothering to check a BP or heart rate. I'll never forget the night I had to call a rapid response on a pt because the previous nurse had given 100 mg metoprolol with a BP in the 90's and HR 50-60.
  7. by   Do-over
    Well, do glance at the ECG's now and again... They might be perfusing for now... and you might need to put the Zoll at the bedside just in case...
  8. by   Do-over
    Congrats, by the way! I love working tele/step-down.
  9. by   fsh1986
    Quote from Do-over
    Well, do glance at the ECG's now and again... They might be perfusing for now... and you might need to put the Zoll at the bedside just in case...
    What is a "zoll"?
  10. by   brainkandy87
    Defibrillator.
  11. by   Do-over
    Quote from fsh1986
    What is a "zoll"?
    Sorry, its the brand of portable monitor/pacer/defibrillator we use.

    Had a few patients with second degree blocks come in recently - and if they don't already have a permanent pacemaker we keep an external one close by.
  12. by   fsh1986
    Oh wow, I'm in for a ride. I'm a new grad starting on a tele unit in two weeks!
  13. by   ummwhome
    Reviews test, labs, and meds commonly given on cardiac floors. Always treat the pt, not the numbers. Be sure the Cardiologist is on board with any changes in pt status. No parameters for all cardiac meds. Dont be afraid to ask if you dont know!!!

    good luck

close