New Grad on Tele Floor-- ADVICE?

  1. 0
    I'm a new grad and just accepted a night position on a med/surg tele floor. I start orientation in a couple of weeks, then I have a 4 week preceptorship on a learning floor, and then my 3 month (?) orientation to the tele floor I'll be working on.

    Cardiac was my weak point in school and I eventually want to work in ICU, so I figured I'd learn a lot and turn my weakness into a strength by taking this position... However, I do not want to come on and be completely blindsided and overwhelmed, which I'm sure happens as a new nurse anyway.

    Do you all have any advice for a new grad coming onto a telemetry unit? Anything that will help me come onto the floor more prepared, ready to go, etc.

    TIA

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  2. 10 Comments...

  3. 2
    I graduated with my BSN in June. Started on a step down telemetry floor in July. I can tell you at times I am completely overwhelmed. Make sure you take BLS and ACLS. If you can take an advanced course on how to evaluate and read cardiac strips that would serve you well. I rely a great deal on the other nurses on my floor, they are an incredible resource. I take my patients best interest at heart, keep in mind what is going on with them, call docs if I feel they are or look different. I question orders if I feel they either, are inappropriate for the patient or don't make much sense. I bounce stuff off other nurses all the time, asking their opinion on stuff. Make sure you know your cardiac meds and side effects. We get all the heart caths, PPM's, ICD's, bypass surgery usually post op day 2 or so with chest tubes intact. I am not going to lie, this floor is very difficult to work on, however, I love the challenge and enjoy my patients and my job. This is so different than school, school hopefully prepared you to think critically, now real life is about to set in. Take some time for yourself on your days off or you will get burnt out fast! Watch, listen and learn as much as you can, ask questions, look up stuff when you are unsure!!! Congrats on the job and best of luck to you. I'm not sure if I made any sense, hopefully I did. Best of luck to you. Keep us posted.
    Vespertinas and mzbree like this.
  4. 2
    You sound like me! Cardiac was my weak point, so my first RN job I took was on a SUPER busy tele unit. (I've been there about 7 months now.) I absolutely love it, even on the worst days. There is just so much to learn... there's not a day that has gone by that I haven't learned something new. I have learned, most of all, to rely on your gut instincts and be the voice for your patients. Its intimidating sometimes thinking that at any moment, your patient can do downhill (and quickly...) but that has made me be more observant and tuned in to my patients. And, when you're super super busy, taking even just a minute to peek into a patient's room to check up on them and let them know that they haven't been forgotten about goes a long way...

    Your fellow nurses are your absolute best resources, and don't ever be afraid to ask questions!
    mzbree and fsh1986 like this.
  5. 0
    I'm going to refresh myself on cardiac meds/side effects, review EKG strips, and review complications of heart caths and other cardiac procedures... Anything else? I just want to be pretty well prepared lol.
  6. 1
    Sounds exactly like me. I swore i would never work in a cardiac area because it was definitely a weak point. It's a challenging area to work. But, this will be an excellent learning experience. Always ask for help if you are unsure- older more seasoned nurses in this area are usually very helpful. I've worked on my super busy tele unit for a little over two years now, and cannot beleive all the stuff I have learned. You're lucky for this experience. Tele experience can get you a job almost everywhere! Good luck, keep us posted--you'll do great!
    fsh1986 likes this.
  7. 1
    ive been off orientation from a cardiac floor for months and i ask questions every two seconds... i rotate between the nice nurses because i think they're getting sick of me!

    but it's great experience so far!
    good luck!
    fsh1986 likes this.
  8. 2
    Cardiac was my absolute worst subject in nursing school (ok, second worst.. my hatred for OB spilled over into my grades) and so when I got my first job on a step down/tele floor, I was kind of freaked, because I couldn't read a rhythm to save my life. It turned out to be great for me. I don't think there's a better way to learn something that to immerse yourself in it. You'll pick up all kinds of stuff fairly quickly. I went from not being able to read afib on a monitor to diagnosing it by palpating a pulse. Just remember to use those experienced nurses and never miss a learning opportunity.
    mzbree and fsh1986 like this.
  9. 1
    congratulations on your job. you've picked the right unit in which to start if you eventually want to move to icu! you've got the right idea with refreshing yourself on cardiac meds, procedures, rhythms, etc. buy yourself a pair of calipers and keep them with you at all times. it really makes those rhythms easier to interpret. ask questions and keep your mind and your ears open and you'll learn a lot!
    fsh1986 likes this.
  10. 1
    fsh, sounds like we're in the same boat!

    I'm a new grad starting on nights on a cardiac/tele floor, after two weeks of classroom orientation and at least 6 weeks of floor orientation.

    I am very comfortable with the cardiac side of things (spent my past life as a paramedic) but I'm still very very nervous! Seems like some good advice has been given already and I'll keep an eye on this post for updates.

    Good luck!
    fsh1986 likes this.
  11. 1
    I am right there with you!!


    I am a new grad on a tele floor that I worked on as a tech for about 1 year. They give us 14 weeks of orientation. I don't have good advice, I was just wanted to encourge you!!! Its a huge learning curve but we will get there. I find that it helps to have a good "brain sheet" to help you remember everything. Also, go to the EKG class, there was alot of good info the other week. GOOD LUCK!!
    fsh1986 likes this.


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