Telemetry monitoring - page 2

Our hospital has a centralized non-nurse monitor tech that monitors patient throughout the hospital on tele (all areas except ED, ICU and OR). The nurses on the floors are not trained to read... Read More

  1. by   INtoFL_RN
    I would have a problem with it if the nurses on the unit aren't trained in basic EKG interpretation and rely solely on the MT's assessment of the rhythm. Reading tele strips is not always cut and dry. I've worked on a unit where we had a MT and now work on one where we do not (we carry pagers to alert us to arrhythmias and run strips q 4 h). When I worked on the unit with a MT, there were good ones and there were not so good ones. I always checked my own strips when we had an MT; I just think it's the responsible thing to do since you are ultimately accountable for your pt!
  2. by   nurse4theplanet
    Our facility has a tele floor with 40 beds! This is where the central MT desk is, but all the nurses on this floor are ACLS certified. There are either 3 or 4 other floors that accept pt's with a monitor, but I don't know if those nurses have any more experience reading strips than basic EKG training. I work in ICU, so obviously we have to know how to read strips very well.

    As far as printing strips, I think they have to print each shift and with each rhythm change. Possibly more often on the tele unit.
  3. by   Spatialized
    I just joined a 46 bed tele unit, nearly every patient is monitored (there are a couple not on the monitor though). We have a monitor tech who watches all the patients and notifies the nurse by pager when there is a change or the patient has a change. There are central monitors at the nursing stations, but only portables in the rooms, so it can be dicey at times, but if you have someone who needs close monitoring (like Tikosyn loading, dilt and amio gtts, fresh sheath pulls etc.) they have the monitor at the bedside. All of the nurses are ACLS trained as well. The MT notifies us and we treat. It works...
    We are supposed to print strips and sign off on the charting that we have done so, and it usually gets done. Also the MTs print off strips as well, since we are not always right there as needed. It's also great to have an extra set of eyes when it comes to interpretation!

    Tom
  4. by   anonymurse
    A while back our hospital's tele unit had these really cool LCD pagers that showed 4 EKG traces per screen as the default display. They were configured (by whom I don't know) to show just your own pts. I don't think they use them any more and I don't know why they would have discontinued them.
  5. by   rsmcc
    Quote from Bwick
    Our hospital has a centralized non-nurse monitor tech that monitors patient throughout the hospital on tele (all areas except ED, ICU and OR). The nurses on the floors are not trained to read monitors and rely on the MT to tell them about the rhythm and base practice off that.
    Does anyone else have a problem with that?

    Also, how often do you mount strips for patients on tele.
    I'm a new grad on a tele unit. The hospital that I'm working for wants me to go to an EKG class in August (8 months away). In the meantime they want me to sign off on the EKG strips. We have tele techs that interpret the strips. Do you think this is ok to do? How can I agree/disagree with the tele tech if I don't even know how to analyse the strips?
  6. by   dona4jc
    Quote from rsmcc
    I'm a new grad on a tele unit. The hospital that I'm working for wants me to go to an EKG class in August (8 months away). In the meantime they want me to sign off on the EKG strips. We have tele techs that interpret the strips. Do you think this is ok to do? How can I agree/disagree with the tele tech if I don't even know how to analyse the strips?

    Our new nurses that has not gone to basic dysrhythmia class yet don't sign the EKG strips, they ask their fellow nurses that had the training already to sight the strips for them.

    I used to be a monitor tech for 5 years, and I'm glad I got that training before I became a cardiac nurse.
  7. by   truern
    Quote from rsmcc
    I'm a new grad on a tele unit. The hospital that I'm working for wants me to go to an EKG class in August (8 months away). In the meantime they want me to sign off on the EKG strips. We have tele techs that interpret the strips. Do you think this is ok to do? How can I agree/disagree with the tele tech if I don't even know how to analyse the strips?
    On my unit, we're initialing that we've been informed of the change indicated on the strip...not that we agree/disagree with the monitor tech's interpretation. It's then up to us to inform the MD of any changes as needed. Oh, and our techs are always informed re: gtts, etc.

    We have a dedicated monitor room manned by a monitor tech at all times, plus we have monitors at the nurses' station. Our monitor tech also monitors patients in the observation unit as needed.
  8. by   All_Smiles_RN
    Quote from rsmcc
    I'm a new grad on a tele unit. The hospital that I'm working for wants me to go to an EKG class in August (8 months away). In the meantime they want me to sign off on the EKG strips. We have tele techs that interpret the strips. Do you think this is ok to do? How can I agree/disagree with the tele tech if I don't even know how to analyse the strips?
    I started tele as a new grad. My preceptor would assist me with my strips and we'd both sign. Then when I was on my own, the charge nurse would assist me and we'd both sign until I took my class. Personally, I would try and take an ekg course sooner if available.
  9. by   burn out
    As the RN over that patient you are responsible for the ekg reading and interpretation. You are the one with the broader knowledge base, the one licensed, and the one the law will hold accountable. Many times I do not agree with our tech and we have a debate over a particular strip but in the long run I win..I find it myself imperative that the monitor tech and myself are both calling the same rhythm the same thing and since I am the responsible for reporting and treating then I call the rhythm.
  10. by   blueheaven
    I worked on a 30 bed tele floor and we had a MT. Part of the cooperative effort between nursing and the tech was for the RN to inform the tech whenever the patient was being placed on a drip and it was documented on the MT pt sheet. Our MTs were taught about the different drugs and the effects on rhythm. RNs were expected and required to be able to read rhythm strips and to know ACLS.

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