Telemetry monitoring

  1. 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.
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  2. 22 Comments

  3. by   Rocky_LPN
    we also have techs that set in a tele room. howvere 90% of are nurses r ACLS and can read the strips, however we dont have time to set and watch the monitors on the floor so its nice to have someone call through a direct line and say hey 4406 is in VT.
  4. by   greatlordduke
    I work in a community Hospital and I personally have fears about this. I like to look @ my strips and know 1- What the rhythm is, artifact, ectopy or arrhythmia 2- If it is an arrhythmia or ectopy, is the patient symptomatic? 3- I am calling that Doc and telling what is going on with that patient. Alot of bigger hospitals are going to this type of telemetry. I have an ICU backround and to think about working on a floor that I do not have direct access to look @ the pt rhythm is alarming to me. Just my input. Deb
  5. by   cardiacRN2006
    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.
    If your patient is on a monitor, then you, as a nurse, need to be trained on how to read them. MTs are fine, but I just can't imagine not knowing how to read them.
    I print strips on my pts Q4 and whenever else they need it.
  6. by   Nightrn16
    The tele floor I worked on had a monitor tech that was trained specifically to watch the monitors .. uh .. watch the monitors. They took off doctor's orders and watched the tele's. Not the nurses. The nurses would sit for them when a break was needed, but as part of the orientation an EKG class was given.

    Frankly, I trust more of the tech's decisions on strips than I do my own and I done cardiac for 2 years. I can calculate .. but they do can do it much quickly .. and normally are more right than me lol.
  7. by   ohiorn_78
    Our hospital is transitioning to having at least four tele beds on each unit to take stable heart pts and having a MT in a "war room" to watch the rhythms. All the nurses have to take a BCRA class and the majority are ACLS certified. The problem with this is that most of the nurses took these classes over a year ago and the hospital is starting the system this December. Everyone knows the old adage "If you don't use it, you lose it". So one can wonder if this is a safe practice or not. I guess we'll see.
  8. by   BrnEyedGirl
    Wow,..monitor techs,..haven't actually seen one in,..maybe 20 yrs,...I work on a tele/stepdown unit,..all of our pts are on monitors,.all of our RN's must be ACLS cert., we are required to document monitors checks q hr, et run strips q 4hrs et prn,..checking the monitor is part of the assessment,..does the monitor tech know that the pt is on a cardizem gtt, or Dobutrex, or that they just started on Tikosyn? I don't think I would feel comfortable w/this.
  9. by   Spatialized
    On the tele floor I previously worked on, the monitor techs were aware of any drips or other variables that might effect rhythms as it was passed down in report between them. The nurses were all tele/ACLS trained, but the tech was really just another set of eyes, especially because there were monitors only in the nurse's station and the tech station. The RNs still signed off on q4 strips and rhythm was part of the assessments. It seemed to work effectively for that unit.

    Cheers,
    Tom
  10. by   Nightrn16
    When we do Tikosyn, or have them on a drip that would affect the HR, we tell the HUC's (the one's that watch the monitor), and they have a clipboard that when they measure each strip out, they record what the qrs interval and stuff on, and they also write down if their on a drip affecting HR, that way when they give report, it get's passed on. It worked the whole time I was working there.
  11. by   BVFD 333
    Quote from RN-Cardiac
    Wow,..monitor techs,..haven't actually seen one in,..maybe 20 yrs,...I work on a tele/stepdown unit,..all of our pts are on monitors,.all of our RN's must be ACLS cert., we are required to document monitors checks q hr, et run strips q 4hrs et prn,..checking the monitor is part of the assessment,..does the monitor tech know that the pt is on a cardizem gtt, or Dobutrex, or that they just started on Tikosyn? I don't think I would feel comfortable w/this.
    I work as a monitor tech for the past 5 years while finishing nursing school, often I do not know on what gtt the pt is on. I do will know about Tikosyn so we can calculate the QTc. The nurses are also responsible to pull a strip q shift and prn for arrythmias. I do believe Nurses working with monitored pt must know basic arrhythmias. :spin:
    Happy Holidays
  12. by   GardenDove
    Where I work, we have a 6 bed icu/stepdown unit and we monitor our own pts, sometimes on days they have a tech/unit secretary/CNA to help, but at night we do everything. We also monitor the tele pts for med/surg. Last year they made them all take a course, plus the unit secretaries, but they don't have the time to master reading the strips, or else not the interest so it was all a waste.

    We are supposed to mount strips once a shift and PRN. I often do it every 4 hours. We also mount the med-surg pts' strips, which we put in a special book.
  13. by   gerry79
    I happen to be a tele tech at the hospital where I will be working as an RN once I pass the boards. Although I watch the monitors and alert the nurses to changing rhythms, the nurses are held ultimately responsible. The tele techs are very good at reading strips and the nurses heavily rely on us. It would be added stress for the nurses to watch the monitors and do the other nursing tasks as the ratio can be 1:7/8 on the evening/night shift.
  14. by   RN ColbyJack
    My tele/caridiac unit doesn't have techs. Our monitors are in the nurses station and all our nurses are capable of and responsible for reading and interpretting them. Of course, we do lots of helping each other out with the tricky ones, and go check on each other's patients if something funky is going on. This is just what I'm used to so I suppose that's why I'd have a hard time not knowing what's going all the time on with my patients' rhythms. Our strips are printed and logged q2 and prn.

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