telemetry vs med surge

  1. Can someone explain the differences or similarities between working on med/surge vs tele?

    I have worked in med/surge before and it's just not my cup of tea. i have an interest in cardiology, so I'm thinking about applying for a tele position. As you all know, in med surge we do gazillion things during the shift....pass out meds, turn patients q2h, measure I/O, do catheterizations, change wound dressings, draw labs, feed pts when PCA's are not avaiilable...all of this can get overwhelimingly impossible, especially when we are a new RN...

    Do telemetry nurses also have to do all of the above things that I mentioned? or do they just concentrate on the "cardiac" aspect of care? Can someone share some feedback on this? I just want to know what to expect if I go into telemetry.

    Thank you so much,
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  2. 17 Comments

  3. by   missnurse01
    Quote from ffliper27
    Can someone explain the differences or similarities between working on med/surge vs tele?

    I have worked in med/surge before and it's just not my cup of tea. i have an interest in cardiology, so I'm thinking about applying for a tele position. As you all know, in med surge we do gazillion things during the shift....pass out meds, turn patients q2h, measure I/O, do catheterizations, change wound dressings, draw labs, feed pts when PCA's are not avaiilable...all of this can get overwhelimingly impossible, especially when we are a new RN...

    Do telemetry nurses also have to do all of the above things that I mentioned? or do they just concentrate on the "cardiac" aspect of care? Can someone share some feedback on this? I just want to know what to expect if I go into telemetry.

    Thank you so much,
    Yes, you do all this. sometimes tele floors have lower nurse to pt ratio though. You may also have more sick pts-on numerous IV drips that you never seen on med-surg to be aware of, may or may not titrate them. Hence the lower nur-pt-ratio.

    I never worked med-surg, went straight into tele back in the day. I don't think I would have made it on med surg.

    good luck

    ask if you can shadow!
  4. by   #InkedRN
    Telemetry nursing IS Med/Surg patients on telemetry.
  5. by   nyrn5125
    everything is the same including ratio. my hospital is1rn to 7-8pt no monitor tech. we carry beepers. all same med surge issued but with ehart monitors. lots of afib
  6. by   DoeRN
    It is the same essentially. I am a float nurse and have worked on both types. The telemetry floors may have drips that you wouldn't see on a regular floor. And some floors you may have less patients and some you don't. I and O's are even more important on telemetry/cardiac floors. It is still considered med surg but your patients have on tele boxes.
  7. by   OnlybyHisgraceRN
    It is the same as others have already posted, with the exception of cardiac monitoring and etc.
  8. by   turnforthenurse
    It is the same with the addition of telemetry monitoring. Not all patients will have telemetry monitoring ordered, however.

    Where I work, our med-surg units have telemetry, but then there is my unit, which is a stepdown floor. ALL of our patients are on continuous tele. Our ratios are lower (1:4-5 depending on staffing whereas med-surg has 1:6-7) because generally our patients are sicker, require more monitoring and may be on drips such as cardizem, dopamine, etc. We carry work phones. All floors have a monitor tech.
  9. by   NurseDeroko
    I have been a Med-Surg-Tele RN for about 6 years now. Our average ratio is 1:6. It is challenging and fast paced. I have done everything you mentioned PLUS titrating Cardiac gtts and monitoring the patient's rhythm. I believe every hospital is different and I would ask to shadow an RN for a day or two if you have the time. Hope this helps!
  10. by   sugarwahine10 BSN,RN
    You do exactly the same thing as med-surg only then you get all the cardiac piled on too. Just as overwhelming, understaffed, and then some. If you didn't like it, you might want to try one of the intensive care units, maybe cardiac. Is higher acuity patients of course, but only 1-2 per nurse and you might get 3, but that rarely happens. Some nurses on our floor went to cardiac unit & said they were able to learn so much more there instead of running around on med-surg/tele floor barely able to complete a full thought. Is definitely busy, but a different kind of busy from med-surg/tele floor. Or maybe try emergency?
  11. by   RainyDayParade22
    Yes, you do all of those same things, plus monitor the patient's rhythms and treat the cardiac aspect as well as the medical aspect. I started out on a tele med-surg and got my experience with managing drips and different types of heart rhythms. I wanted more cardiac focused patients, so I transferred to a specialty cardiac hospital. Now I work on a cardiovascular post-surgical unit. We care for patients who have had CABGs, lobectomies, AVR/MVRs, peripheral bypasses, etc. I love it, it is exactly the type of nursing I wanted to do. The nurse-pt ratio is 1:4-5, although rarely do we get thrown into 1:5, the management is excellent at trying to limit that as much as possible.
  12. by   LuxCalidaNP
    I work on a Cardiac Tele floor in California, and while it is technically also a Med Surg floor, we are a progressive-care/step-down floor for the ICU. Our patients are much more sick/unstable than our other med-surg floors, and thus we have smaller ratios (that are union-protected, mind you) of 1:4. I like to describe our floor as ICU minus ventilators and titrated drips (we still have some vasoactive and antiarrhythmic drips). Most night on our floor, 3 patients feels insane.

    We often have the unstable ACS patients come to us before cath lab, 3rd degree heart blocks before they get their device, CHF and COPD exacerbation patients, and of course heart surgery patients, post-op.

    Most tele units are med-surg, but depending on the facility, may be more acute.
  13. by   chris21sn
    I work on a telemetry floor. We are severely understaffed - but we accept all drips - amiodarone, cardiziem, dobutamine, heparin, insulin. We accept ventilator patients (the stable ones), tracheostomies. We are CHF based, but when we need beds or when the patient is too stable to go to ICU or the PCU is full it goes to us. We do all the things in the telemetry floor and the some. You learn a lot though believe me -- and as of right now, my usual ratio is 6;1, but times than not I receive 7;1 and 8;1.
  14. by   pmabraham
    Chris21sn, for your 6 to 1 and sometimes 8 to 1 ratios, is that day shift, evening shift, or night shift. How do you feel about patient safety with those ratios? On our floor it is typically 5:1 for day and evening with 6:1 up to 7:1 for night shift. And even with those ratioes, I feel I'm not spending enough time with each patient, and if I have more than one unstalbe patient, I feel things are very unsafe for the patients.

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