I am a new grad working in a progressive care unit and I love it! It can be stressful at times. The nurse to patient ratio is 1:4, but sometimes 1:5 or even 1:6 if we are really short staffed. We can have patients on drips (NTG, amiodorone, cardizem, dopamine among others) but our titration abilities are limited (for example, we cannot go higher than 15mg/hr for cardizem and no greater than 5mcg/kg/min on a dopamine drip; this varies by facility). We get a lot of chest pain/CHF-ers along with patients with dysrhythmias (a-fib/flutter), patients going for cardiac cath (and post-cath patients) - some need to have their sheaths pulled! We also get a lot of patients with respiratory problems - COPD, pneumonia, ARF, asthma exacerbation, etc....but really, we can get anything and everything on that unit! We get patients who overdosed, patients with DKA/HHNKS (usually those patients are sent to the ICU and then when more stable come to my floor), tamponade/PE, renal failure, even pediatric patients! You definitely learn a lot. We have monitor techs but watching the monitors is also our responsibility. Some are great at calling you with changes; others hardly watch the monitors. It helps to let them know to tell you what you are looking for. For example, I had a patient on a cardizem drip and had the BP recycle Q15min. I watch the monitors, but I cannot watch them all of the time (such as if I am in another patient's room or something). I told my MT to call me if they see the SBP has dropped below 100. Things like that...it helps.
Nov 20, '11 by turnforthenurseRNI am a new grad working in a progressive care unit and I love it! It can be stressful at times. The nurse to patient ratio is 1:4, but sometimes 1:5 or even 1:6 if we are really short staffed. We can have patients on drips (NTG, amiodorone, cardizem, dopamine among others) but our titration abilities are limited (for example, we cannot go higher than 15mg/hr for cardizem and no greater than 5mcg/kg/min on a dopamine drip; this varies by facility). We get a lot of chest pain/CHF-ers along with patients with dysrhythmias (a-fib/flutter), patients going for cardiac cath (and post-cath patients) - some need to have their sheaths pulled! We also get a lot of patients with respiratory problems - COPD, pneumonia, ARF, asthma exacerbation, etc....but really, we can get anything and everything on that unit! We get patients who overdosed, patients with DKA/HHNKS (usually those patients are sent to the ICU and then when more stable come to my floor), tamponade/PE, renal failure, even pediatric patients! You definitely learn a lot. We have monitor techs but watching the monitors is also our responsibility. Some are great at calling you with changes; others hardly watch the monitors. It helps to let them know to tell you what you are looking for. For example, I had a patient on a cardizem drip and had the BP recycle Q15min. I watch the monitors, but I cannot watch them all of the time (such as if I am in another patient's room or something). I told my MT to call me if they see the SBP has dropped below 100. Things like that...it helps.
Jan 13, '12 by monsterRNI am a potential hire for a cardiac hospital, for the med/surg telemetry unit. I am somewhat of a new grad and never had any experience with the telemetry unit. From what I am hearing, it seems to be a whole lot of stress. I hear the ratio on this particular hospital is 1:7 and can sometimes can go up to 8 or 9. I don't know how I feel about this considering I've heard the orientation for this hospital is fairly short, about 4 weeks on the floor. I don't know if anyone can give me some insight or advice about working on this kind of stressful unit.