Hi all,

I passed my NCLEX in August, got hired to work as RN in an LTC and February 12 I finally started my orientation as an RN at the Cardiac Telemetry Floor. I am thankful I got the job. Not easy for me to get a job in a hospital because I don't have yet my BSN.

I am excited, yet scared. Any tips for a new RN in this field is highly appreciated.

Thank you.

Know your rhythms and practice good time management. Tele units can get BUSY BUSY. Other than that, enjoy yourself and congrats on the NCLEX!

Hi all,

I passed my NCLEX in August, got hired to work as RN in an LTC and February 12 I finally started my orientation as an RN at the Cardiac Telemetry Floor. I am thankful I got the job. Not easy for me to get a job in a hospital because I don't have yet my BSN.

I am excited, yet scared. Any tips for a new RN in this field is highly appreciated.

Thank you.

A question to you tele nurses-I suspected a nurse where i work of not passing her meds, specifically Warfarin. I watched their doses go up and up- Then, one day, after her taking the week off, 4 of her pts. Inrs went critical, What would you guys think? I feel like this should raise a flag to the Dr.

Coumadin takes a few days to kick in, so when doses are increased you don't see an increase for about 3 days. What did she do to make you think she wasn't giving her meds?

A question to you tele nurses-I suspected a nurse where i work of not passing her meds, specifically Warfarin. I watched their doses go up and up- Then, one day, after her taking the week off, 4 of her pts. Inrs went critical, What would you guys think? I feel like this should raise a flag to the Dr.

If she wasn't giving the Coumadin, the INRs wouldn't be going up. And those INRs should be monitored daily especially if their dosages are being increased. It also takes a few days for Coumadin to start working. I'm also wondering what makes you suspect she isn't passing her meds.

I too am working as a new grad on tele. It gets very busy with discharges and admissions. I think I get the most stressed with admissions. With time it gets better. I write down the meds at beginning of shift so I won't be looking them up every time, and take your full time of orientation.

Hi all,

I passed my NCLEX in August, got hired to work as RN in an LTC and February 12 I finally started my orientation as an RN at the Cardiac Telemetry Floor. I am thankful I got the job. Not easy for me to get a job in a hospital because I don't have yet my BSN.

I am excited, yet scared. Any tips for a new RN in this field is highly appreciated.

Thank you.

Congratulation you will do well just make sure that you ask question if you are not sure about something .Try to find your own way of doing things that work for you. Always assess your pt and always look at the monitors to see what your pt is doing never assume nor take any ones word check your heart rhythm always good luck :) welcome to the world of tele

Congratulation you will do well just make sure that you ask question if you are not sure about something .try to find your own way of doing things that work for you. Always assess your PTA and always look at the monitors to see what your pt is doing never assume nor take any ones word check your heart rhythms always good luck :) welcome to the world of tete.

Oops always assess your pts welcome to the world of tele.

I too am working as a new grad on tele. It gets very busy with discharges and admissions. I think I get the most stressed with admissions. With time it gets better. I write down the meds at beginning of shift so I won't be looking them up every time and take your full time of orientation.[/quote']

Great idea so do I. I have a way that works for me and I am very rarely late on my meds unless pharmacy doesn't have them available and if so I then put in a missing med to cover myself document always very important if you don't document then you have not done it . I give you credit day shift is very hard and heavy.

Moderators - any chance this could be a stickie note topic? I get the feeling that this board is about to have lots of questions from new grads (myself included!!) about advice for starting on a cardiac unit. Pretty please?! :)

Take your time with orientation. Do not be afraid to ask questions. Know your rhythms and cardiac meds. If your unit takes drips, know those as well. My unit will take patients on cardizem (max of 15mg/hr), NTG (titrate for chest pain only, not BP), heparin, integrillin (we supposedly take it but I have never personally seen it), ocreteotide, dopamine (max of 5mcg/kg/min on my floor), dobutamine (again, ICU transfers if they are being weaned), Lasix, amiodorone. When you can, take an ACLS course and a 12-lead EKG course. Best of luck to you and congratulations! I work on a cardiac stepdown (progressive care unit). I started out there and I love it!

A question to you tele nurses-I suspected a nurse where i work of not passing her meds, specifically Warfarin. I watched their doses go up and up- Then, one day, after her taking the week off, 4 of her pts. Inrs went critical, What would you guys think? I feel like this should raise a flag to the Dr.

Coumadin is a particularly fickle drug. In addition, it takes a few days to have a effect on INR...and that effect can be modified by other medications the pt is taking as well as the pt's diet. I have seen INRs become supratherapeutic after many days at the same dose with therapeutic results. I would not necessarily blame this on a nurse not passing her meds.