[bellehill]

Originally Posted by Sadie04

Thanks Bellehill, how intensive was the cert class? Do you often have patients on your unit that are inappropriate and sent there because there are no other tele beds in the house? Do you read strips and include them in the nursing notes Qshift? I don't think it will be so bad once I'm used to it, I just hope I get thorough training as it's been a long time since I've worked with telemetry. Thanks for sharing your experience

The class was 16 hours with a test after...awarded me 19 CE hours. It was a very helpful class. The opposite is happening with us, we get these patients who have no business being on telemetry and no histpry of cardiac problems. We run strips qshift and document alarm settings in the nursing notes...takes 2 minutes.

[Owney]

I hope that if you will be responsible for telemetry patients, you will have protocols in place not only to recognize dysrhyrthmias but what to do about them. I have been certified in ACLS for 20 years and I would recommend that your hospital train all RNs who are responsible for tele patients to be trained to at least that level.

I would also insist that the hospital equip your crash carts with AED's (most units are doing this, since airliners now have them) and train everyone on the unit to apply them.

Adminstrators need to understand that monitoring means more than just hooking up a patient to a machine. I once saw an OB physician order an ER nurse to take a patient OFF of a fetal monitor. When the doctor explained that the monitor may show fetal distress, and there was no one to interpret it, we were simply creating a legal record of negligence. We did train nurses in fetal monitoring and established a telemetry monitoring system to L&D.

Excuse an ignorant ER nurse's naivete, but to me the words "step-down" and "telemety" are almost interchangable.

[ItalianRN]

I work on a Tele unit that has just added Neuro. No additional training or staffing has been offered & most of the Neuro patients are completes. Our PCT's are killing themselves & still can't keep up either. The other day I had a patient trying to kick me in the head. It got so bad that we had to call security to help. He was a big guy. It wasn't his fault, it was due to the injury but I still don't want a trip to the ER for myself. As a Tele unit we usually had 5 & sometimes 6 patients. That hasn't changed. Many nurses & PCT's, who have worked on this unit for years, are looking to transfer. It already had the reputation of being the busiest unit in the hospital, & the added Neuro patients makes it 1000x worse. I never wanted to work Neuro. I absolutely hate it.

These patients aren't getting the complete care that Neuro patients should be getting. We are not doing Neuro checks other than checking pupils & hand grasps when possible. We note speech & gait, if there is any & that's about it. We mostly send them for tests & give meds. A lot of them need to be restrained because they are so out of it that all they do is try to pull everything out & get out of bed. They're either calm & non-responsive, or they are very aggitated & want to fight you on everything. Neuro is not my thing. I knew that from my first day in Neuro clinicals when I was in school.

I am only on this floor temporarily because my Tele Stepdown unit is temporarily closed due to construction. My unit will reopen in 2 more months. We get post open heart surgery patients mostly. I already asked my Manager if our Stepdown unit will include Neuro too & she said "no way". If she said yes, I'd already be looking to transfer to the OR or someplace that they couldn't add on like this. As it is, we are all overworked & overwhelmed with our responsibilities. I do not want to risk a patient's care or my license due to administrative decisions. They really need to decrease the ratio if they are going to keep this unit as a Tele/Neuro floor. They also need to offer Neuro training & perhaps include some Neuro nurses in our staffing.

I love the people I work with in this unit, but I'm looking forward to going back to my Tele Stepdown Unit.

[gitterbug]

Typical administrative crap, keep beds full, no matter what patients really need. Glad to hear your old unit will be right up your alley.