[nurseJ88]

Hello. I am a new graduate registered nurse who is being offered a position in Medical-Surgical Telemetry. To those Tele nurses out there, please give me some advice about having a head start and thriving on the Tele floor.

Description of this Position:
-Medical-Surgical Telemetry
-Night Shift (11 pm to 7 am)
-1:4 nurse to patient ratio
-RN, CNA Team (There are no LVNs on the floor. There are EKG Technicians.)
-New Graduate Program with Preceptorship for 8 weeks
-Salary is high as compared to other hospitals in this area.
-Benefits are excellent.

Questions about Telemetry floor:
*What nursing subject areas do I need to go over with before the start of the orientation (i.e. EKG, ACLS, cardiovascular anatomy and physiology, cardiovascular pathophysiology, cardiovascular procedures, cardiovascular medications)?
*What is your usual 8-hour routine on the Tele floor?
*What are the differences of the night shift Tele floor from the day and evening
shifts in terms of patient care and task load?
*What is your advice for me, in general, as a new graduate registered nurse starting on the Tele floor?

Of course, I do have an idea about the Tele floor but your experiences as seasoned Tele nurses has given you wealth of knowledge and skills specific to this nursing specialty. Anything would be of assistance. Thank you.

[Tele_Nurse4u]

I just graduated last May and started on a cardiac tele floor. Although it is not just cardiac! WE get everything!! It sounds pretty much the same as yours. The ratio is 4:1.
Honestly, if you like a challenge then go for it. Some days are craziness, but im sure thats true with any floor. The wealth of knowledge you receive is incredible. DONT BE AFRAID TO ASK QUESTIONS!! These patients are usually on monitors for a reason! So if im not sure about something I ALWAYS ALWAYS ASK!! LOL

I would DEFINETLY go over cardiac anatomy, cardiac patho, maybe the common meds. Cardiac anatomey and patho were a biggie for me. In school we briefly went over EKG strips, so I reviewed all of them. I also had to take (AND PASS) an EKG class at work. ACLS (at my facility) usually comes 6-12months after you are out of orientation. The reason for this is because you are on the code team and thats A LOT for a new nurse!!

For me, days is kinda chaotic. I dont know if thats how it is everywhere...but for me it is. Its faster, more doctors in, more families, more tests...etc. Dont get me wrong though...3-11 and midnights can get crazy too! I trained on all 3 shifts...I liked them all.

I guess from one new nurse to another...dont be afraid to ask questions. You are never alone. Even when you get funky EKG strips, someone is there to help. If a patient is going bad..you have help.

Cardiologists always seem in a hurry..so dont take offense LOL
My first week I was like " why are they so mean?!?!" But theyre not...lol
just busy

Good Luck!! Im sure youll do great!

[dianah]

Congrats on the position, nurseJ88, great opportunity for learning!

And I certainly agree with Steph: ask questions!

Try not to get frustrated or down on yourself for not "getting it" as quickly as you'd like.
Give yourself time to learn the routines and to digest lots of new information, and especially for learning how to apply all your schooling to "real time" critical thinking.

Let us know how it goes!

[ckc6977]

Originally Posted by nurseJ88

Questions about Telemetry floor:
*What nursing subject areas do I need to go over with before the start of the orientation (i.e. EKG, ACLS, cardiovascular anatomy and physiology, cardiovascular pathophysiology, cardiovascular procedures, cardiovascular medications)?

I would also suggest reviewing physiology and patho and some common meds (Metoprolol, Cardizem, Digoxin, Amiodarone, Coreg, etc). Don't concern yourself too much with the procedures. You probably will be able to see some of these procedures during your orientation. Also, you should be able to ask your preceptor questions and listen to how he/she describes/educates the pt on those procedures. This will come with time.

*What is your usual 8-hour routine on the Tele floor?

Typically, I work 12-hour shifts (nights). I usually show up about 20 minutes early to write on our pt-care sheets. Things are the most important to know: tele, O2, IV, orientation, activity (bedrest, up ad lib, etc). Others: if they are diabetic, are they ac/hs and how much insulin/what kind of insulin they received.

*What are the differences of the night shift Tele floor from the day and evening
shifts in terms of patient care and task load?

Days: tons of people (families, MD's, transport taking pts for tests/procedures, bringing them back from tests/procedures, more RN's in nurse's station - which means less places to chart, dealing with dietary, giving insulin x3/day, admissions, transfers and discharges, nurse managers - - IMO too many chiefs and not enough indians)
Evenings: lots of families, probably the busiest dealing with the families.
Nights: a little busy initially (7p-11p), admissions, less people (less families, less MD's - practically none)

*What is your advice for me, in general, as a new graduate registered nurse starting on the Tele floor?

It takes 6months-1year to get your routine down. Wait on taking ACLS until the 1st year. You're too busy figuring everything else out. Really learn your telemetry strips, arrhythmias. Take an active role in learning your telemetry and taking your EKG test ASAP. Try to sit in your monitor room for a shift (hopefully your orientation will allow for this). Don't be discouraged. Listen to what your preceptor is telling you. Don't act like you "know it all" - act as a sponge and take everything in. Don't forget that you will be off orientation soon, so ask all the questions you can now - - it's your time!!

Good Luck - and great choice on choosing tele as your 1st RN job!!!

Cynthia