[mamason]

I worked on a telemetry/step-down unit last year. (Had a baby) We had no monitor tech to watch our monitors. We, the RN's, were responsible for all monitoring. We were generally assigned 8 pts each. We carried "beepers" that were set up with the tele monitors. Any type of alarm would sound off the RN's beeper and show him/her what type of arrythmia was going on with the pt. It also gave a particular buzz/beep for certain life threatening readings. A lot of false alarms because this system was not fool proof. A lot of time and aggravation with pacemaker pts. Some how the system would read a pacer beat as asytole. RN's spent a lot of time trying to reset false alarms. This took much needed time away from pt care that was needed. Some RN's got to the point of ignoring the alarms assuming that it was a false reading. Very bad and unsafe floor to work on. I think that a monitor tech, RN, etc. would have been benefici al to this unit to help weed out interference and such on these cardiac monitors. But, the facility wasn't willing to spend the money for that. The RN's were constantly overwhelmed and still are. I have a friend that still works there and she states that it's crazy.

[dawngloves]

I have to say, having worked both with a tech and without, I'd much rather have a tech. One place had a beeper system, which was a huge PITA. Imagine trying to start a difficult IV and your beeper goes off for V tach and you run off to find your pt scratching himself or you are with a scared pre CABG pt,talking to them, and you have to run off for a V fib that is actually someone brushing their teeth.You want to throw the damn thing out the window.
Another scary place had monitors at the stations, that were at the ends of hallways.If it is 9am and everyone is in a room checking vitals and passing meds, no one can hear it.I've come out a room many a time to hear an alarm for V tach, and it's now SR and you look in the history and it was artifact, but heaven forbid.
Having a tech gave me much more uninterupted time with my pt so I would not have to run off during a bath for artifact.They would also call the code team while we initiated a code giving the coding pt that much more time.

[vamedic4]

Dawngloves and mamason illustrate some things that I said earlier. It can be inherently dangerous NOT to have a tech. And with patient ratios increasing for nurses everywhere, are you willing to put your license on the line? That's what's happening when something is missed, and someone's head is going to roll. I can guarantee you it won't be an administrator either. They can weasle their way out of just about anything.

vamedic4
Monitor tech, medic, HUC,
all around do it all guy

[SillyLilly]

Last week I saw the importance of needing a monitor tech, and when it makes sense to not have one.

I interviewed at 2 tele units. 1 was very busy and had 'lots of sick pts'--the nurse manager claimed they just got monitor techs and it has taken some of the stress off.

Other hospital did not have "really sick" patients like the other hospital claimed, was smaller, and seemed quiter. They used the pager system. To me, both make sense.

I guess it is good to take the load of the nurses if the load is too much. Why not?? Nurses will still assess the strips, just not have to respond to all the beeping and booping.

We have nurse assistants to help us with our duties of ADLs and etc. It makes sense to have monitor techs if it is needed on the unit.

[mamason]

Originally Posted by vamedic4

Dawngloves and mamason illustrate some things that I said earlier. It can be inherently dangerous NOT to have a tech. And with patient ratios increasing for nurses everywhere, are you willing to put your license on the line? That's what's happening when something is missed, and someone's head is going to roll. I can guarantee you it won't be an administrator either. They can weasle their way out of just about anything.

vamedic4
Monitor tech, medic, HUC,
all around do it all guy

Yes..Yes...Yes.... This is why, when I re-enter the nursing profession, I will be cautious when applying for cardiac position. I was a new graduate when I took the previous job and didn't realize how dangerous the situation was. I could tell you horror stories about Rn's ignoring alarms and such. Mainly involved pt deaths. If they don't have a monitor tech, then, I won't be working on that particular cardiac unit. TOO....STRESSFUL WITH HIGH PT LOAD.

[mamason]

Originally Posted by SillyLilly

Last week I saw the importance of needing a monitor tech, and when it makes sense to not have one.

I interviewed at 2 tele units. 1 was very busy and had 'lots of sick pts'--the nurse manager claimed they just got monitor techs and it has taken some of the stress off.

Other hospital did not have "really sick" patients like the other hospital claimed, was smaller, and seemed quiter. They used the pager system. To me, both make sense.

I guess it is good to take the load of the nurses if the load is too much. Why not?? Nurses will still assess the strips, just not have to respond to all the beeping and booping.

We have nurse assistants to help us with our duties of ADLs and etc. It makes sense to have monitor techs if it is needed on the unit.

I feel that the pager system is useful if it is applied to the right type of floor. It was not working well in the unit that I had worked on. The pt's were too unstabile. The workload was extremely heavy. It was hard for the seasoned RN to keep up let alone a new grad. It was an overwhelming responsiblity that you had to contend with at all times. This does not mean that I'm against the pager system at all. Nor, do I think that monitor techs are fool proof either. It just depends on how comfortable you feel in working in that particular situation. Research the unit and decide if that's what you can handle. Ask to shadow an RN on a shift that you're interested in applying for. These are things that I did not do, but, should have done. Then you could get a feel for how things might go for you once you start working on that floor.

[Indy]

I like having monitor techs to a degree. What I don't like is having monitor techs but no computer screen at one of our nurse stations. Yah, they can call me if something goes wrong but it's not always possible to answer the phone! So Vamedic, you're asking if we're willing to put our license on the line not having a tech? I've told my manager the nurse is responsible for the patient whether or not an unlicensed tech picks up the phone to call for a problem so having a monitor at the desk is a necessity.

I pay good attention to the screens on the units where I have them, and if I have time I'll talk to the monitor techs to explain why I am or am not worried about something. They appreciate the consideration; I may get less phone calls or more appropriate phone calls. But nothing replaces a nurse who's good at reading rythyms, not even a cardiologist, because they are on the unit maybe an hour a day. One other thing, besides a desk monitor screen, that I have on my wish list: a portable monitor like the one on the code cart, that does nothing but monitor, and is fairly small. I want it for when I'm pushing cardizem boluses, or spending time titrating dopamine, etc. That'd be sweet!

[NurseyPoo]

We do not have monitor techs at my location and the RN is responsible for monitoring the patient. On the telemetry floor there was a huge bank of monitors and they were VERY NOISY. So, if an alarm sounded everyone on the floor knew it. We carried phones and would be alerted to a problem via phone. If I was busy and my phone went off after hearing an alarm sounding I would either yell down the hall or stop what I was doing if possible to make sure that I was not needed. I think a monitor tech is a great idea, but I do not think the facility I work in has ever had them.

In the ICU that I work in there are 4 monitor banks. We also have a screen in each corner of the unit with a message that lights up with the room number and the problem while the alarms are sounding. If there is a code the system alerts the nursing supervisor and he/she will be there in minutes. Sometimes after shift I can still here the alarms in my head when I try to fall asleep...

[augigi]

We don't have monitor techs at all in Australia. We do have the paging system. We also have nurse/patient ratios mandated by law, so I haven't ever found I couldn't observe the montitors of my assigned patients.

[vamedic4]

Originally Posted by Indy

I like having monitor techs to a degree. What I don't like is having monitor techs but no computer screen at one of our nurse stations. Yah, they can call me if something goes wrong but it's not always possible to answer the phone! So Vamedic, you're asking if we're willing to put our license on the line not having a tech? I've told my manager the nurse is responsible for the patient whether or not an unlicensed tech picks up the phone to call for a problem so having a monitor at the desk is a necessity.

_____---___----___----___----___----____----

The above makes perfect sense, Indy. We're lucky here as we have both- central monitoring (unobtrusive and hidden down a hallway), as well as monitors at both ends of the unit where nurses can keep an eye on their patients as well. Overhead paging and "priority messaging" are a must, however...no matter where you are.


I pay good attention to the screens on the units where I have them, and if I have time I'll talk to the monitor techs to explain why I am or am not worried about something. They appreciate the consideration; I may get less phone calls or more appropriate phone calls. But nothing replaces a nurse who's good at reading rythyms, not even a cardiologist, because they are on the unit maybe an hour a day. One other thing, besides a desk monitor screen, that I have on my wish list: a portable monitor like the one on the code cart, that does nothing but monitor, and is fairly small. I want it for when I'm pushing cardizem boluses, or spending time titrating dopamine, etc. That'd be sweet!

--Right!!

Here working with kids we have a good idea what to expect from certain CHDs and their corrective surgeries so it's not so big an issue. It's those general peds kids we have to worry about!!!

vamedic4