[SarasotaRN2b]

Originally Posted by TeleRNer

I'm just wondering regarding the telemonitor's role here, couldn't he or she slip away from the monitor fix the leads, adjust the battery on his/her own and so forth? Just a thought! Especially if your hitting heavy stuff early on your shift! Or do you simply have only one monitor tech?

As a cardiac monitor tech, the answer is no...what if during the time you go into the patient's room to change this, another patient goes bad? who is going to watch the monitors then?

Also as a monitor tech, we are only seeing what is going on with the monitors. I can't tell you how frustrating it is at times to see something going on on the monitors and we let the nurses know who may know that their patients' are nonsymptomatic...I never realized how stressful it can be having to sit in front of the monitors watching a patient's heart rate going up, with the alarms going off and getting little response from some of the nurses. If the patient is known to have a higher heart rhythm, why not just up the heart rate limit.

I work with a great bunch of nurses (night shift), but it can still get kind of hairy.

I also work in a remote tele room in which we are monitoring patients throughout a very large hospital...only seeing the monitors, we can't see what is going on with that particular patient. Our protocol is that we are supposed to call every 3 minutes if the leads are either off or the battery needs changing. If a patient has been in normal sinus rhythm throughout their stay, then we may stretch that slightly, but if a patient has a known dysrhythmia, then I'm sorry, but I will call until I see the monitor go back on. If there is some change in the patient's condition, I always bring it to the attention to the nurse.

Having been on this side, I will make sure that when I am a nurse, I will be attentive to what the monitor techs are telling me and if I know that the patient is asymptomatic, I will let the tech to know. the tech's primary responsibility is to let the nurse know when there is a problem or change in status asap. What the nurses do then, is their responsibility.

Kris

[CrazyPremed]

I've worked as a Tele Tech, and I will soon be starting as an LPN on a tele floor (can you believe it!).

I appreciate this thread - and those who have contributed - so I can see both sides of the story. This will help in my career as a telemetry nurse.

Hopefully, no feelings have been hurt.

CrazyPremed

[methylene]

Originally Posted by kcalohagirl

I'm sorry if I offended you, but this was clearly labeled as a rant, was a way to blow off steam, and though you may have made some points, the snide and condescending tone you used to make them (sorry if that wasn't your intention, but that's how I read it. The printed as opposed to spoken word can be a rotten way to pass on the tone of a post) really took away from anything constructive you may have had to say.

I realize your post was a rant- I just wanted to clear up some perceived misconceptions. I was trying to be objective about the matter- I apologize if this came across as snide and condescending.

Please don't assume that because I post a "rant" and you don't have the blow-by-blow account of what actually ticked me off, that I am a bad nurse that doesn't know jack about telemetry, or that I am somehow neglecting my patients.

Peace.

I haven't assumed as such nor have I insinuated such. I'm just trying to explain why certain things occur from a monitor tech perspective. I agree that the monitor tech in question has his/her priorities screwed up notifying you about leads being off and not major changes in rhythm.

It's happened to me as well. On some days we have 45-50 patients on ambulatory packs with only one monitor tech, and our system is pretty crappy (GE patientnet)- it doesn't alarm irregular rhythms like others such as the Agilent system do, which means if someone converts to A-fib we won't know until we personally observe it, which might be a bit delayed if the rate is acceptable and when you have 5-10 other alarms going off at any given time. It doesn't excuse it (you're not even using patientnet if you use AA batteries), but
the scenario certainly can happen more easily than, say, your patient going into VT.


By the way, I readily admit my perspective may be a bit skewed, because at my hospital we're required to have ACLS and we also monitor patients' daily labs for electrolyte/cardiac enzymes in order to provide more in-tune monitoring of patients. I know at some other hospitals, sometimes the monitor techs are simply a unit secretary that's taken a 6 hour basic EKG course.

Have a good one,

Matt

[kcalohagirl]

It sounds like your hospital is really on the ball as far as the skill of the techs is concerned. Ours isn't quite so rigid, I'm afraid.

I want to say our tele system is Agilent (I'm sure I could look it up, but it's 4 in the morning, and I'm a little braindead.) We opened a new cardiac center this past year, and everything got upgraded. I seem to remember "Agilent Training" as part of our orientation when we moved into the new heart center. On our old unit, the telepacks all had 9volts, and I remember them telling us the AA bit was part of the upgrade. . . . .it's a pretty rockin' system, actually.

Thanks for letting me hear the tech side of the picture.

[CrazyPremed]

Originally Posted by methylene

By the way, I readily admit my perspective may be a bit skewed, because at my hospital we're required to have ACLS and we also monitor patients' daily labs for electrolyte/cardiac enzymes in order to provide more in-tune monitoring of patients. I know at some other hospitals, sometimes the monitor techs are simply a unit secretary that's taken a 6 hour basic EKG course.

Have a good one,

Matt

What is the training for that monitor tech position? Are you all paramedics or LPN's. That sounds like great experience for a tech (it also sounds like its out of the scope of practice of a tech)! What is the training like?

CrazyPremed

[All_Smiles_RN]

My hospital has a 3 week training class to get the monitor techs started. They don't need to be nurse or paramedic.

[methylene]

Originally Posted by CrazyPremed

What is the training for that monitor tech position? Are you all paramedics or LPN's. That sounds like great experience for a tech (it also sounds like its out of the scope of practice of a tech)! What is the training like?

CrazyPremed

Well, I haven't seen them ever train anybody in-house. Our hospital offers basic and advanced EKG classes, but you mostly see med/surg nurses looking to gain advanced training in them (I helped teach one recently).

There is no standard certification required, but our hospital typically won't hire anyone with less than 2-3 years of prior monitor tech experience (we're a desirable hospital so supply is pretty good), and they of course favor EMT/Paramedics, although I think I'm the only one on staff currently.

As far as being out of the scope of practice for a tech, it really is neither here nor there. We hold no ultimate responsibility in such matters- it's still the nurses' responsibility. We don't notify doctors nor do we take orders, but for nurses that don't deal with cardiac patients all that often we are a vital source of information they can incorporate into their patient assessment. Our readings are much more accurate if we have an idea of what's going on with the patient- ie, knowing their diagnoses, basic medications, lab results, how the patients are feeling, and what possible or probable effects this might have on the patients' rhythm and rate. It's also great experience as a nursing student that wants to go into CVICU/cardio upon graduation, as I can correlate what I'm learning with school to delve further into the disease processes and pharmacology of each patient. I might not get to practice assessing them physically, but I can build a good picture of the patient's health and perceived nursing needs by reviewing their charts.

-Matt