So what's next? Techs telling us to call the docs?

My facility got rid of monitor techs before I started working there. Each floor with tele monitoring has central monitors at the front and the back, and we're responsible for monitoring ourselves. They've been talking off and on about bring the monitor techs back...personally, I'm resistant to the idea. I know what's going on with my patients, what's usual for them, what each doc's idea of when to be called is. I suspect that if I had someone telling me when I needed to call the doc (aside from fellow nurses whose opinion I trust) it would annoy me greatly.

i have 8 patients on tele at night and i thank god for the monitor techs. they are excellent at their job and are 99% of the time spot on. we are responsible for checking and signing our strips atleast once every 4 hours and verifying the measurements are correct....

they will notify us if there is a change in rate/rhythm and they have documented underneath the patients strips the baseline they came in with... so they know if its an ongoing thing.

we are also responsible for telling them if the patient is any kind of drip that could affect their rate/rhythm. we also have standing orders like, if the pt has up to 10 beats of vtach, to run a mag/k level, and replace electrolytes if needed, call at 7am. our doctors do not want to be called for stuff like that in the middle of the night.

they are also either trained as a CNA, EMT, PCT, etc and when there is a change in rhythm to a lethal arrythmia they have the authority to get up from their seat and check the patient, while the other monitor tech calls us on the portable phone.. so we usually end up getting there at the same time.... there is very little downtime for us between when the patient goes down and when a rapid response or code is called...

i don't know how it would work on my floor is we didnt have monitor techs... because 8 patients is way too much already... they are such a valuable asset to our floor.

I worked as a monitor tech for a month when I'd injured my knee too badly to keep up in the ICU. It was one of the toughest jobs I'd ever had -- the phones were the worst part of it! We were expected to answer the phones so the secretaries could continue taking off orders, ordering tests, etc. The phones nearly drove me crazy! The other thing that drove me crazy was that the newer nurses (who didn't know me) often argued with me about rhythms. Until one day I told the RN "this is atrial flutter" and she gave me a nasty attitude. The cardiologist, who happened to be standing right there said "Yes, it is atrial flutter and who are you to question one of our best ICU nurses about a rhythm when you didn't even recognize V tach last weekend?" After that, they'd ask me my opinion rather than tell me what it ought to be.

But I agree -- it's infuriating, having techs telling us when to call the doctors. Especially when the doctor already KNOWS the patient goes in and out of VT 30 times a day, tolerates it well, and is scheduling them for an AICD.

oh it's great! we have a big medicare/medicaid population too... i didn't know you only get 1 lab run a day! sometimes our lab can use the blood already drawn from the morning labs...

once you get the labs theres a sheet with standing orders for how to replace the electrolytes, like if your mag is 1.5-1.9 you get 1g IV over 1 hour, recheck labs in 4 hours. you just check the box with the lab value that corresponds with your pt's labs, fax to pharmacy, and you're set.

saves alot of unnecessary phone calls to cranky docs.