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

I was a monitor tech for many years before becoming an RN and I have a plethora of horror stories involving me informing nurses of dysrrhythmias where I can hear their deer in headlight glaze over the phone.

I think the canned response is silly, but new policies aren't just created out of the blue so you should be taking a look at what instigated this change.

The very last week I was a monitor tech before my internship started I had a nurse tell me that the torsades his patient just went into I was urgently calling about was "just artifact", so I had to call the code overhead myself.

We don't have monitor techs any more, thank goodness,...but that was always a huge argument with some techs,...they would call to tell us room 440-2 was in v tach when in fact he was brushing his teeth, or standing at the nurses station laughing with staff,......Rule #1 in nursing,.treat the pt not the monitor!

Yes, treat the pt, not the monitor... but you have to be able to see the pt first. The only thing the tech has to go by is what is on the screen. It is still our job to assess the pt when we are told by any other staff member that something is wrong.

As busy as we are on the floor with ratios of 1:8 sometimes, it never hurts to have an extra pair of eyes looking at that monitor. Better safe, than sorry. On my unit, we think that the monitor techs (located in a central monitoring room) don't call often enough!

I agree with the previous poster, I like having the extra set of eyes. And technically any rhythm change needs assessment and a call to the physician. But I have the nursing judgement to say "I don't think MD is going to care about the patients brady of 54 when they are in a deep sleep." I still have to document that I got the call from the techs and that no further action necessary based on clinical condition of patient.

We recently had a pt. that was in and out of torsades for several hours, and was tolerating it just fine. Whenever I'd peek in on her, there she'd be, sitting on the couch chatting with her husband as if nothing was out of the ordinary at all. I'm glad the MT didn't call a code, especially since the MD was well aware of the arrhythmia and we were treating it.

There is often a lot the MTs do not know about the patient situation, though I do try to keep them informed. Reperfusion arrhythmias are one of those that I won't call the doctor about, because they are an expected finding. I'll tell the MT not to keep calling me for every 8 beat run, unless they become longer and/or more frequent.

I love my MTs and am glad they're there, but their job is to report rhythm changes to the nurse, not tell the nurse whether a call to the MD is warranted. If an MT feels that the nurse is not listening, or is not taking appropriate action, then the MT should say something to the charge nurse; use the chain of command.

I've never worked at a hospital that utilized telemetry techs. Nurses who work on units which utilize telemetry are sent to classes where they learn the various rhytyms. We are taught which arythmias are life threatening and which ones require closer monitoring. Our nurse to patient ratio is 1 to 6 on nights