Tele unit staffing

[sharann]

I work in recovery but have a question for you. I recently took a pt up to telemetry where the recieving nurse said "this is my 10th patient, and I am giving blood to 2" Is this shocking only to me?

[HeartRNJenn]

Wow! Unbelievable! I work 7a-7p on tele cardiac step down complete with almost any gtt you can think of, day 1 open hearts, and fresh cath labs a dime a dozen- we have 3-4 on days with an occasional 5 patient assignment. While I was on nights 6-7 was typical, 8 maximum. 10 would be INSANELY UNSAFE!

[pickledpepperRN]

70217(a)(9)

Proposed by the California state health department:

The nurse-to-patient ratio in a step-down unit is proposed to be

1:4 or fewer at all times. A step-down unit is defined as a unit for the monitoring and care of patients with moderate or potentially severe physiologic instability, requiring technical support but not necessarily life support; a unit reserved for those patients requiring less care than standard intensive care, but more than that which is available from standard medical/surgical care.

The nurse-to-patient ratio in telemetry units is proposed to be 1:5 or fewer at all times. "Telemetry unit" is defined as a unit designated for the electronic monitoring, recording, retrieval, and display of cardiac electrical signals (Position statement of the American College of Cardiology, Exhibit NN). Cardiac monitoring, which in the past was reserved to critical care units, is now used routinely in non-critical care settings to improve patient care and provide a more accurate and continuous assessment of cardiac function for those patients whose underlying disease state, e.g. conduction disturbances or arrthymias, makes monitoring appropriate. This ratio is necessary because patients on telemetry require licensed nurses to be readily available to expeditiously detect and treat the irregularities that the monitor identifies.

It is also proposed that the person monitoring the telemetry screens monitor no more than ten at any time. The person monitoring the screens shall not have any other assignment. This is necessary because human surveillance is critical for prompt recognition and response to clinically significant cardiac rhythm disturbances detected by the monitoring equipment.

The Department determined that, with an appropriately trained individual watching no more than ten monitors, it will be possible for that person to distinguish problems with the equipment and leads from serious, and potentially life-threatening, arrhythmias, so that nursing and medical personnel can be promptly alerted. Without adequate available personnel to respond to changes in cardiac functioning detected by the equipment, the value of using the equipment at all is questionable.

[Jayne LPN]

I work on a tele floor (7p-7a) the RN'S have 6 pt's (usually 4 RN's) and then between the 2 LPN'S we have have 6 (cover).Oh and we always have 2 aides.......I could never imagine what it would be like if we where made responsible of anymore that is so insane. :)

[Totone656]

Wow! Only 10??? The floor I am on now it is not unusal for the 11-7 shift to have 15 patients with at least 4 on monitor, 1 get Platelets, 1 getting PRBC, 1 actively dying onlcology patient and the rest being either Renal failure, pnemonia, or other Med Surg patients.

I have just learned the floor is going to be having a 3rd RN. I myself am ready to transfer off of this floor because I know only too well this will never happen. And I for one am tired of risking my licence every night!

[AHarri66, BSN, RN]

10 tele pts????? YIKES! :eek:

My floor is M/S-Tele, and on days we carry 5-7 (max). Not all pts are on monitor, and we only hang heparin, vasotec and lopressor. It's off to the Unit for nitro, amiodarone or diltiazem. I can't imagine having 8 or 10. I'd leave...my license is too important.

[Going80INA55]

I worked tele for many years and I can honestly say that after running my legs off on that floor, that any other floor or unit, IMHO, that I worked since has been boring in comparison. Tele is the floor that they will work you to death.

Massive turn around of patients. Anywhere from 5-9 admits per shift, so that just meant we had to do the bed shuffle. If they werent ready to dc (if they were close we would hound the mD to give the order for DC), then we would have to do some creative work.

Staffing days:3-5 nights 8-10. We hung everything mentioned above. All of our folks were monitored, if they were not monitored they would not even stay on our floor...did not have the bed for a non cardiac.

[RNpupil]

I am so sick of tele. I'd rather Med_surg, Oncology or even Long term care any day.

[emily_mom]

WTF? You said you work LTC in another thread. Do you even know what Tele is?

[RNpupil]

Edited

[eldernurse]

It is why the hospitals are having trouble getting telemetry nurses. The poor suckers in telemetry are really getting dumped on. Don't they realize how important it is to have the time to double check drips and blood transfusions and the like? They could kill somebody! And for $15.00 an hour!

I work in an ER setting (I just left telemetry). Hospital administrators do not appreciate the work of caring for very ill patients.

[MishlB]

Originally posted by RNpupil

I am so sick of tele. I'd rather Med_surg, Oncology or even Long term care any day.

Get the heck out of here, would you?? Pathological.