What do you do when telemetry calls? - page 2

So I work on an extremely busy medical floor that receives the majority of admissions in our small county hospital. We're a catch-all for everything! We have a lot of patients on telemetry and... Read More

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    Our techs also print the strip out, put it in the chart and write on it that nurse so and so was notified. I always try to be nice to the tele techs because I sure as heck couldn't do their job nor would I want to! Though I know they can hear the strain in my voice sometimes. There's one particularly good tech that's empathetic especially when she knows that I have seven on tele and one pt. is going bad and if one more thing is added to my stressful load that I just might cry! (which has happened : /). Anyway, she's great! Thanks for the good advice and kind words. I guess this is just another one of those experience things because right now I don't feel like I have enough knowledge base to make a judgment call so I'll have to err on the side of pt. safety.
    juliaann likes this.

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    First law after getting a call, check the patient. ;-)

    A lot of times I will look at the tele strips from several days back to see if their is a trend. Sometimes the patient has a string of PVCs nightly, so not really a worry. But of course you are on guard for the next possible Vtach scenario.

    It's when it's a new abnormal that has not been seen before, that's when I'm on the phone to the cardiologist.
    Last edit by CaLLaCoDe on May 20, '10
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    You said you would be concerned if they had symptomatic bradycardia. How do you know if they are symptomatic unless you check the patient?

    A 6 beat run of PVC's in a concern if this has never happened before and may well still be a concern if they've had it happen in the past.

    I also feel if a tele tech feels a patient needs to be checked any available nurse should go check the patient, it doesn't initially have to be the patient's nurse

    What do you do about replacing monitor leads that fall off or tele pads that need to be replaced? I am sure you get those phone calls too. Though if you have aides they can handle those calls.

    It is unfortunate that you have to have 6-7 tele patients at a time.
    Last edit by RNKPCE on May 20, '10 : Reason: error
    CaLLaCoDe likes this.
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    Quote from RaziRN
    The pt. that I kept receiving calls about the other night had, had PVCs before and he had come in with a CVA and HTN and to be honest with you I was more concerned with his deteriorating mental status and new onset of left sided paralysis.
    The symptoms and the heart rhythm are all interrelated. One can cause the other, and if you fix one it can improve the other. So the tech's report was definitely significant and useful to you as a nurse. I think it's a shame you cannot eyeball the monitor as you observe the patient and call the doc. It would be helpful to you if reading strips wasn't such a chore, so keep practicing. Nursing needs a whole body view when a critical patient's situation is evolving.
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    As I've mentioned before...I ALWAYS check the patient. And yes I do get calls to replace leads and then I go replace the leads or delegate it to a CNA if I'm swamped with other such things as a pt in excrutiating pain or a pt who is having chest pain (in which case we have to call rapid response per protocol). I was simply asking what was an important rhythm to chart about and what wasn't. Now I know it all depends on the pt. and their particular situation and to be honest neither you nor I are ever going to know everything there is to know. I'm trying but when your'e a new grad with seven patients it's freakin' difficult to impossible to know enough or stay on top of everything all the time. I'm not super-human and this is why I HATE my job. I want to be able to care for these patients the way they deserve to be treated but let's be honest...it's impossible with seven patients. And it's a sad truth. I'm sorry, I was just a little offended by the above two posts. It seems as if you were accusing me of neglecting my patients when I really do try my best and it's never good enough for our floor or anyone else for that matter.
    CaLLaCoDe likes this.

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