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 patients just transferred out of ICU. Often times I'll get several calls from the telemetry technician during the night. Mostly the calls are telling me that patient A had a six beat run of PVCs but are now back to their regular rhythm or Patient B has "bradied" down from the 70's to the 50's. I'm not usually all that concerned about these calls but I tell the telemetry tech that I'll check on the patient and the patient is usually fine. I even take the extra step to call the tech back most times to let them know my findings. Most of the time the patient is either sleeping, having a bowel movement or up and moving around (causing them to be tachycardic or at least have a higher HR than what they usually have.) Don't get me wrong, I appreciate the telemetry techs and realize that they have to let the nurse know. I'm especially appreciative when they call about something that should be taken very seriously (ie. pt converting to A-fib or a pt. with a HR in the 200's). However, I'm a new grad and 99% of the time I have 6-7 patients to care for. And it never fails that telemetry calls with these things while at your most stressed point ( such as trying to fulfill at least five different pt. demands/needs.) Now I certainly do not know everything, so I'm asking what do you more experienced nurses do in this case? I've talked to my fellow nurses who have more than 30 years experience and they tell me that they chart what telemetry reported and their assessment of the pt. and any interventions they may have needed to make. I can completely jive with this if it's something really serious such as symptomatic bradycardia, tachycardia or new onset A-fib or a run a v-tach. However, it's those calls where they tell you about the six beat run of PVCs but rhythm is back to normal where I have trouble with that concept. If I charted every time telemetry called with something like that I would never get any pt. care done nor would I leave the hospital ( at least on most nights). So, what do you do in those situations? Am I looking at this in the wrong perspective? I'm a new grad and am still trying to improve my time management/organization skills and knowledge base. Any advice would be greatly appreciated.
May 20, '10
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
May 20, '10
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