I've never worked telemetry, but I did some work in a major ED at a large medical center, and I know the types of patients we sent to telemetry. There were multiple telemetry floors at the hospital I worked at prior to nursing school (there had to be, it was a 700+ bed facility), and each telemetry unit took different patients. It sounds like your facility is just a big conglomerate of all the telemetry patients in the house, so I will try to give you an extensive example of the types of patients you might see. Anyone who was having chest pain, but not an acute MI, who seemed slightly unstable (yet not unstable enough to land an ICU bed) went to telemetry. The patients who had just had open heart surgery, or were recovering from an MI, a CVA, AAA repair, stent placement, etc, went to telemetry beds after being moved from ICU. Patients who presented to the ED in SVT (which resolved in the ED), with asymptomatic (or slightly symptomatic) bradycardia/tachycardia, or other heart issues went to telemetry (provided that they were stable enough). The telemetry floors at this facility took patients on some pretty heavy-duty drips, too, so it wasn't uncommon to see a patient on nitroglycerine, or a low-dose pressor on the telemetry floor. Of course, if they had to be intubated, they went straight to ICU, or if their condition became so critical that they needed to be one-to-one or needed more invasive monitoring (like a PA line, ventilator, ICP bolt, etc). You definitely need to know how to interpret cardiac rhythms. You need to know how to identify atrial flutter and fibrillation, sinus tachycardia and bradycardia, SVT, ventricular fibrillation and ventricular tachycardia, first, second, and third degree AV block, asystole, PEA, and torsades. You should try to get ACLS certified if you can, as this would help you tremendously during code situations. If you can't get ACLS, learn the drugs given during a code, learn how to do effective CPR, learn to ventilate the patient effectively, and get an idea of what your role would be during an arrest. Also, learn to note subtle changes in your patient's condition. This might be a slight drop in BP, a slight elevation in heart rate or respiratory rate, a slight drop in oxygen saturation, etc. These slight changes can be the harbingers of disaster later in the shift, and if you notice them when they aren't major, you can watch that patient more closely and sometimes avert disaster. Also, become familiar with doing 12 lead EKGs, as you will end up doing your fair share of these. Also keep in mind that just because a patient is on telemetry doesn't mean that their other needs aren't tended too. If they are post-surgical, know how to empty their drains, change their dressings, and set up PCA pumps. If they are medical, know their medications, their diagnosis, and any pertinent history and lab work. As with any medical unit, you can expect to be giving blood at some point (especially if you are working with surgical patients) so get comfortable with that. In my area, a lot of post-op patients get IV fluids with KCL, so we have to keep a close watch on their potassium levels, and the IV site. If potassium infiltrates, bad things happen. There are a lot of considerations to keep in mind, and there are a lot of things you will still have to learn. It will be a fun experience, but it may seem a bit overwhelming at first. No matter what happens, keep your head up, learn something new each shift, and enjoy the experience!