Reading Tele Monitors in Medsurg?

[sandiegonursecocoa]

We know we are seeing patients on the medsurg units that are sicker than in years past. Are you monitoring patients on your medsurg units? Are the monitors on the unit itself, or elsewhere? Are you and your colleagues (in medsurg) trained to read lethal rhythms? all rhythms? And lastly, what about ACLS- is it required in your unit?

Thanks in advance for your informaiton.

[queenjean]

We have always had tele pts on our medical floor. Just within the last 6 months we have had monitors in our nurses station where we can see them (as opposed to having them exclusively in the ICU and having the tech call us). We are all supposed to have a basic rhythm strip interpretation class, though I know a good half of our nurses haven't attended. Our director wants all charge nurses to take ACLS. I charge occasionally, and I *have* taken ACLS. If anyone wants to take it, she'll try to work it in, schedule-wise.

We're trained to read the most basic of rhythms. I can certainly identify the most common or most lethal--SR, afib, PVCs, BBB, vtach, vfib that sort of thing. I can't always identify the nuances in rhythm changes. The techs and the ICU nurse have the ability to enlarge and electronically measure the different aspects of the pt's rhythm, and they can pull up the rhythm history, too--we can just view the little real-time screen. So we are at a disadvantage.

Practice makes perfect. I always check my rhythms out several times a shift, and check the corresponding report. I've gotten a lot better at identifying bundle branch blocks, for example, doing this. I still sometimes have a problem identifying afib, mostly because of artifact and the fact that I can't examine the strip close up.

Ultimately we are not responsible for reading the rhythm (the ICU nurses and tele techs are) but we definitely have a greater role in it now that the monitors are on the floor.

[sandiegonursecocoa]

Great info.

Does anyone else have any other info?

[BlueBug]

The above post sounds like my unit, and all beds are med/tele. We have no med/surg beds, all are up for tele if needed.

We all are required to have ACLS within a certain time frame of being hired, and all are required to have basic rhythms classes.

~BlueBug

[piel_canela26]

well in my case i work on a medsurge floor but they opened a surgical stepdown unit within the unit. it's a forbeded room where the 4 pt are hooked up to the cardiac monitor... we were trained to read all strips and we got refreshed on how to take care of post op pt blah blah blah.... to be honest this unit is an extension to the ICU since most of the times they dont have room in the ICU so they down grade some pts who are not that unstable but not stable enough to go on a regular mesurge floor.... and for ACLS, they are considering making it madatory.

[mcknis]

We do have monitors on our med surg units (4units). The unit I am on is a primarily cardiac/tele med surg floor and we have 20-24 monitors and can handle up to around 30 pts. If more monitors are needed, then we have to keep bedside/transporter monitors hooked up, or get telepacks and wire them to our ICU 100' away. When our pts are on monitors, they only have a tele pack in their shirt pocket and a wireless monitor screen is in the nurses station (max of 90-100' away). We are looking at purchasing bedside monitors (housewide) in addition to a central screen in the nurses station. We are all required to take a basic rhythm class, but its our choice if we take ACLS.