Any hospital units that DON'T use telemetry?

melizerd, ASN, RN · Feb 28, 2015

I'm on an onc/med/surg floor and we have patients on tele. Not all of them but many, it's nice when there are less on it, but I don't think we have ever had zero patients on tele.

We have several tele techs in the hospital that do nothing but watch everyone's tele and will call if something shows up.

Nola009 · Feb 28, 2015

My only experience in onc was through nursing school clinicals. Most patients there had stage 4 cancer. I didn't see any tele there. Maybe bc it was palliative care.

melizerd, ASN, RN · Feb 28, 2015

Yeah once you're on comfort/hospice no tele. I have lots of patients living with cancer though and not dying from it.

Here.I.Stand, BSN, RN · Feb 28, 2015

Our trauma/surgical floors don't use it (stepdown does). Otherwise I'm not sure which do and which don't; I've never been on the floors, but transfer my pts to the trauma/surgical floors.

In the LTAC hospital I worked in, all of the ICU patients had bedside monitors; some floor pts had bedside monitors, and many more were on tele. The admitting physician made that decision on a case-by-case basis, and then of course if condition changed they might be put on it.

The first hospital I worked at, most units did NOT use it. We had one floor dedicated to cardiac/tele; but med-surg, ortho, bariatric, neuro/ENT (my floor), solid organ transplant, BMT, heme-onc, etc. did not use it. Within those units, we did have some bedside monitors; my neuro/ENT unit had a stepdown room, and the BMT unit had a couple ICU rooms. It's been many years since I worked there though, so it could be different now.

ParvulusPuella · Feb 28, 2015

Huh. I've never worked in a place that had tele techs or someone dedicated to solely watching the monitors, and I've only worked on cardiac floors. Whoever happens to be at the desk checks out any alarms, and if everyone is in a room, the alarms are loud enough that we can hear them and rush out to check the monitor.

cheezwizz90 · Feb 28, 2015

Too many patients are on telemetry for no reason other than a generic admission order set. I aggressively pursue orders for NO heart monitor if the patient is stable with no cardiac history or reason to be monitored. Less work for me as far as wasting time reading and interpreting NSR strips. Sorry, but a 20 year old patient with a burn to the hand, no grafting needed, doesn't need monitored.

As far as monitor techs, we don't have those. We wear an alarm device clipped to our shirts called a Vocera and it verbally states the room number and arrhythmia if it's a fatal or threatening one. Otherwise it will just beep once for leads fail or call lights. That way I don't need to freak out for every beep I hear and alarm fatigue is decreased.

Proverbs 17:22

A merry heart doeth good like a medicine:

but a broken spirit drieth the bones.

MunoRN, RN · Feb 28, 2015

We've gone full circle, from using telemetry only in critical care, progressive care, and cardiac floor to the entire hospital, and then back to just critical care, progressive care, and cardiac (along with OR, ER, procedural, etc). There's no established improvement in outcomes but it does reduce the time available for care that does have some established benefit behind it and can contribute to delirium. There are established indications for the use of continuous cardiac monitoring and they don't recommend it for all patients. The trend towards using it for everyone seems to be based on an inaccurate belief that it can replace proper nursing assessment and monitoring.

dah doh, BSN, RN · Feb 28, 2015

In my hospital, the non-telemetry areas are: Ortho, Brain Mapping, Peds, Post-partum, & rehab. All other areas are telemetry or at least telemetry capable.

Have you considered a non-patient care area?

vanilla bean · Feb 28, 2015

The facility that I work for does not have patients on monitors unless they are specifically admitted to a telemetry unit (in terms of floor status patients, of course the various ICUs and pediatrics have their patients on monitors). Med-Surg, oncology, ortho - all unmonitored beds.

If there is a change that requires patients admitted to those units to be on monitor, they are transferred to TELE. Conversely, if there is no justification for a patient to be on monitor anymore, they are transferred off the floor.

The TELE units have dedicated monitor techs.

RainMom · Mar 1, 2015

We have tele pts admitted to every floor/dept with monitoring done in the ICU who call with any changes.

Lev, MSN, RN, NP · Mar 1, 2015

My old med-surg floor had no tele. There was one med-surg floor at my old hospital that took stroke patients so they had several tele beds. The 3rd medsurg floor had no tele like my floor and there was also an observation unit that did have tele. My PRN med-surg floor is onc/med-surg and it does have tele capabilities and those rare patients are monitored by remote tele techs who call in on the tele phone to make sure our patients are ok. At that hospital, the ortho med surg floor does not even have tele capabilities. There are two other tele floors at that hospital. At current hospital, I am in the ED full time. There are 3 med-surg floors and only one can take some tele patients since that floor is neuro-tele so they take the stable strokes. So, in my experience, About 1/3 med-surg floors have tele patients and the other 2/3 do not.

Palliative Care, DNP · Mar 1, 2015

The facility I left was at about to have telemetry on every unit when I stopped working to focus on grad school. Their reasoning was that an admission should never have to wait because a unit "didn't take tele patients." Also, the other reason they had was that if everyone is ACLS and understands tele then a nurse is a nurse and should be able to float anywhere from ER-med/surg-ICU. The only nurses not affected were L&D and mother baby.