Any hospital units that DON'T use telemetry?

JMCP · Mar 1, 2015

count hospitals in los angeles don't really have a tele unit...

gettingbsn2msn, MSN, RN · Mar 1, 2015

When I was a traveler a few years back I did an assignment at a small rural hospital that did not use telemetry. There were only 2 of us (myself, a traveler and a RN from that facility) on nights. It was scary at times. This was in Georgia.

RN_2012, BSN, RN · Mar 1, 2015

Maybe my question is a dumb one and I apologize if it is. But are there any hospital units besides oncology, psych, and OB that do not use telemetry? I am on med surg and sorry, but I hate telemetry.

Telemetry is used on the OB unit at my small hospital if it is indicated and I would think in oncology as well if we had that type of unit.

michlynn, BSN, RN · Mar 1, 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.

I don't really think that's necessarily safe. Yes, we watch our own monitors but we also have a designated tele room staffed with at least 4 people per shift that watch every single monitor in the hospital with the exception of the ICU's. I think it's absolutley necessary if you have an entire floor of patients on tele.

Personally I don't think I would like working on a floor without tele. I know exactly what my patients are doing at all times. :up:

imintrouble, BSN, RN · Mar 1, 2015

There's no one watching the monitors... if somebody happens to pass by and see a cause for concern they might say something to that patient's nurse. As busy as we all are, they need someone watching the monitors!

Why even have the patient placed on telemetry if nobody's going to watch?

It seems legally safer to not know, than to not pay attention.

CTnewgrad826 · Mar 1, 2015

I work in med/surg and we aren't a tele floor but we have tele available...therefore if they fill up and we get an admission that requires tele they have to go somewhere else that has it available. While our floor only requires BLS, it's believed that every nurse should be able to have the basic skills to calculate the PR and QRS waves and identify the rhythm, that's all we have to document on. We also don't have anyone designated to sit and watch the monitor. We have alarms set that save so we can go back in and review and emergency strips will print automatically anyways.

annie.rn · Mar 1, 2015

The med/surg unit I work on does not have tele but soon will. The CNO was reluctant to add tele to our unit for fear we'd become another cardiac unit. Her plan is to only allow pt.'s who need short term monitoring (24-48 hrs. or less...i.e., someone with a critical K* that needs short term monitoring until K+ level is treated) If they are having a new dysrhythmia or need drips, etc. they will go to the tele unit. If this is enforced, I won't mind having tele too much. The problem will lie w/ enforcement. I have a feeling LOTS of pt.s w/ any cardiac hx. will be on monitors and stay on them throughout their stay. That will be frustrating. We have centralized monitor techs. As far as I know, they won't be adding a bank of monitors at the desk. I'm not crazy about tele either but I've learned you've got to be flexible in this business. It will be nice to not have to transfer out the post-op pt. who vaso vagals down while on the toilet. Nothing I hate more than a middle of the night transfer.

sistrmoon, BSN, RN · Mar 1, 2015

I work Onc and we have many tele patients. I spend so much time replacing batteries and replacing leads, it's unreal. We aren't responsible for watching the monitors though. The remote tele unit does that and calls with changes.

Nola009 · Mar 1, 2015

Why even have the patient placed on telemetry if nobody's going to watch?
It seems legally safer to not know, than to not pay attention.

I agree, but that's the way they do things at this very small hospital. Anybody who has any current or history of heart issues and isn't a DNR goes on tele

Aliareza, BSN · Mar 1, 2015

I work on an orthopaedics floor as a CNA and have seen many tele patients. Every floor in the hospital is "tele capable". It's turned into a huge thing recently, because most of these nurses were hired and told there is a tech who watches the tele monitors and will call to notify them of any dangerous changes. Well, it came to light that the techs actually weren't trained at all to interpret the tele readings, so in effect, the non-ICU tele patients have been left without a skilled person looking out for their cardiac dysrhythmias for years. Who let that one slip through the cracks!?

Now the administration is saying it's the patient's nurse's job to interpret the tele strips, and the nurses are in an uproar because after years of not having to, most of them don't even know basics of tele strips, muchless the advanced ones. You can bet I'm paying close attention to the tele chapters in school! It stresses me out, though. I can't imagine how those nurses must feel.

CelticGoddess, BSN, RN · Mar 1, 2015

I work on an orthopaedics floor as a CNA and have seen many tele patients. Every floor in the hospital is "tele capable". It's turned into a huge thing recently, because most of these nurses were hired and told there is a tech who watches the tele monitors and will call to notify them of any dangerous changes. Well, it came to light that the techs actually weren't trained at all to interpret the tele readings, so in effect, the non-ICU tele patients have been left without a skilled person looking out for their cardiac dysrhythmias for years. Who let that one slip through the cracks!?
Now the administration is saying it's the patient's nurse's job to interpret the tele strips, and the nurses are in an uproar because after years of not having to, most of them don't even know basics of tele strips, muchless the advanced ones. You can bet I'm paying close attention to the tele chapters in school! It stresses me out, though. I can't imagine how those nurses must feel.

The frightening thing about allowing nurses to interpret the strip is that things can be missed. When I worked on a tele floor, a patient started throwing very frequent PVC's and had 3 second runs of v-tach. The strip we got didn't show the v-tach or the PVC's. However, the monitor tech saw it and we were able to get the patient to the unit. He kept having runs of v-tach on the unit. If we had relied on the 6 sec strip only, we would have missed the v-tach.

All of us on the floor had alarm fatigue. It got so we ignored the alarms. (when 9/10 times the alarm is due to low battery, lead off, or pt turning in bed, that can happen).

I no longer work tele. (Thank god). I work onc/palliative and we wills end pts to the heart center if they need tele.

Wrench Party · Mar 1, 2015

The large hospital I left had the better Phillips monitors on the cardiac, surgical and CT stepdown floors, and all ICUs. Central tele was used on patients with cardiac issues, but admitted to other services. Tele techs watched these patients, and would call the nurse with rhythm issues or changes. Some units like onc and neuro used bedside monitoring.

I don't recall ortho or med/surg using them much.