Tele vs. M/S

ashfost, BSN, RN · Jan 2, 2010

I have this same question about whether to start on a telemetry floor before moving on to ICU. Any advice is greatly appreciated!

AnnaN5 · Jan 3, 2010

It depends on the floor. There are some med/surg units that have patients on telemetry monitors and then there are cardiac floors where every patient is on a telemetry monitor. The med/surg floor I used to work on had a few patients on monitors but they were remotely monitored (meaning we did not have screens to monitor their rhythms on our floor). We did not have to chart their strips or really do anything with their telemetry. The monitor techs would call us if something was abnormal. Now I am on a cardiac floor where every is on a monitor and we monitor their rhythms. We are obviously required to now the rhythms, treatment, etc.

Lidlsadie · Jan 8, 2010

I work on a Telemetry floor & I can tell you that in a lot of ways it's similar to med/surg because we get some of the same patients that med/surg does but that need cardiac monitoring. [usually] it's a little bit higher level of care because these patients need that monitoring & tend to have cardiac problems (or else they would have gone straight to med/surg) but it really just depends on the day. Our Tele unit also gets CVA's which is another difference between us and a typical med/surg floor. I think that being a med/surg nurse, you have a great foundation & will find the switch fairly easy! They'll just make you take ACLS & a Telemetry/EKG course.

On our particular floor, we do all of our own EKG's & rhythm strips & have the telemetry monitors right at the nursing station so we are directly responsible for them. Some hospitals have a designated Telemetry-Tech that keeps an eye on all the monitors & notifies the RN with any abnormalities. Just depends.

Good luck!

ashfost, BSN, RN · Jan 9, 2010

Ok, maybe we should ask the question in another way. I think the original poster (and myself) would like to know whether starting on a Med-surg or Telemetry floor would better prepare ourselves for specialties like ER and ICU. The younger nurses seem to say "Yeah! Go for the ICU or ER if thats where you know you want to be!" while the more seasoned nurses ::ducking:: seem to say "A new grad needs to get floor experience first." It has been rumored in my hospital (don't know about others) that once a nurse gets on telemetry, med-surg, etc. its SOOO HARD to transfer to the specialized areas. So the question is: Which route is the better to take? Thanks!

AnnaN5 · Jan 9, 2010

With the job market the way it is currently, the specialty areas can be picky about who they want working on their floor so it wouldn't hurt to get med/surg experience first. I personally worked on a cardiac floor right out of school then switched hospitals and worked med/surg for a bit. Now I am back on a cardiac step-down floor with plans of possibly transferring to ICU soon. I don't think I would have wanted to be on my current floor straight out of school because it can be a pretty stressful floor so I think my previous experience really helped me get ready for it.

surferbettycrocker · Feb 4, 2010

if you are actually willing to get floor experience before icu kudos to you. i have friends that went straight to icu and say 'i could never do floor nursing' and it wear that statement like a badge of honor which is sad to me. if you are considering ER i would strongly suggest tele first. if you want icu go right to icu but BE PREPARED. i say learn to walk before you try to run.

it is not hard to transition from tele m/s to other areas. bedside is bedside. each area teaches you time mgmt. tele/m/s both great experience. i personally think learning tele will give you an advantage in any other specialty.

LoveANurse09 · Feb 5, 2010

Tele or m/s would be a great preparation before ICU/ER/. Floor nursing will always teach you your organization skills that you need as a new grad. I know of people that have done ICU/ER right after graduation so it can be done.

gwendelyn · Mar 4, 2010

When I was in nursing school most of the nursing instructors told us to start out in med/surg. So I took their advice. It's been a great learning experience in med/surg. I've gotten good at starting IVs,inserting caths,etc. My critical thinking skills have improved immensely over the course of 2.5 years. Med/surg also taught me time management,accuracy, and speed.

On the other hand, I feel a little trapped. I want to try a new specialty, but I've gotten so good at med/surg that I hate to start all over again at the bottom. There's a nice comfort in what you already know and do well.

So, I guess that's my point. Med/surg has been both a blessing and a curse...easy to get in but hard to leave.

wife&mommyRN · Mar 4, 2010

Gwendelyn,

Thanks a bunch for the advice! I think you have an excellent point, I never considered never wanting to leave. I hear people talk so much about how they would never enter med- surg, it's nice to hear someone that actually loves the job. In nursing school, my biggest challenges have been learning to critically think and assess whats going on with my patients. I think my best option would be to start off on med- surg so I can build those skills. I've noticed every hospital has a certain level of expectation for their nurses and don't teach you everything you need to know. For the safety of my patients and my license, med- surg it is. Unless, I get something in PEDS.

gwendelyn · Mar 4, 2010

I wouldn't say that I love med/surg...some days are better than others...like any job.But it's the perfect place to develop your nursing skills.

bluesnurse · Mar 9, 2010

If critical care is your goal then definitely work tele! I worked tele all through nursing school, from CNA-LPN-RN, and it was great experience. In places like ICU and ER, you HAVE to know your rhythms cold and you will get that experience on tele.

You won't miss out on m/s; when a post-op pt goes into afib you will likely be meeting them. You will also get good at insulin management because at least one of your pts will be a brittle diabetic. The ratios tend to be better than m/s too; it was 4-5:1 where I was (m/s was 7-8:1).

If you are really good at rhythm recognition and interpretation, you will have a big advantage in critical care and a lot of other areas!