telemetry vs med surge

[ffliper27]

Can someone explain the differences or similarities between working on med/surge vs tele?

I have worked in med/surge before and it's just not my cup of tea. i have an interest in cardiology, so I'm thinking about applying for a tele position. As you all know, in med surge we do gazillion things during the shift....pass out meds, turn patients q2h, measure I/O, do catheterizations, change wound dressings, draw labs, feed pts when PCA's are not avaiilable...all of this can get overwhelimingly impossible, especially when we are a new RN...

Do telemetry nurses also have to do all of the above things that I mentioned? or do they just concentrate on the "cardiac" aspect of care? Can someone share some feedback on this? I just want to know what to expect if I go into telemetry.

Thank you so much,

[pmabraham, BSN, RN]

Chris21sn, for your 6 to 1 and sometimes 8 to 1 ratios, is that day shift, evening shift, or night shift. How do you feel about patient safety with those ratios? On our floor it is typically 5:1 for day and evening with 6:1 up to 7:1 for night shift. And even with those ratioes, I feel I'm not spending enough time with each patient, and if I have more than one unstalbe patient, I feel things are very unsafe for the patients.

[amzyRN]

They do all those things, except usually with higher acuity patients who require cardiac monitoring, like CVA, MI, CHF, COPD/respiratory failure, ARF with electrolyte imbalances may require tele, post cardiac arrest, rapid afib, heart blocks. Some tele units are really step down units, the one I worked on got post CABGs (once stable enough to leave CVICU), patients on titratible vasoactive drips, post cardiac cath, AVR, VATS, etc. The ratio varied between 1:3 and 1:5 (I wasn't working in CA at the time). I really liked my cardiac floor and it was very challenging because some of the patients were unstable and required a lot of intervention and critical thinking on the part of the nurses.

[OUxPhys, BSN, RN]

It depends. Some floors are med-surg with some of their pts requiring tele, not all. My floor, a cardiac step-down, requires all pts to be on tele. We also can do things RNs on med sure floors can't do. Pts tend to be a little more acute because they can require an ICU transfer at the drop of a hat.

[chris21sn, BSN, RN]

pmabraham said:

Chris21sn, for your 6 to 1 and sometimes 8 to 1 ratios, is that day shift, evening shift, or night shift. How do you feel about patient safety with those ratios? On our floor it is typically 5:1 for day and evening with 6:1 up to 7:1 for night shift. And even with those ratioes, I feel I'm not spending enough time with each patient, and if I have more than one unstalbe patient, I feel things are very unsafe for the patients.

Hello I work 12 hour shifts, from 7pm - 730am. As a for patient safety, no I don't feel safe most of the time. I have to work twice as hard to make sure my patients are safe. I usually forego eating and talking on my days of work to ensure safety to my patients and my license

[PacoUSA, BSN, RN]

Currently working tele unit in California, we never have more than 4 patients at once as regulated by law. On med-surg units where I sometimes float, the ratio goes to 5 patients per nurse. The only difference is the telemetry box, which magically reduces your patient load by one. I recommend learning tele so that you can avoid 5:1 ratios, because I personally feel that there is a fine line in workload between 4 and 5 patients.

[OUxPhys, BSN, RN]

PacoUSA said:

Currently working tele unit in California, we never have more than 4 patients at once as regulated by law. On med-surg units where I sometimes float, the ratio goes to 5 patients per nurse. The only difference is the telemetry box, which magically reduces your patient load by one. I recommend learning tele so that you can avoid 5:1 ratios, because I personally feel that there is a fine line in workload between 4 and 5 patients.

Im going to second this. It is a huge difference going from 4 to 5 patients especially on day shift.