cross train ... med surg - tele - ER

Published

Thanks in advance for reading.

I have been an RN for about 6 years now.  All medical/surgical experience.  My hospital is rolling out a cross-training program to the med-tele unit / telemetry overflow.  My ultimate goal is to be an ER nurse. They will not let me transfer there because “I need telemetry experience.”  

What questions should I be asking?  What should I avoid?  What accommodations should I be requesting?  I do not want this to turn into a float pool position (floating more than I am in my home unit) but I guess that depends on staffing.  I’m not going to pretend I am super bright, so I need as much advice as possible.

I am also in school right now obtaining my BSN so my brain will be overloaded.

Up Vote Up Vote ×

Appears you only need to be taught how to interpret telemetry. What is that training going to consist of?  You would need specific classroom training for at least a couple of weeks.  Not sure what you mean by "accomodations".

3
Up Vote Up Vote ×
13 hours ago, goingtodoit7 said:

Thanks in advance for reading.

I have been an RN for about 6 years now.  All medical/surgical experience.  My hospital is rolling out a cross-training program to the med-tele unit / telemetry overflow.  My ultimate goal is to be an ER nurse. They will not let me transfer there because “I need telemetry experience.”  

What questions should I be asking?  What should I avoid?  What accommodations should I be requesting?  I do not want this to turn into a float pool position (floating more than I am in my home unit) but I guess that depends on staffing.  I’m not going to pretend I am super bright, so I need as much advice as possible.

I am also in school right now obtaining my BSN so my brain will be overloaded.

If it's optional, it will turn into a "float pool position", because a lot of your co-workers will decline. If you want to be in ER, I say go for it.

I am the only one on my home unit who agreed to float to other areas and I float constantly. I've been on my home unit maybe one time in the past six months? No worries ...I have others homes away from home. I actually feel a little off balance when I am assigned to my original unit, because I'm hardly ever there.

I don't understand the "accommodations" thing, either.

Up Vote Up Vote ×

 So...You want to work in the ED and your place is offering an opportunity that theoretically could lead them to consider you for an ED position by way of the fact that if you agree to cross-train you would then have telemetry experience.

I think these two things (1. Your end goal and 2. Their current cross-train opportunity) should be considered separately.

Why? Frankly because I don't trust them if they can't figure out a way to get a 6-yr RN trained on basic rhythms.

I say go ahead and cross-train if you are agreeable to the situation after learning more details (how often you are likely to float, etc). Meanwhile, find out who is willing to hire you in the ED without this non-sense about telemetry experience. In other words, start looking elsewhere for your ED position.

Good luck ~

Oh. By accommodations I assume you are referring to stipulations or agreements that you would like to negotiate, such as not having to float more than X% of the time or something like "if I do this for X length of time you will agree to let me work ED." All I can say is that anything you negotiate like this will not be worth the paper that it won't be written on. Which brings us back to why I say the two issues should best be considered separately.

3
Up Vote Up Vote ×

An example of an accommodation would be along the lines of “my home unit is priority” or “cannot be floated mid-shift if there is a need for a telemetry nurse and I am on my med/surg unit” etc… but I am dreaming at this point. 

The position isn’t so I can transition to the ER.  They require telemetry experience to be hired in the emergency department.  It just so happens; I can stay on my home unit, keep my schedule (which is awesome), and my seniority (which is near the top, on my home unit) without having to directly transfer to another unit/telemetry unit with a crappy schedule/seniority.

I do not plan to quit/leave the hospital, yet...  I work at a location that is a revolving door.  You know... people hire in for that golden 1 year experience and leave.  I may do that in the emergency room, depending on how I am treated as an employee.  I feel its easier to transition through the same hospital than to start the process in another.  Thanks again for the replies.

Up Vote Up Vote ×
18 minutes ago, goingtodoit7 said:

It just so happens; I can stay on my home unit, keep my schedule (which is awesome), and my seniority (which is near the top, on my home unit) without having to directly transfer to another unit/telemetry unit with a crappy schedule/seniority.

So do it. But don't do it under any illusion that it is going to eventually get you to the ED. It might, and it might not--even after you have that tele experience. They could put you in the ED right this minute if they wanted to.

They are probably not going to limit their own options by agreeing to accommodations. But...you could always observe the scene there at your workplace and get an idea for how many of your coworkers are willing to crosstrain. If there aren't many, you may be able to get at least a verbal agreement on some of your requests, and sometimes (if you're good at holding people to their word) you can get them to comply with their verbal agreements.

Good luck ~

Up Vote Up Vote ×
Specializes in school nurse.

Go for it. It'll be a good skill to learn and hone, and make you more marketable. You can do it for awhile then look for ED positions elsewhere if your hospital won't hire you for that.

And not giving up your seniority in the meantime helps sweeten the situation.

Re: accommodations- yeah, that's a nice fantasy...

3
Up Vote Up Vote ×
Specializes in Cardiology.

Despite what they say it is a float position. Anytime they mention cross training it's so they can use you between whatever units they are training you for. I would still take it since you need the tele experience to get the ER job. I would just ask questions about the rhythms, treatments, medications, etc. 

1
Up Vote Up Vote ×

thanks for the replies... 1 last question(s).

how do I prepare?  ACLS, rhythm strips, what else?  how do I remember all of that?    I know what a mumur sounds like and that's about it.  what do I auscultate for? etc... what do I assess for ?  in med/surg, it's "I have chest pain" and you do an EKG.  that's it.  what common drips/meds... do I need to know.?

thanks again.

everybody on that unit always looks so stressed out. 

Up Vote Up Vote ×
Specializes in Community Health, Med/Surg, ICU Stepdown.
2 hours ago, goingtodoit7 said:

thanks for the replies... 1 last question(s).

how do I prepare?  ACLS, rhythm strips, what else?  how do I remember all of that?    I know what a mumur sounds like and that's about it.  what do I auscultate for? etc... what do I assess for ?  in med/surg, it's "I have chest pain" and you do an EKG.  that's it.  what common drips/meds... do I need to know.?

thanks again.

everybody on that unit always looks so stressed out. 

I think rhythm strips is a great way to prepare, and knowing the treatments for each one. But remember it is the doctor's responsibility to prescribe the treatments. You can notify them that the pt has gone into an abnormal rhythm and notify of any symptoms, even recommend treatment after getting lots of experience.

I would also review what causes abnormal rhythms, conditions, labs, etc. As for drips and meds, probably beta blockers, milrinone drip, bumex and lassie IV push and as drips, amiodorone, adenosine, atropine, metoprolol IV push, lots more. You could review indications, doses, and side effects if you want to be really prepared. But I think the best way to learn is through experience ? good luck and I hope you like it!

Up Vote Up Vote ×

Here are the stipulations:

ACLS

AACN telemetry course

I am the priority floater, regardless of rotation.   

Orientation: 4 hours with a telemetry monitor tech and (1) 12 hour shift with an RN.  This is a bit concerning because I do not feel 1.5 days of training is adequate.

-

I haven’t sat down with my manager, yet.  I am assuming this transitional position is ONLY because of the staffing issues we’re having during COVID 19.  When this all blows over, I don’t believe they will utilize me anymore.  Although it does state in this contract I will be signing, I have to maintain ACLS, telemetry certifications, and whatever competencies to continue to function in this role.

My concern is putting this on my resume, if I ever decide to leave my current hospital… into an ER position.  If I transfer (officially) to telemetry, it will be within my current hospital.

Thanks again all.  I will be making my decision sole based on this thread.  Looking forward to replies.

Up Vote Up Vote ×
+ Join the Discussion