Floated to Tele, no experience...

[RNewbie]

I work per diem as an agency nurse. My specialty is med/surg. A few times I've been floated to Tele/DOU. I am clueless regarding cardiac issues and rhythms. I had to ask the charge nurse what I should do every time the monitor tech called with a rhythm change with my pts. I had to get someone to review and sign off on my strips at the end of the shift. I spent the entire night asking questions about what to do and trying to understand why. It's not safe and I don't feel comfortable taking others word for what to do regarding pts that I am responsible for. I'm going to ask the hospital if there is a class I can attend if there is a chance I will keep ending up in working Tele from time to time. Just wondering if anyone knows of any good material that I can use to teach myself the rhythms and nursing interventions or something that will give me a clue. Staffing doesn't understand when I tell them I dont work Tele. They say it's like med surg and that I just need to get someone to sign off on my strips. I'm expected to be flexible since I'm agency and I dont want to get put on the do not return list. So I have decided to take it upon myself to learn enough to function on a Tele floor. Any advice would be appreciated. Thanks.

[RnfromUK]

First thing is know the basic rhythms. Learn what is normal (Sinus rhythm) and what is dangerous (VT, VF, etc). I agree with the above and take an ACLS class for those. 2nd thing is ALWAYS check your patient first. If the monitor tech calls you with a rhythm change, check the patient. Are they short of breath, do they have chest pain, are they dizzy or lightheaded? What is the BP/HR and is it normal for them? Sometimes the monitor can show a rhythm that looks terrifying but when you check your patient they are simply moving around in bed or brushing their teeth. If after all these steps you are still unsure, ask a fellow RN or charge.

In the case of a CODE....just run into the room ASAP and grab the code cart if not already there. Chances are someone will be doing compressions already but maybe you can grab the ambu bag or load up the latest lab results for the doc. Maybe run and grab equipment when asked or even be the recorder. Also bare in mind that compression are exhausting so be ready to swap with whoever is currently doing them to give them a break and keep the compressions effective!

Cardiac nursing is extremely complicated and takes time to learn. I have been a cardiac RN for nearly 4 years and I am still learning. Good luck and dont fear tele!

[UnbrokenRN09, BSN]

I second that! Been in cardiac for 4 years as well and I still am definitely no expert! There is always more to learn.

[Ruby Vee, BSN]

I'd suggest getting an ACLS book -- it will help you to identify the rhythms, distinguish between the lethal and the non-lethal arrhythmias and give you some sort of an idea what to expect as orders when you call the doctor.