What is telemetry?

Patients are sent to telemetry units when their physicians, for some reason, wants them on 24-hour monitoring of their EKG. EKG pads are placed on the patient and a small box attached to them with wire. The box is a transsmitter that sends a continuous signal to a central location of monitors where someone is constantly watching each patient's heart rhythm and rate. Many of these newer systems are able to record 24 hours or more of the patient's EKGs for the physicians to review when they come in for their visits. The advantage to this is if the patient develops an arrhythmia, the nurses can note it immediately and treat it based on pre-written protocols. Physicians can also note changes in a patient's rhythm and base their medication orders on what works or doesn't work to correct a patient's arrhythmia. Nurses on telemetry units are usually required to take an EKG interpretation class very soon after starting to work there if they don't already have this skill. Some units also require ACLS certification of their telemetry nurses.

As the other poster said, telemetry may be called ICU stepdown or CCU stepdown. On the ICU stepdown I worked, we often got patients during the night shift that the doctors wanted monitored until they came in to see them the next morning. We also had patients that were either transitioning between going to ICU or coming out of ICU. We were cross trained to work in ICU (that's where we usually had to float). Telemetry units get more than their fair share of code blues.

Be very careful of taking a job on a telemetry unit if you are a new grad. They are often very hectic units and some of them have difficulty retaining staff because of the level of skill and sheer constant activity occurring on them. You can interpret that as "having no time to sit down and take a break". A new grad going onto a telemetry unit should be promised a very good orientation and precepting before accepting a job on this kind of unit.

Each telemetry unit is different, so you have to investigate what kinds of patients they are caring for. The telemetry unit I worked on was an ICU Stepdown/Telemetry. We had patients on ventilators, comatose patients, post-op thoracotomies with chest tubes, dopamine drips sometimes and occassionally had to do some hemodynamic monitoring on patients with Swan lines. Our acuity was very high, so the nurse/patient ratio was low. However, I have seen telemetry units that were just cardiac patients who were ambulatory and only there for monitoring where the nurse/patient ratio was 10 to 1. Depends, as I said.