Transportation of Telemetry/Stepdown Patients

Nurses General Nursing

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For those of you who work monitored telemetry or stepdown areas: when your patients go for inpatient testing, are they transported with a monitor and accompanied by an ACLS qualified RN (or other person)? If not, do you have complete facility wiring so that the rhythm can be visualized en route and during the procedure? If a patient is removed from telemetry for a procedure (or even for showering) who makes that decision (and accepts liability for it)? The doctor? The nurse? A criteria list or decision tree? We're grappling with this issue right now and an idea of nursing standards (and comfort levels!) would really help. Thanks! :kiss :o

On my floor there is no one constantly watching the monitors at all times. There are several different alarms that go off if anything goes out of range or anyone goes into a different rhythm. When this happens, it is the responsibility of the RN's to run to the monitor to see what is going on. Usually whoever is closest. Certainly if a patient is really critical, they will take a portable monitor, an RN, and a critical care tech with them for transport.

Specializes in ER,Neurology, Endocrinology, Pulmonology.

Erinkate, I can't imagine what it must be like to watch your own tele patient.

I am a monitor tech right now and it is not an easy job!

Sometimes I have 3 or 4 patients next to each other who have problems. How can one RN do everything she has to do and watch the tele too? That is just not fair. I feel for you.

Specializes in Interventional Pain Mgmt NP; Prior ICU and L/D RN.

In my facility the patients must go with a Defib validated nurse on the monitor; unless the doc has written "may travel without monitor". Any pt with a trach though still has to have a nurse with them. My floor is set up in "Pods". Its a 1-4 ratio with a central monitor for those 4 patients above your desk in the pod. We don't have monitor techs. Although our gen monitor floor and Cardiac stepdown does. Anyway, how pt's go with rn/monitor. It is policy for us unless a written order by doc:)

All patients on the tele floor go without RN and the tele doesn't reach everywhere, like radiology. If your patient is on drips like dopamine... it would be a prudent nursing judgement to go anyway.

From my ICU, I transfer patients to step down WITHOUT tele, because our policy states and if they were on tele, they would go without RN, assuming not on cardizem, dopamine ect.

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.

I work Neuro. The telemetry med-surg and neuro intermediate patients leave the floor all the time without their monitors. I've never really thought about it. I'll have to check for a policy.

We have portable packs, and I usually accompany patients when I'm in charge and they are being tested for a change in status, or a change for the worse and they are being upgraded and transferred. I'm not ACLS certified, but am telemetry certified. Our codes are run by the resident MD's on hand.

I take care of post op cardiac patients, we just take them off tele for testing as long as they've had a stable rhythm. Any rhythm that's not stable, or if the patient is on certain IV cardiac meds, I take my patients down personally. I don't work the tele unit often, but I do know that their admission orders have a check off area that includes the order "Patient may come off telemetry for testing", the doctor just checks it off if they'd like to.

An ACLS RN must go with our tele pts unless the physician ordered "may go non-monitored." This is really a pain because our pts are forever going off the unit for tests. It really puts you behind for the day because all your tasks are still waiting for you when you get back. There have been some days where I spent hours off the floor. Also the physician must write an order for the pt to take a shower.

The tele boxs on my unit communicate only on our unit. we have a monitor tech who has 38 computer screens,one with each pts info.We have transports who come and take pts to different parts of the hospital for tests,and the boxs dont go with them.To be honest,I have never gave it much thought as this has always been the practice. I am going to check the policy on my next shift.Thanks for the thought.

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