I am a new grad RN who has just accepted a position in a hospital unit that is a "progressive care unit" or "telemetry" unit. I'm a little confused about the terms telemetry vs. progressive care vs. step-down unit. California law lists Telemetry and Step-Down as two different types of units, with Telemetry having a mandated nurse to patient ratio of 1:4 while Step-Down is mandated at 1:3. I don't know how many patients I'll have, but I assume no more than four.
Can anyone explain some of the criteria used to classify Telemetry vs. Step-Down? And which specialty forum most closely corresponds to my new unit, so that I can browse the forum and learn more about this.
Thank you for any help!
Generally speaking step-down and progressive care units are the same thing. They have very sick patients that may even be ICU type patients in certain hospitals. They could be on vents have multiple drips and lots going on which is why you may only have 3-4 patients. Depending on the hospital it can be a mixed population of medical step down and surgical step down patients, some hospitals have separate step units for each of these.
Telemetry means they are on a heart monitor continuously which is also seen as progressive care (or step down) because they require closer monitoring, more frequent vitals signs (usually q4 hours) among other things. Outside of California you might have up to 6 telemetry patients since a lot of them will be a&o x3, ambulatory. Typically these patients go for a lot of tests (ECHO, Stress, Cath Lab) and are also on drips so it can be considered a cardiac step down unit. Some will come back with sheaths that need to be pulled by the floor RNs who are certified to pull them. Most patients on a step down unit or tele unit will be on continuos heart monitoring though. Hope this helps.
Last edit by KeepinitrealCCRN on Oct 18
: Reason: error
What specialty forum depends on what kind of PCU it is. Cardiac, Surgical, Oncology, Stroke, etc.
none because 3/4 the patients dont even need tele on most tele floors
OP: The specialty is Medical-Surgical Nursing, where telemetry is the use of telemetry monitoring on relatively stable, but acutely ill patients.
Telemetry units are generally med-surg units, though there may be a few patients who are more step-down or PCU level.
Step-down/PCU is a critical care unit, less acute than ICU, but more unstable than med-surg.
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