Recently, our 33 bed cardiac step-down floor changed from centralized telemetry with telemetry techs to decentralized. Which means that the RNs now carry pagers filled with our patients room numbers (usually 5 patients each-spread throughout our large unit) but the pagers go off for arrhythmias on all 33 patients. There is a central bank of monitors at the desk but no one is watching them. Already, there have been several instances where patients went into afib or had runs of vtach without anyone noticing. One patient's monitor was on standby for several hours. The problem is that the pager goes off every 2-3 minutes in our pockets, causing us to run and check on the patient. Some are true arrhythmias, most are artifact. Sometimes it alarms asystole with a heart rate of 70. I can't make a phonecall to a doctor or pull medications without constant interruptions. I am concerned that we will become complacent and miss an arrhythmia or make a medication error with all this chaos. I have never heard of this being done before. I am sure that it is a cost cutting measure. Does anyone else work in environment like this? How have you managed this successfully?