Is Telemetry Difficult For New Grads?

Daytonite, BSN, RN · Apr 3, 2007

luv2shopp85. . .i worked on a icu stepdown (telemetry) unit for 5 1/2 years and was an experienced nurse when i started working it. this is not the kind of unit that i recommend any new grad to work on. it's too busy and it is incredibly difficult for a new grad to develop any kind of routine amid all the chaos going on. patients on these units are either in the process of going bad and eventually end up being transferred to the icu/ccu, usually during a crisis that occurs, or coming out of the icu/ccu because they're either getting better or icu/ccu needed a bed for someone else which means the patient can still be teetering on the edge of critical. these kinds of units really require someone who already has had some med/surg experience. i've said it before on the forums and i'll say it again. . .any nurse manager who hires a new grad for one of these units needs to have their head examined. we had one new grad that convinced our nurse manager to hire her at the time i worked on the stepdown unit and, believe me, this kid struggled for months. she got pregnant, took maternity leave and went back to work on one of the medical units.

orthopedics and oncology are considered surgical and medical units, respectively. i am in favor of new grads going to medical or surgical units because these kinds of units have some degree of routine--more so than a unit like telemetry which sees a variety of patients. i was the nurse manager of a medical unit and took on a number of new grad orientees at each graduation cycle. most made a very good transition from school to working rn on our unit. i'm not saying that any of these units are not going to be busy, oh, they will be busy. in today's world, all the hospital units are pretty busy. however, when you are going to be seeing the same types of patients with the same types of problems again and again you will begin to develop a routine, learn how to organize and master specific skills.

my first acute hospital job was on a general medical unit, one of three in the hospital, where many of the patients had gi, gu and heart related problems. certain doctors routinely asked that their patients be admitted to our unit. i learned about ulcers, alcoholics and alcoholic hepatitis, bph because we had a lot of turp patients, kidney stones, renal failure and congestive heart failure. those were our regular mix of patients. you get to know those specific diseases and their treatment and tests for them pretty well after you've worked there for a few months.

if you liked oncology/med/surg mix then look for that kind of unit. i've worked on a gyn surgical oncology and found it a very nice unit. my best friend has worked oncology units for years and years. the bigger the hospital, the more specific diagnoses of patients they admit to that unit will be; the smaller the hospital the more generalized the medical units will admit patients to those unit with problems from a to z.

cardsRN · Apr 3, 2007

ummm...don't be too scared. i started in tele. it is very fast paced and can be stressful, but you learn a lot. you learn how to get you stuff together in short order. and when you move on later, you at least have your rhythm interpretation down (in addition to basic assessment and time management skills) which will give you an advantage. just mho.

coolvibesRN · Apr 15, 2007

I have worked in tele since getting my RN. Its really fast paced so you have to manage your time wisely. I love cardiac and i love tele. I did an internship for 3 months then started working on my own. I was working in a hosp where the tele floors get 7-8 pts. So really hectic. Don't work there no more. Stressful but learn to mage your time well and you can do it

mom2michael, MSN, RN, NP · Apr 16, 2007

I started out on a Tele floor and for the most part, I love the job itself. I love cardiac related conditions though. I was a PCS on that floor before I took the RN position though - so that helped the transition.

I didn't like my commute (1.5 hours), management provided no support and there were some major issues with certain staff that never seemed to be addressed but those issues carried over to patient care and I didn't feel safe working there anymore on multiple levels.

It was fast paced though and you never stopped for 12 hours. Patients are always coming and going, there are always new orders, tests, procedures, etc... You get time management down to an art though, in a very short period of time. Moving to nights helped somewhat, but not really because we still got a lot of admits overnight and the patient load was higher on nights (7-8).

If you get a good solid orientation and you are willing to learn and jump in with both feet and ask lots and lots and lots of questions....you'll do fine.