Med Surg nurse being given Tele Patients

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EllaBella1, BSN

377 Posts

Specializes in ICU. Has 8 years experience.

Honestly, I didn't read through all of these responses. I did however, read bits and pieces, and while I agree that it isn't a scope of practice issue, I do think it's an issue. You need to be trained or receive orientation on tele patients. As a med-surg nurse, would you know to check QTc before giving Tikosyn, for example? My guess is probably not. You will have someone else watching your tele monitors who will be able to alert you to changes in rhythm or potential problems, but you would still need to have the clinical insight to know when to check your tele. That said, I don't think it would take much training or orientation to get you up to speed, and I think it says something that your floor feels comfortable and confident in floating you to a higher level of care. 

Katie82, RN

642 Posts

Specializes in Med Surg, Tele, PH, CM. Has 41 years experience.

I agree that under normal conditions, this would not be considered beyond your scope of practice. As a RN, you should be able to handle telemetry. I did. The last hospital where I worked Med/Surg pulled me to Telemetry all the time. The big deal with telemetry is that it is a step-down from the ICU, but still considered a "specialty" floor, so it is usually a big money-maker for the hospital. I hated Telemetry, there were always so many patients who did not need to be there, they were just generating revenue. The staff always felt sorry for me, and gave me the easiest patients. I never told them that the reason I hated floating was because I thought it was incredibly boring, had nothing to do with feeling out of my level of expertise. 

But your problem is compounded by the fact that you are working at so many different hospitals. Don't think I would feel comfortable either. 

Specializes in Surgical Specialty Clinic - Ambulatory Care. Has 15 years experience.

Scope of practice describes the procedures, actions, and processes that a healthcare practitioner is permitted to undertake in keeping with the terms of their professional license. The scope of practice is limited to that which the law allows for specific education and experience, and specific demonstrated competency.

Let’s be clear here. Any nurse taking telemetry patients regardless of this stupid excuse of “My hospital makes me take tele patients all the time. If I can do it so can you.” is in fact practicing out side of their scope of practice if they have not received formal education on how to read EKGs. If the nurse has taken and passed an EKG course, then they are not practicing outside their scope of practice. There is no gray line here. Doesn’t sound like the OP has received EKG education, thus taking tele patients is outside the scope of her practice. If any other responder is floating from a med Surg unit to tele and being asked to monitor “stable” EKG patients, and they accept this assignment, they are practicing outside the scope of their practice. If you are Med Surg nurse and you need to float to tele “to take the easy patients” then I would suggest you tell your employer you are happy to go to the tele unit to watch Med Surg patients than cannot be moved to your floor due to space issues. And you are only willing to do it if they get an order for those patients to be taken off of tele first.  The only other acceptable way to take them is to under go a basic EKG course. Basically if you are not ACLS certified, you are not qualified to take care of tele patients.