Med/Surg nurses floating to telemetry

UM Review RN, ASN, RN · Dec 23, 2007

You might ask about that. Some hospitals do not require you to float to an area that is not within your expertise and others will make the med-surg nurse float to tele.

I wound up in Tele because I hated to float so much, I decided to take the tiger by the tail and learn about that specialty. (That was before I found out that tele nurses have to float to ICU. :madface: Sometimes ya just can't win.)

I certainly recall the fear when one of my patients was going bad and I was floating and knew nothing about how to fix it.

Way more stress than we need, IMO.

But the sad fact is, in our hospital, the tele nurses get training after they start working on our unit, so we have regular nurses who work there who can't read an EKG strip or administer certain medications or know what to expect from their patients' conditions. So you are by no means alone.

All I know is, if you make sure that you tell the nurses that you are not a tele nurse, there's usually one or two who will be happy to help you through it.

Tweety, BSN, RN · Dec 23, 2007

We float to Tele as well. I just made sure to be aware of who was in charge of the monitor, and the licensed personnel in charge of interpreting the strips. To me it wasn't enough to know who the monitor tech was, as skilled as they might be, but the nurse responsible, and usually it was the charge nurse. I made sure there was documentation in my notes of what the rhythm was, patient is in A.Fib with a rate of 89 per Nancy Nurse, RN. It's never been a problem.

The last time I floated I was taking care of a post-defib. implant patient that began to have chest pain. I can handle, head-to-toe assessment, monitor vital signs, give oxygen and nitro. etc. but you'd best believe the nurse responsible for the monitor was drug into the room to assess the patient, read the strips and talk to the doctor for me about our findings. In these type of situations a med-surg nurse is perfectly capable of handling things, with their resource, and we must be assertive in that regard.

We have 8 telemetry beds on my unit for trauma tele and surgical tele, so I have had to learn it, so it's no issue with us to float.

I know that doesn't answer the legalities of it. No one should accept an assignment they are uncomfortable with because when you go to the BON, that's what they will ask "why did you accept the assignment and why didn't you use the resources available to you...." etc.

Good luck!

Daytonite, BSN, RN · Dec 23, 2007

hi, missingmyerica, and welcome to allnurses! :welcome:

i worked for many years on a stepdown (telemetry) unit. when i became a supervisor in the same hospital one of my duties was to float people to that unit. our other choice was sometimes to float them to the icu. none of the med/surg nurses liked to go to the stepdown unit to work and i can honestly say that i've heard all the excuses and reasonings from med/surg nurses as to why they shouldn't have to float to stepdown (telemetry) including one or two who actually picked up their purses and walked out of the facility insuring their termination from the job.

it's true that if you can't read ekgs then the other staff must do it. they should know that and shouldn't need to be told, but i always reminded them. if a patient codes or runs into arrhythmia problems you also shouldn't be expected to know or carry out the standing orders for this. the staff there should also know that and shouldn't need to be told, but i also reminded them of that as well.

my view on floating med/surg nurses to telemetry, and feel free to ask for this when it is your turn, is that you should be given an assignment of patients of the lowest acuity, preferably patients who are likely to be transferred or discharged the next day. ditto goes for patients on ventilators. if that is not possible then i had the staff rework their assignments and put the float nurse into a nursing assistant role of taking vital signs, passing oral medications and checking and maintaining ivs while the regular staff took care of the telemetry and patient assessments.

there is always a solution. refusal is not an option.

as far as the legalities of this for your state, check your state nursing board website. sometimes they have published position statements on these kinds of things if there have been problems in the past. however, i have a feeling that you won't find anything on this particular issue. as i said, there is always a creative solution that can be worked out.

RNperdiem, RN · Dec 23, 2007

If the telemetry is used as overflow space for med-surg patients and they assign you med-surg patients, then you will do fine.

If your hospital has classes in EKG monitoring and heart rhythms, see if they will let you take classes, and pay you for them. Knowledge like that is never wasted.

Floating as you are now puts you in a gray area. How you do in unfamiliar situations will depend on how much support from the charge nurse you get.

oldiebutgoodie, RN · Dec 24, 2007

I personally think every med-surg nurse should learn how to read EKG strips. In our hospital, every single bed can be monitored, so you can get plenty of practice. Take a class through your hospital, or take it twice. I didn't find it all that hard, once you did the exercises.

I am also amazed when med-surg nurses can't do an EKG. All floors should train their nurses to learn this, so you aren't waiting around for the tech to do it.

Just my .02 worth. Feel free to disagree!

Oldiebutgoodie

blueheaven · Dec 24, 2007

I personally think every med-surg nurse should learn how to read EKG strips. In our hospital, every single bed can be monitored, so you can get plenty of practice. Take a class through your hospital, or take it twice. I didn't find it all that hard, once you did the exercises.
I am also amazed when med-surg nurses can't do an EKG. All floors should train their nurses to learn this, so you aren't waiting around for the tech to do it.
Just my .02 worth. Feel free to disagree!
Oldiebutgoodie

You are right oldie, if you know that part of your job is going to require you to float to a tele unit...be proactive! You never can learn too much in this field!!

Most of the time the regular floor staff knows which patients are on tele that are stable. These and the regular med surg pts should be given to the floaters. PPl stress out over telemetry...I used to joke that at least we never find our patients cold and deceased!! (no flames please-i have hot flashes enough for everyone)

EmmaG, RN · Dec 24, 2007

I personally think every med-surg nurse should learn how to read EKG strips. In our hospital, every single bed can be monitored, so you can get plenty of practice. Take a class through your hospital, or take it twice. I didn't find it all that hard, once you did the exercises.
I am also amazed when med-surg nurses can't do an EKG. All floors should train their nurses to learn this, so you aren't waiting around for the tech to do it.
Just my .02 worth. Feel free to disagree!
Oldiebutgoodie

Doing an EKG is easy... if nothing else, just follow the picture on the machine. I can read basic strips, but since I'm not working with them day in and day out, I would feel more comfortable having the more experienced nurses read them for me. I have no problem floating to tele, and while I was traveling most of the units I worked were med/surg onc floors set up for remote tele anyway. I also agree with the above; you can always function as a med nurse and help with vitals, dressings, procedures, etc.