Med-Surg Telemetry

I am a supervisor of a 40 bed med-Surg Unit and we have 6 Telemetry beds, almost all of the RN's that are on unit are ACLS certified and many of the LVN's are as well, we have a unit clerk that is also a Te;etry Tech that watches the monitor and alerts nursing of abnormals..it works well...

I work on a 32 bed med/surg floor that also accepts telemetry patients, however we do not read the strips ourselves. The telemetry is monitored by our ICU and during each shift the secretary goes up to the ICU and writes down the readings for us on a clipboard. Most of our nurses on the med/surg floor are not ACLS and generally have an Associate's degree. I find a lot of times in report the nurses will tell what the patient's telemetry has been reading, but don't actually know what it means unless it's something normal.

Hi

I am an RN student, but find the same situation...the telemetry beds on the floor are monitered by the RN's or LPN's on the floor, but when I quizz them on the meaning of the report info., they are vague. They usually respond that the ICU would call if the readings were bad. It comforts me to know that thay are being watched by someone (ICU) in the know :) , however I wonder...'where is the double check system?' I guess there isn't one, huh?!?

Being a student I do KNOW that telemetry patients are monitered constantly by a well trained/educated person in the ICU. It is difficult not to be concered though. I would want an ACLS cert. if it were my license on the line .

Thanks for your time...

I work on a cardiothoracic surgical unit, 30 beds.

We have 8 telemetry units (portable) plus 4 beds that can monitor pts via hard-wire & be transmitted thru the monitor in the nurses station.

We watch our own pts (glance over as you pass the monitor), plus have the Team Leader (level 2) floating & watching. Most the time we are looking for AF post surgery (not hard to miss). Occaisionally we have a medical pt on telemetry but if they are a high risk for a ischaemic changes and/or MI they really should be transferred to CCU.

It works well, the alarms alert us to immediate changes to arrythmias, rates, elevation, depression & we get to learn & read the monitor first hand.

I do know of others working in hospitals where the telemetry units are not visible on their ward but I find it hard to imagine working like that.

i cant even imagine monitored beds on our unit. holy heck!

I felt the same when I started on this ward but now see the telemetry as 'my friend' as it alerts me to changes.

The first time I saw a pt convert to AF, I noticed nobody seemed too bothered, whereas I was thinking "hello, this pts rhythm is out of whack, BPM @ 160-170, irregular, etc, do you want the emergemcy trolley a little closer to them?', ofcourse it was treated quickly and the reason the staff were so layed back is because a high percentage of pts go into fibrillation.

But now I see the benefit. I can spot one of my pts starting to change their rhythm, PVCs & irregular pulse is usually first sign & I can monitor them carefully, check electrolytes, as soon as they hit AF I can get them digitalised quick smart.

I guess its all relevant to where you are working & how you approach things.

My first job was Med./Surg. We were a 34 bed unit. 8 beds were step down...we took CVP's, A-Lines and cardiac monitored patients. I now currently work on a cardiac step down.

I love any knowledge I get. I feel more comfortable now that I've learned telemtry. I'm also glad I took ACLS. When a code happens I feel more at ease with the knowledge. Though code's don't happen often on my floor.

On the medical surgical unit and at my current job we have monitors at the desk. You're lucky to see the telemetry more than once or twice a shift....unless it beeps.

At the hospital I work at now...all the medical/cardiac floors that are not step down or ICU have telemtry techs reading the monitors. The nurses have beepers if one of the patients go in a irregular arrythmia, you are beeped.

What is a telemetry tech??? Where I work, ICU monitors telemetry patients who are on the medical floor. When there is a problem, change of rhythm, etc., ICU calls upstairs to inform the floor. We have considered the possibility of installing a read-only central monitor on the medical floor.

I hated the pager/beeper system when I worked step-down.UGH. Every time the pt brushed their teetn, turned or (more likely) ripped of the leads so they could sneak outside for a smoke the damn thing buzzed or vibrated. I think we got so used to false alarm rythyms that we we too lackadaisical. I spent more time running into the room to make sure the pt was alive and nonsymptomatic. A monitor tech would certainly help, but our admin didn't feel they were cost effective. Much better to have the RN do everyones jopb and their own. Iii think ideally, the RN MUST be trained and SEE the monitor. If you depend on ICU to call when the pt is in VT/FIB it may be too late by the time you get in the room with the crash cart. Or due to thier own undrstaffing and untrained staff (in our ICU anyhow), they may not notice a change right away.

I must say that I am shocked that there are still hospitals that have not mandated a Basic Telemetry training class for ALL of the nurses who work in areas where Telemetry patients are assigned-- paid for by the hospital, of course.

When will the insanity ever stop! My goodness! An eight hour class in Basic Telemetry goes a long way in preparing a nurse to recognize what rhythm his/her patient is in! Learning Basic Telemetry is easy, too, so why the continued delay in providing this course to hospital nurses working with any cardiac patient is beyond me!

Someone asked "What is a telemetry tech?"

A telemetry tech is a person who is trained to read rhythm strips. They have taken a Basic Telemetery class that has prepared them to read the cardiac monitors, and sometimes they have taken advanced classes in this as well. They are great to have on every unit that has telemetry patients, but it is even more essential - IMHO - for the nurses to be able to read their own strips. It's also a fun class to learn, so don't hesitate to take the class if you get the chance. It should be one of those mandated CEU classes for every nurse. :)

Originally posted by Renee Williams

I must say that I am shocked that there are still hospitals that have not mandated a Basic Telemetry training class for ALL of the nurses who work in areas where Telemetry patients are assigned-- paid for by the hospital, of course.

The hospital I just left only required an 8-hour tele course to work on telemetry.

The hospital I am going to requires a 40-hour tele course to work on the unit where I will be working.

Neither hospital has a "telemetry tech" or ICU monitoring floor beds. I'd rather know how to monitor my own patient instead of having to rely on someone elsewhere in the hospital doing it.

JMHO :)

Amen Jules-RN! Good for you! That's the way it should be! :)