Medical Telemetry

AnaCatRN · Jan 23, 2011

I was a telemetry tech before I went to nursing school. I earned a certificate in EKG at a community college to learn how to read rhythms and 12-lead EKGs. I suggest you get a book like ECG Interpretation Made Incredibly Easy to learn the basics, or you can take an American Heart Association EKG course. While an RN will check your interpretation before the doc sees it, if you are working in central tele, not all nurses can read ECGs, so you do need to know your stuff, because you will have to call the RN when there are changes, and you may need to convince the RN that there is a problem. Usually an RN is in charge of the tele room, and he or she can help you, if needed.

Yes, you can learn them all. I've based my career on being an expert at reading even the rare rhythms, and you will see them. You will have to take a test to get the job, and each hospital has a different pass rate. You will be given several pages worth of rhythm strips to interpret. If you don't pass or don't get them all right, they will counsel you on your deficiencies so you can study more and try again.

Obviously you will need to know the basics: normal sinus rhythm, sinus tachycardia, sinus bradycardia, atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia, and asystole, but you also need to know the junctional rhythms and the AV blocks (which can be tricky) because you will see them. You do need to be an expert. While you don't need to be able to read a 12-lead EKG, you need to know every single rhythm.

I hope that helped!

NewToRX · Jan 23, 2011

I was a telemetry tech before I went to nursing school. I earned a certificate in EKG at a community college to learn how to read rhythms and 12-lead EKGs. I suggest you get a book like ECG Interpretation Made Incredibly Easy to learn the basics, or you can take an American Heart Association EKG course. While an RN will check your interpretation before the doc sees it, if you are working in central tele, not all nurses can read ECGs, so you do need to know your stuff, because you will have to call the RN when there are changes, and you may need to convince the RN that there is a problem. Usually an RN is in charge of the tele room, and he or she can help you, if needed.
Yes, you can learn them all. I've based my career on being an expert at reading even the rare rhythms, and you will see them. You will have to take a test to get the job, and each hospital has a different pass rate. You will be given several pages worth of rhythm strips to interpret. If you don't pass or don't get them all right, they will counsel you on your deficiencies so you can study more and try again.
Obviously you will need to know the basics: normal sinus rhythm, sinus tachycardia, sinus bradycardia, atrial fibrillation, atrial flutter, ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia, and asystole, but you also need to know the junctional rhythms and the AV blocks (which can be tricky) because you will see them. You do need to be an expert. While you don't need to be able to read a 12-lead EKG, you need to know every single rhythm.
I hope that helped!

Your answer did help, and I appreciate the information!! ECG interpretation is confusing to me. Regardless, I'm going to the interview with a positive approach, and hope for the best. I'm a Medical Assistant, and I know that this site is for nurses, but who would know the answer to my question any better than a nurse?! And with the hospital knowing that I'm a Med Asst., I seriously doubt that they are going to expect as much from me as they would a nurse. Most likely (hopefully)they will provide additional training. Thanks again for sharing your knowledge.!! :up:

NurseGuy30 · Jan 23, 2011

Your answer did help, and I appreciate the information!! ECG interpretation is confusing to me. Regardless, I'm going to the interview with a positive approach, and hope for the best. I'm a Medical Assistant, and I know that this site is for nurses, but who would know the answer to my question any better than a nurse?! And with the hospital knowing that I'm a Med Asst., I seriously doubt that they are going to expect as much from me as they would a nurse. Most likely (hopefully)they will provide additional training. Thanks again for sharing your knowledge.!!

I'm a CNA / telemetry tech. At my hospital they taught, trained, and tested me in-house. Central monitoring is something of a pain, to be honest. You have to learn the rythms--didn't mind that part--and then get fast at measuring them (we use calipers, another hospital in a nearby city is lucky enough to have a central monitoring system with which you can measure and print strips on screen. Measuring lines in 1/2 cm increments (0.02 seconds) can hurt your eyes after a while. We typically stay around 40 pts at a time or so.

Occasionally, though, RNs themselves can be the most difficult part of the job. The previous poster is right, some don't know how to read EKG strips. I don't mind explaining how I can tell a patient is in A-fib, or differentiating between a-fib or a-flutter for a nurse. What I do mind is calling an RN multiple times to tell them their patient's Sp02 is in the low-80s and being told, "it's fine" (another nurse finally put O2 on the pt). Or being snarkily told that the RN knows that the pt. converts from A-fib to Sinus often, don't call again--only to have another RN get on you for not calling her the very second the pt. converted. You're dealing with all of this while putting in admissions and listening to alarms go off constantly, most of them insignificant.

I would probably get grouchy real quick if I had to stay in monitors all the time. As it is now I'm only there occasionally. I do enjoy it--nothing gets your heart pumping like calling the Nurse for a nineteen-beat run of V-tach--and for a student, the educational value is extraordinary. But I don't think I'd ever want to do it full-time. Since you're an MA, maybe you can work two jobs. I do CNA mostly and MT only occasionally. Nothing makes you more valuable to the hospital, to my mind, than being cross-trained.

As far as rythms, don't worry, you'll get it, given enough time and training. And you can always use references if you're unsure if something is 2nd degree or 3rd degree HB. I view my job as, primarily, bringing arrhythmias to the attention of the nurse.

AnaCatRN · Jan 23, 2011

Occasionally, though, RNs themselves can be the most difficult part of the job. The previous poster is right, some don't know how to read EKG strips. I don't mind explaining how I can tell a patient is in A-fib, or differentiating between a-fib or a-flutter for a nurse. What I do mind is calling an RN multiple times to tell them their patient's Sp02 is in the low-80s and being told, "it's fine" (another nurse finally put O2 on the pt). Or being snarkily told that the RN knows that the pt. converts from A-fib to Sinus often, don't call again--only to have another RN get on you for not calling her the very second the pt. converted. You're dealing with all of this while putting in admissions and listening to alarms go off constantly, most of them insignificant.

That made me laugh! I used to get so mad at the nurses! You have no idea how many times I would call at 3am to tell a nurse a pt was in VTach, only to be told "he's brushing his teeth." It happened every night with every nurse. Seriously?! Everyone on that floor brushes their teeth at 3am? It just added to my list of things not to do as a nurse. Don't ever let the nurses who don't know what you're talking about get to you. You wouldn't believe it, but we spent less than an hour in nursing school going over rhythms. That explained everything to me.

It's awesome that your hospital trained you. The hospitals around here don't do that, and most tele techs are paramedics or echo techs moonlighting (or echo tech students). We had up to 180 pts on central tele with up to 2 tele techs. The "false alarms" drove me nuts at first. It was stressful, especially when there were a bunch of admits at once, but it's a decent job if you're interested in cardiology, and in some places it pays better than being a CNA. I learned a lot.

Good luck to the OP!

NewToRX · Feb 1, 2011

Thank You!!

AnaCatRN · Feb 1, 2011

Thank You!!

You're welcome! Did you get the job?

NewToRX · Feb 3, 2011

You're welcome! Did you get the job?

I'm still waiting to hear from them. It's been over a week now, I called and got the usual "give it more time" answer. So I guess it's just a waiting game. :confused: