Need: Information about Telemetry

[tiroka03, LPN]

I have worked on a Cardiac Step down unit. I wasn't involved in telemetry, but have always been interested. I have learned a few things on my own. But, I am curious what things you are looking for. What is good and what is not.

[April, RN, BSN, RN]

A cardiac-step down unit is essentially the same as a telemetry unit because all patients are on heart monitors, but a step-down is typically higher acuity. How is it that you worked cardiac step-down but weren't involved in telemetry?

[tiroka03, LPN]

I was an LPN, I did basic care, and in some ways acted like a CNA. The RN's watched the telemetry, and took care of the Critical patients. The patients who I watched were still on telemetry, but basically much more stable. Any meds that would need to be monitored closely were given by the RNs. Otherwise I acted like a floor nurse, giving run of the mill meds, doing insulin, doing cares, monitoring I &O's, draining tubes, doing dressing changes. I did at times get to see the EKG strips and tried to listen to the pulse points and figure out what it all meant. I still would like to know more about it.

[April, RN, BSN, RN]

I see you are an LPN - maybe that is why you weren't involved in tele monitoring? I've worked in hospitals where techs watch the tele monitors so that thought didn't come to mind right away. We look to see what a patient's "baseline rhythm" is and then monitor for any changes in rhythm. For example, atrial fibrillation is an arrhythmia, but some people live with it all the time. If someone is in a normal sinus rhythm and then all of the sudden went into atrial fibrillation, or was suddenly having frequent irregular beats, that would be concerning. Changes in the length or height of different parts of the heart beat can signify many things, include MIs, ischemia, electrolyte abnormalities, etc. It's complicated and can be overwhelming if you don't have any training in telemetry monitoring. There are many books out there you could look into. I've heard "EKGs for Dummies" is a good one.

[ObtundedRN, BSN, RN]

Try "Rapid Interpretation of EKG's" by Dr. Dale Dubin. Excellant book.

[mama_d, BSN, RN]

I'm assuming the RNs where you are initially took a tele course...is there any way you could take it as well? Where I am we all had 24 hrs worth of classwork on rhythm recognition and interventions, and are all ACLS certified (RN and LPN both). We are all responsible for keeping an eye on the monitors. I can't imagine working tele on a regular basis and not having that knowledge. Then again, I'm lucky enough to work in one of the few places that the whole RN vs LPN thing makes little difference, it's more about the experience and capability. So I guess I'm a little spoiled in that regard.