New to Tele

[Tell me 'bout Tele]

I am have been a nurse for 4 years and have accepted a position in tele today. My background is Med/Surg.

As for being on the floor, it will be alittle while since I have hospital orientation in September.

Please, any feedback and knowledge from other nurses is welcome.

Anything about ECG, Cardiac conditions, procedures, ACLS, meds, routines nurse use during their work days.

I look forward to reading replies and learning from all.

Thanks

[turnforthenurse, MSN, NP]

Know your rhythms! Are you familiar with them? I know med-surg nurses typically do not deal with tele monitors. See if your institution offers an arrhythmia course. If not, I recommend either ECGs Made Incredibly Easy or ECG Workout - both books are excellent.

Regarding rhythms, know your heart blocks! Here is a cute little mnemonic I learned:

If your R is far from your P, then you have a 1st Degree (prolonged PR interval >0.20sec)

Long, longer, drop...then you have a Wenckebach (Second Degree Type 1)

If your P's don't go through, then you have a Mobitz II (Second Degree Type 2)

If your P's and QRS' don't agree, then you have a 3rd Degree.

Be familiar with cardiac drugs, drips (Cardizem, Amiodorone, etc).

I work in progressive care, but it is essentially a cardiac/telemetry step-down. We get A LOT of chest pain/NSTEMI/post-intervention STEMIs, angina, pre & post-cath patients, CHFers, HTN, rhythm disturbances, patients undergoing pacemaker/AICD placement, etc. We also get other patients with other primary diagnoses, such as SOB, pulmonary edema, COPD, DKA, ARF, etc, but they have an underlying cardiac history that requires closer monitoring.

[Tell me 'bout Tele]

Awsome advice and post! Please keep me in mind for any updates you have.

Currently, I am getting more and more familiar with rhythms. The hospital does offer and EKG course and has an educator exlclusive the the Tele unit.

In the future, this floor will be doing drips, but for not they are not. Heart blocks have confused me so I will be working on my recognition of them.

I will be spending a shift or two with the monitor techs that watch the rhythms of all the patients on a monitor.

I am going to review the above medical dx you listed.

Thanks

[Tell me 'bout Tele]

I am also looking for medical/ critical situations that nurses have run into with patients.

Also, case questions you can ask me and I can come up with actions (care plan) and interventions

[Do-over, ASN, RN]

I am also looking for medical/ critical situations that nurses have run into with patients.

On my unit, I've learned to really watch the patient's respiratory effort - rate, rhythm, effort, sounds, etc. My most critical patients have been "respiratory" often related to CHF, COPD, etc.

[Tell me 'bout Tele]

Thanks Do-Over. Great advice!