I've been working as a tele tech for almost 7 years. Recently I moved to a new hospital (Providence to Kaiser). While learning the ins and outs of the new job I was told we as techs need to be writing the patients Dx, along with their Name and Age on our hourly patient tracking forms; that this is status quo. In my experience our main function as a tele tech is to simply observe and report to the RN; changes in rhythm, rate, if a patient comes off the monitor, batteries, leads off, etc...
To have us write the patient Dx seems unnecessary, irrelevant and clearly outside our scope as a tele tech. Consider the fact that in most cases the tele tech position requires zero education beyond a basic ecg interpretation course.
The way I see it is, it isn't my job to speculate, make assumptions about a patients condition or be anything but completely objective in the way I handle each rhythm on the screen. Think about the buzzilion diagnoses a patient could have upon admission. Does your tele tech with no education need to know that the patient whose rhythm they are watching has pancreatitis, abdominal pain, colon cancer, prolapsed uterus? What about TIA, PNA, crani, chole, appy, lami, spondy or diverticulitis? What about femur fx, sepsis, hematuria, CAD (any diagnoses imaginable). How would this information shape the way I react to the rhythms I see tracing along my screens? "You don't treat the rhythm, you treat the patient", right?
So, to put the question directly: Should your tele techs be privy to patient diagnosis's? Would you as a nurse feel better if your tele tech knew the Dx of your patient?
Whether or not a tele tech knows a patient's diagnosis is irrelevant, because they are only expected to alert nurses when a rhythm is outside its parameters. Unless a tele tech has had other types of education, I don't see how knowing a diagnosis would be of any use to them or to nurses.
I'm not a huge fan of having tele techs to begin with. I've worked in environments with and without them, and I've seen many times when a nurse noticed a subtle, but important, change that wouldn't have been reported by a tech...QT intervals becoming gradually more prolonged, sudden increases or decreases in heart rate, a notched p-wave...not to mention that the tele techs hardly ever looked at anything other than lead II.
I don't think it's necessary. Techs don't need to be told a diagnosis to report a rhythm change. I will give them a general idea of what's going on if the patient is dying so they don't call me every time the HR drops below 30 and the SpO2 drops below 80%, or I may mention that they're severely dehydrated if they come in with DKA and a rate in the 150s, but other than that, I don't say much.
The tele techs are a part of the care team. Knowing diagnosis and information about the patient can be brief and succinct. They should know information about the patient, especially diagnosis, and any pertinent past medical history. also for pt identifiers, to make it clear, across the board and consistent with communication, it should be name and Medical record number. These two are the only two identifiers. Just because they are a different part of the team, all members should be speaking the same language, same communication. it does not make a difference, education or training level, all members of the team should use the same identification. It can minimize mistakes.
Wish we had tele techs, they got rid of them years ago to save money and because they had trouble keeping enough CNA's. So instead they added lots of loud alarms and monitors in the nurses station and hallways and now we have phones that alarm constantly mostly false artifact alarms and drive you crazy. You can't get them to stop ringing even if you are on the phone with a Dr so I don't use them to speak. I use the station phone and wait for the Dr to call back, so annoying when you can't hear on the tele phone to begin with and then alarms ringing while trying to listen! Wish we still had tele techs it was more peaceful back then and less alarms to stress you out!
Specializes in Medical-Surgical/Float Pool/Stepdown.
All I have is a rhythm, name and age, a room number and a pt. dx. and you can't give care to a patient with only that information from a remote office. We work directly under the RN. They are our boss. The rhythm is what I monitor; the name, and room number are my pt. identifiers and are essential. The rest is non-essential, but nice to have in some cases, but our job doesn't rely on Dx.
Why has it not crossed minds that the hospital may be using the diagnosis, along with name and room number etc., as another patient indentifier safety measure. When I worked monitors we could have had several patients with the same last name on the screens/charting at any given time. We used to have the person that was hooking up the tele box to the Pt call the monitor tech at the time they were doing so and read off the Pt name, room number, and the tele box number. Because people take short cuts and things get crazy busy we still at times would get boxes switched and on the wrong Pt's. I think we can all agree that errors can be deadly and/or waste precious time for life-saving interventions. Even though the admitting diagnosis has always been part of the tele charting, now the Pt's last name and MRN are placed on a removable strip that sticks to the box until it's returned and each box sent out has to be verified with this information along with the box number. Maybe it's just for safety and record keeping/narrowing down potential mix ups from miss placed boxs to potential mix-ups in Pt billing...
Wish we had tele techs, they got rid of them years ago to save money and because they had trouble keeping enough CNA's. So instead they added lots of loud alarms and monitors in the nurses station and hallways and now we have phones that alarm constantly mostly false artifact alarms and drive you crazy. You can't get them to stop ringing even if you are on the phone with a Dr so I don't use them to speak. I use the station phone and wait for the Dr to call back, so annoying when you can't hear on the tele phone to begin with and then alarms ringing while trying to listen! Wish we still had tele techs it was more peaceful back then and less alarms to stress you out!
If I had to carry a phone around that alarmed every time there was artifact I would lose my mind. I didn't even know this type of nurse torture existed!!
SubSippi
911 Posts
Whether or not a tele tech knows a patient's diagnosis is irrelevant, because they are only expected to alert nurses when a rhythm is outside its parameters. Unless a tele tech has had other types of education, I don't see how knowing a diagnosis would be of any use to them or to nurses.
I'm not a huge fan of having tele techs to begin with. I've worked in environments with and without them, and I've seen many times when a nurse noticed a subtle, but important, change that wouldn't have been reported by a tech...QT intervals becoming gradually more prolonged, sudden increases or decreases in heart rate, a notched p-wave...not to mention that the tele techs hardly ever looked at anything other than lead II.