mycoholic1

Please, can you explain why I need to know the diagnosis? I'd like to know how I would act differently by knowing it. Thanks.

Thanks for the link icuRNmaggie, I certainly hope my hospital follows similar high cardiac monitoring standards. I don't see how it supports your vote, though. We have techs, myself included who have a solid understanding of cardiac diseases and the associated arrhythmias, medications and side effects. As a monitor tech I still fail to see how access to the pt's Dx would influence how I perform my duties. If I just used pt diagnosis in any way to shape my actions, I've just become a nurse and am outside of my scope. I just observe and report. It's up to the RN to decide whether what I report is important and needs addressing.

Hi, Granny. Yes, but you do need a college degree to treat and care for patients. I know what my part of the health care team is. A huge part of being an effective member of a team is knowing exactly what your role is. While I'm a valued part of the health care team the fact remains, I don't give care to the patients. I don't have a license to treat patients. 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. My argument is based on the experience I've gained over the last 7 years as a tele tech "watching squiggly lines" and rarely, if ever have had the need cross-reference a pts rhythm with their Dx. I understand the squiggly lines well and have taught 12-lead. I know what is normal and what isn't. I know when to call the RN and maybe even more importantly, when not to. My job is to simply observe and report in a swift manner as to avoid any potential delay of treatment. Not to speculate about what a patient may or may not be doing. The Dx really doesn't help me in any way. But, lets dive down that rabbit hole for kicks and grins. I've just received notice of a new patient going on tele. Schmoe going in room 322, 75yo male, Dx - COPD. I'm looking at the rhythm and see a bunch of different looking p' waves. I methodically analyze the rhythm and decide he has an atrial arrhythmia; WAP. I'm not surprised because I know from educational literature that WAP can correlate with COPD and hypoxia, but I call the RN and let them know that the patient was admitted in wandering atrial pacemaker, because it's abnormal. Did I need the Dx to reach my conclusion? Did it even help? OK, pt being admitted. I have their name, age, room number and Dx is AMS. Oh! I'm glad I had that diagnosis! They have an altered mental status and might be pulling at their leads, or they might try to get out of bed and fall, or they might have tachycardia from being confused and saw spiders in their corn-flakes. Might. None of that matters because this is science, not a guessing game. If there's artifact I'll call the RN. If leads come off I call the RN. If they get tachy, call RN. I report anything notable because that's what we do for EVERY patient. I can't make judgment calls. If the RN wants to give me special parameters about when and what to be notified that's up to the RN. I can't assume anything based on the patients Dx. Yes, Granny you're exactly right and I thank you for your thoughtful reply. I wish we had RT's like you in our hospital, they never talk to us. I also love it when RNs take the time to call and give us a quick report and discuss alarm parameters, but they almost never do where I'm working now. I didn't want to come off as if I had the "it's not my job" attitude, that's not what this is about. I see it like this; If I wanted to use my understanding of arrhythmias and how they relate to the patients total condition, in a hands-on the patient capacity then I should chose another modality; be an RN, an EP doc or even paramedic. I don't like to think of my own mother or daughter in a hospital bed on continuous ecg and O2 with an un-licsenced monitor tech who's privy to their Dx.

Hi All, 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? Why or why not?