buncee

I just started working as a telemetry resource nurse in a mid-sized hospital. They required a minimum of 3 years ICU experience to take the job (I've worked in ICU for 5 years). I really don't mean to sound rude, but I don't think that 1 year is enough experience to run a code/ rapid response, interpret EKG rhythms, and the various other things that a resource nurse does. Even if you are a very smart nurse, it's the hands on experience that is essential to take a role like that.

We have a telemetry assistant and a resource nurse who checks on all patients on telemetry, especially those on any type of hemodynamic drip. The TA keeps a continous eye on the HR and makes notes beside the patients rhythm that they are indeed on a hemodynamic drip. The resource nurse makes sure that the patient is stable, and if unstable, arranges for them to be transferred to a progressive care unit or ICU.

The one that got a few of the nurses when we were applying for the critical care fellowship was "your patient is post op 2 hours. His blood pressure is 75/40. What would you do first?" Almost everyone said "call the doctor". They were looking for a more "critical care" answer such as "how are you getting the pressure, via a manual cuff, dynamap, or arterial line?" Also, they wanted to know if the patient was stable, what their heart rate was doing...stuff like that. They want to make sure that you see the BIG PICTURE of your patient, and not just the fact that their pressure is low.

That is the whole point of being ACLS certified, to begin ACLS treatment if you are the first to respond. Paramedics aren't Doctors, but they can administer medications without a doctors order.