(And I do mean here. This is not meant to be a rant against all tele techs everywhere, I've just had a really annoying week.)
Thanks so much for taking time to let us know the minute someone has a lead off (even if the waveform is still visible) and if a battery goes dead in a tele pack. We appreciate that, we really do.
But please understand that my guy being rapid responsed in room 8 may mean it takes me a little while to get into room 6 to replace that lead or battery. And when we are short staffed with no aides and only 3 RNs on the floor and we have 2 patients circling the drain, please don't call me 5 times to tell me the white lead is off. I heard you the first time, I've just been a bit busy.
Oh yeah. And since you are obviously watching the monitors closely enough to tell me within 5 seconds that a battery needs replacing, why were you not watching the monitor closely enough to tell me my patient in room 10 flipped into rapid A-fib an hour prior? And after I mentioned that to you, why did you further neglect to inform me when he later flipped back into sinus?
These are things that are just as important, if not more so, than my patient who has been stable for the past 3 days needing his white lead replaced. (While I can still see a decent wave form)
Oh yeah, and after I asked you about it, I don't really need the snide page telling me that the run of PVCs was artifact. That, I can take a look at the monitor and see. However, I would really rather you called me for the little things than for you to tell me that you didn't call because you thought something "wasn't that important". It is not your job as a tele tech to tell me what is and is not important. So on second thought, thanks for the call about the run of PVCs.
I know you are busy and you are watching a ton of monitors up there. But please. We are short staffed down here. We really do rely on you to help us keep an eye on what is going on with our patients. You are our eyes when we are stuck in a room and something goes completely to hell elsewhere while we are there.
Help a sister out, okay?
Thanks. Hope you are all having a decent day. . . .
I'm sorry if I offended you, but this was clearly labeled as a rant, was a way to blow off steam, and though you may have made some points, the snide and condescending tone you used to make them (sorry if that wasn't your intention, but that's how I read it. The printed as opposed to spoken word can be a rotten way to pass on the tone of a post) really took away from anything constructive you may have had to say.
I realize your post was a rant- I just wanted to clear up some perceived misconceptions. I was trying to be objective about the matter- I apologize if this came across as snide and condescending.
Please don't assume that because I post a "rant" and you don't have the blow-by-blow account of what actually ticked me off, that I am a bad nurse that doesn't know jack about telemetry, or that I am somehow neglecting my patients.
Peace.
I haven't assumed as such nor have I insinuated such. I'm just trying to explain why certain things occur from a monitor tech perspective. I agree that the monitor tech in question has his/her priorities screwed up notifying you about leads being off and not major changes in rhythm.
It's happened to me as well. On some days we have 45-50 patients on ambulatory packs with only one monitor tech, and our system is pretty crappy (GE patientnet)- it doesn't alarm irregular rhythms like others such as the Agilent system do, which means if someone converts to A-fib we won't know until we personally observe it, which might be a bit delayed if the rate is acceptable and when you have 5-10 other alarms going off at any given time. It doesn't excuse it (you're not even using patientnet if you use AA batteries), but
the scenario certainly can happen more easily than, say, your patient going into VT.
By the way, I readily admit my perspective may be a bit skewed, because at my hospital we're required to have ACLS and we also monitor patients' daily labs for electrolyte/cardiac enzymes in order to provide more in-tune monitoring of patients. I know at some other hospitals, sometimes the monitor techs are simply a unit secretary that's taken a 6 hour basic EKG course.
It sounds like your hospital is really on the ball as far as the skill of the techs is concerned. Ours isn't quite so rigid, I'm afraid.
I want to say our tele system is Agilent (I'm sure I could look it up, but it's 4 in the morning, and I'm a little braindead.) We opened a new cardiac center this past year, and everything got upgraded. I seem to remember "Agilent Training" as part of our orientation when we moved into the new heart center. On our old unit, the telepacks all had 9volts, and I remember them telling us the AA bit was part of the upgrade. . . . .it's a pretty rockin' system, actually.
Thanks for letting me hear the tech side of the picture.
By the way, I readily admit my perspective may be a bit skewed, because at my hospital we're required to have ACLS and we also monitor patients' daily labs for electrolyte/cardiac enzymes in order to provide more in-tune monitoring of patients. I know at some other hospitals, sometimes the monitor techs are simply a unit secretary that's taken a 6 hour basic EKG course.
Have a good one,
Matt
What is the training for that monitor tech position? Are you all paramedics or LPN's. That sounds like great experience for a tech (it also sounds like its out of the scope of practice of a tech)! What is the training like?
What is the training for that monitor tech position? Are you all paramedics or LPN's. That sounds like great experience for a tech (it also sounds like its out of the scope of practice of a tech)! What is the training like?
CrazyPremed
Well, I haven't seen them ever train anybody in-house. Our hospital offers basic and advanced EKG classes, but you mostly see med/surg nurses looking to gain advanced training in them (I helped teach one recently).
There is no standard certification required, but our hospital typically won't hire anyone with less than 2-3 years of prior monitor tech experience (we're a desirable hospital so supply is pretty good), and they of course favor EMT/Paramedics, although I think I'm the only one on staff currently.
As far as being out of the scope of practice for a tech, it really is neither here nor there. We hold no ultimate responsibility in such matters- it's still the nurses' responsibility. We don't notify doctors nor do we take orders, but for nurses that don't deal with cardiac patients all that often we are a vital source of information they can incorporate into their patient assessment. Our readings are much more accurate if we have an idea of what's going on with the patient- ie, knowing their diagnoses, basic medications, lab results, how the patients are feeling, and what possible or probable effects this might have on the patients' rhythm and rate. It's also great experience as a nursing student that wants to go into CVICU/cardio upon graduation, as I can correlate what I'm learning with school to delve further into the disease processes and pharmacology of each patient. I might not get to practice assessing them physically, but I can build a good picture of the patient's health and perceived nursing needs by reviewing their charts.
hypocaffeinemia, BSN, RN
1,381 Posts
I realize your post was a rant- I just wanted to clear up some perceived misconceptions. I was trying to be objective about the matter- I apologize if this came across as snide and condescending.
I haven't assumed as such nor have I insinuated such. I'm just trying to explain why certain things occur from a monitor tech perspective. I agree that the monitor tech in question has his/her priorities screwed up notifying you about leads being off and not major changes in rhythm.
It's happened to me as well. On some days we have 45-50 patients on ambulatory packs with only one monitor tech, and our system is pretty crappy (GE patientnet)- it doesn't alarm irregular rhythms like others such as the Agilent system do, which means if someone converts to A-fib we won't know until we personally observe it, which might be a bit delayed if the rate is acceptable and when you have 5-10 other alarms going off at any given time. It doesn't excuse it (you're not even using patientnet if you use AA batteries), but
the scenario certainly can happen more easily than, say, your patient going into VT.
By the way, I readily admit my perspective may be a bit skewed, because at my hospital we're required to have ACLS and we also monitor patients' daily labs for electrolyte/cardiac enzymes in order to provide more in-tune monitoring of patients. I know at some other hospitals, sometimes the monitor techs are simply a unit secretary that's taken a 6 hour basic EKG course.
Have a good one,
Matt