does this sound extremely unsafe or is this typical??

[raindrop]

Due to Budget cuts, our Telemety/CVCU unit is doing away with Tele Techs for every shift beginning Jan 1st. Doesn't this sound a bit unsafe? Both day and night shift nurses have 6-7 patients each. Night shift CNA's are also getting cut - no more CNA's from midnoc to 0600. Night shift nurse will have to prep any first case open heart with hibicleanse, sage wipes, etc and bring all their own patients to diagnostic areas if between 0000-0600. Our hospital Admin said this is becoming typical for many hospitals. Really???

[TriciaJ, RN]

Yikes! Remind me to never have a heart problem. In the meantime, keep your liability premiums paid up. Your hospital probably won't back you when something bad happens.

[SnowboardRN]

I work on tele with 5-6 patients and no monitor tech, sometimes no patient care aide's either.

[lmccrn62, MSN, RN]

My facility has no telemetry monitor techs. I work on a med surg unit with some telemetry beds and all telemetry issues are programmed to beep you on your beeper . We have had no issues.

[nursemami4]

We also had no techs or cnas on any shift on on the telemetry unit I worked for. However it was 7-8 patients between an rn and lpn team. Still was hard to manage a safe shift but can be done. However I did resign from that job as I didn't feel it was the best and safe care for patients nor my license. Beat of luck.

[PatchycatRN, BSN]

I've never worked in a facility with monitor techs. Maybe it's regional? I'm in Boston. RN's are responsible for all rhythm interpretation and for notifying the M.D. of any significant changes. Personally, I don't trust anyone but myself to be responsible for my patients monitor alarms but then again I work on a highly specialized arrhythmia unit and the expectations for rhythm interpretation are high.

Ratios are 2-3:1 days/eves and 4-5:1 on nights.

[kfitzy89]

This sounds like the perfect recipe for a patient safety issue. I would not be thrilled to be working like that knowing my license could be on the line! :-/

[Do-over, ASN, RN]

I finally just went to ICU - responsible for everything still, but at least its only 2 patients (although I am often busier with those 2 than I ever was with 5...)

[::Goodie::, RN]

At our world famous heart/cardiac centered hospital...

Nights - most often 5 patients (4 is a luxury, 6 isn't unheard of...) regardless of drips or Sx prep/acuity; NO techs; frequent admissions; monitor techs in the monitor room; monitors in the unit hall and in the nurse's station; floating unit secretary - often none. There is transport in the morning.

Days - 4 sometimes 5 patients but frequent discharges and admissions, no allowance for drips or acuity; 2 - 3 techs; same set up with monitors and monitor tech in the monitor room; dedicated unit secretary; transport available.

I've moved to special care, cardiac short stay (post cath) tops out at 4 patients each with rare 5th patient... we are trained to pull sheaths as well. No techs at night, very nurse-y... no monitor techs or monitor room - we monitor them ourselves, in the hall or in the nurse's station; they are hooked up for frequent intensives. TONS of assessments/evaluations and CHARTING.

[nursefrances, BSN, RN]

Prior to leaving a tele unit a while back we lost our medical records department (guess who gets to copy the whole chart when there is a SNF transfer?), no secretary, we lose our CNAs at noon after vitals were done, we were going to start doing our own monitoring. Did I mention I am not there anymore?

I think this is becoming more common. I was thinking about making a change for a while to my current field but all the changes that were occuring helped me decide.

[RNGriffin]

I think it's a bit much, unless they're going to make monitors more accessible to nurses. You all will have to develop a routine of watching each other's patients.

No CNAs after midnight? Are there many admissions after midnight? You may have a patient on a drip & tied up with one patient requiring multiple eyes, what happens for the other patients?

If a patient is coding at night, what happens to the other patients?

I would definitely question my manager on the strategic planning or how do we maintain a functioning floor. This is ok for a floor that has low-acuity, but for those( cardiac in particular) I would definitely question the ratios. When you alter staffing, you should alter workloads as well.

[amflane]

Unfortunately its become a culture of doing more with less help. and who's watching your other patients when you're off the floor. That is unsafe!

[_Haley_]

Where I work, we don't have tele techs, although I wish we did! There is no guarantee that someone will be sitting at the desk 24/7, so there is the chance that something can be missed on the monitor. I do think it's unfortunate that they are getting rid of night shift CNA's. The night shift is not necessarily less busy than any other time of the day, and typically nurses have more patients at night. That could make things a little crazy!