Staffing a telemetry unit

Having worked on telemetry units before, no more than four patients per nurse should be assigned if those patients have acute cardiac issues. It's hard to deal with more than one or two patients who are in need of bedside monitoring during their c/o of chest pain radiating down their arm or back..... One patient benefits and the others have to wait their turn if there aren't any other nurses to help you out.

Having worked on telemetry units before, no more than four patients per nurse should be assigned if those patients have acute cardiac issues. It's hard to deal with more than one or two patients who are in need of bedside monitoring during their c/o of chest pain radiating down their arm or back..... One patient benefits and the others have to wait their turn if there aren't any other nurses to help you out.

I'm working Southern MO at this time and it isn't uncommon for the night shift to care for eight monitored patients during the shift. Seven is about the norm. It's interesting to note that this hospital doesn't consider telemetry a "critical" care area. It's considered a med/surg area. In OK the telemetry floors are considered critical care areas, but the ratio can be as high as 10 patients on the night shift to each nurse. California limited tele patients to only five per nurse, unless you had an LPN on the "team" then they could give you 10 monitored patients. (Which they routinely did and the LPN could not be assigned any of these patients.) Nevada tried to limit the ratio to a maximum of six patients on the tele floor, but it was fairly common to have seven on the night shift.

LI, NY. Days routeinly have 9 patients, nights 9-11, in the winter as many as 12. Way too many for this nurse, 8 mos. of experience.

LI, NY. Days routeinly have 9 patients, nights 9-11, in the winter as many as 12. Way too many for this nurse, 8 mos. of experience.

I agree! Way too many for me as well. Are the nurse aids able to do much of anything in the way of accu-checks, foleys, and that sort of thing? Sometimes that can be a big help.

The nurses aids can only do accu-checks if they are nursing students. The other night 6 out of 10 pts, were accu-checks. They empty foleys and do patient care and work very hard. we have 38 beds and 2 nurses aids. Too much work for everyone. Sometimes I feel lucky to get out of there without anything bad happening.

It does sound like a disaster waiting to happen. Is it like this in other area hospitals? I thought it was only Southern states where these kind of conditions were the norm.

The telemetry floor that I work on in Southwest MO 8-7 patients per nurse...on days & evenings...more at night.....patients admitted directly from ED, MD office, or a unit transfer.......

No way would I work on a telemetry unit where the patient nurse ratio is larger than 5 to 1. That's insane and dangerous!

LI, NY. Days routeinly have 9 patients, nights 9-11, in the winter as many as 12. Way too many for this nurse, 8 mos. of experience.

That's scary. Day shift RNs here can max out at 7 patients with a tech for each assignment. Evenings get up to 8 with a tech. Nights, we have 6-8 patients and share a tech.

I agree, I wouldn't want to work day shift with 9 patients, especially if your techs can't do accuchecks. Ours can.

On the floor where I extern, which is a tele floor, the ratio is no more than 4:1, sometimes dropping into 2:1 or 1:1 depending on the severity or disorientation/agitation of the patient. On top of that we usually have 3 techs on the floor, plus a unit secretary and a monitor tech. Unfortunately our techs can't do accuchecks, so it's not unusual to have 4 patients and checks on all 4. This even continues at night. It seems dangerous to me to have more than a 5:1, but I'm still learning.

Cheers,

Tom

I work as an RN on a cardiac step down/telemetry unit in Michigan. We work 12-hour shifts. On days, an RN can have as many as 5-6 patients. An RN-LPN team have have 7-8 patients. But on nights, which I work, an RN can have as many as 7 patients and an RN-LPN team can take as many as 12 patients. Point in fact, last night I had an RN-LPN team with 11 patients which would not have been too bad because I had an awesome LPN with me, but we had 1 patient with a feeding tube, trach, and continuous pulse ox that kept going off every 10-15 minutes. I spent most of my time in her room. Thank God for my LPN who probably saved my butt that night.

Unfortunately, we are losing our night shift RN's left and right, so having more and more patients at night is getting to be the norm. Yes, it is unsafe, and management doesn't care. But I need the job, so I do the best I can.

Anyway, thanks for letting me rant. :uhoh21:

Have a wonderful day!!

"Thank God for my LPN who probably saved my butt that night."

I agree that having an LPN on the team is a great asset IF they are allowed/able to function as nurses and not glorified CNAs.