Staffing a telemetry unit

arak1547 · Sep 30, 2005

"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.

DianeS, RN · Sep 30, 2005

"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.

Our LPNs are. They are able to pass most meds (not IV pushes) and do assessments. They only things they cannot do are initial assessements when a patient is admitted, IV push meds, and getting orders from the docs. I'd be lost sometimes without my LPN.

christvs, DNP, RN, NP · Oct 26, 2005

On my tele unit each RN-LPN team has up to ten patients. So the entire unit has 28 patients max, covered by 6 nurses (3 RNs, 3 LPNs) and 3 CNAs. The LPNs can do everything except initial assessments, no IV pushes, no hanging blood or TPNs, and no phone orders. So I usually have 4-5 patients, & then do the above extras on all my LPN's patients.

Christine

tonet0908 · Nov 10, 2005

I just started working as an RN on a telemetry unit and there are 6 RN's for 6 pts on a good day, on a bad day there are 4 RN's and 8 pts. There are no LPN's on our unit and we have 2 nursing attendants, one for each side of the unit. I hate when the nurses call out because you know your day is going to be hell.

Indy, LPN, LVN · Nov 10, 2005

4 patients to 1 nurse is common on days, it can get up to 5 on nights. Four is hard. Almost no patient is "just" a cardiac patient- they have cancer, GI bleeds, renal failure, drug/alcohol withdrawals, diabetes, you name it. I have had 5 patients on only one night so far, and I didn't know my name when I left in the morning. I was just grateful they were all alive.

geekgolightly, BSN, RN · Nov 12, 2005

I want to understand how someone can safely monitor progressive care/tele patients with a ratio of more than 1:4. 4 patients seems to be the max for a group with insulin and pressor gtt's, trachs, feeding tubes, sheaths, open hearts.. etc etc. How is this done safely?

I am starting in a tele/progressive care unit that staffs 1:4 with techs staffed at 1:8.

nancyrsharpe · Nov 16, 2005

in philly, we usually had 6-1. sometimes 8 very rarely if we were short...and no drips except bumex or dobutemine. 3-1 if on drips..like a jackass I didn't apprecate it until I left

stutl2ep · Nov 26, 2005

On this Telemetry floor we try to keep a 1:5 nurse/patient ratio, we consider ourselves lucky if we have 2 CNA's. Sometimes if/when someone calls in the ratio may be as high as 1:6 but never no more than that. Telemetry isn't exactly a place where a nurse will enjoy high ratios that might jeopardize a patient's life, waiting in turn can turn into a CODE situation!! In order to receive adequate care, all states should adopt a policy for ratios so no patient goes without the proper standard of care. Besides, who wants to work where they feel like they may lose a patient or risk losing their license due to being overloaded/overwhelmed? The lower the ratio...the better the care, the better response we get from our patients: physiologically, and psychologically. Just a few ideas....

stutl2ep

telenurse2 · Dec 6, 2005

I work on a telemetry floor and we have 19 tele beds. We are fully staffed with 4 RNs 1 LPN and a NA. They usually have 1 RN in the charge nurse role but lately we are lucky to be working with 3 RNs and a LPN and they always float or call off are NA and they like to float are 4th RN so that leaves us with 1 RN to 6 or 7 patients (usually only primary to 4 or 5 and cover the LPN) and the LPN takes 5 or 6 but she does her own assessments and passes meds with RN doing doctor calls and IV meds. What makes it difficult for us is when you have 3 or 4 patients getting blood on the floor, patients on drips you have no nurses aide and your RN and LPN are having to do VS, glucoscans,etc (what we rely on our aides to help us with) and watching these patients and the monitors. There have been times when we have had a patient go bad and if you have 3 RNs and 2 are with the critical patient that leaves 1 RN and 1 LPN for the other 18. The nurses are getting burnt out and we don't feel like we are able to give the care/time are patients deserve.

zacarias, ASN, RN · Dec 9, 2005

On our telemetry floor it's 6:1 on nights with a tech for every eight patients. This is pretty good but still it can be horrible at times! Mostly because we have a high med/surg population.

Kowden · Feb 13, 2006

I worked on a Tele floor which was considered to be our "step down unit" cardiac ICU. We had 30 monitored patients with 4 RN's. The RN in charge had to take 2 patients plus charge duties. We didn't have a monitor tech, so the charge RN had to do that too. There were patients not even a day out of their CABG along with all the cath's, angio's, stents, MI's, etc. We didn't have aides to help us either. I worked the 3-11 shift which never ended until after 1 am with all the paperwork as you all know. We always felt patient's were at risk with this nurse/patient ratio, but no one would listen to us. There were so many "cut-backs" they kept telling us, so it was their way or the highway! So as many of you know, where would an older nurse go to get the same rate of pay to start with as you had with where you were, you know that story....years of experience/rate of pay/benefits vs. starting all over again at the bottom of the ladder!

Needless to say, things were pretty terrible for us. The thing that most amazed me was the way patient's family treated us....like it was my fault that I didn't have the ability to have "bilocation" and answer 3 call bells at once! We constantly got yelled at by patients and families all the time. It was so deflating personally, not to mention professionally......it seemed we were not nurses but maids, cooks, housekeepers, dishwasher, etc....we didn't really have time to do our actual nursing duties and provide the actual nursing care we were suppose to give....no matter how we tried! I left work feeling really bad most of the time because there were things I could have done and should have done but were unable to do because there wasn't enough timme to do it!

We were constantly getting called into the "office" because families complained about us in one way or the other, our supervisors knew the situation, but were unable to take our sides of course, they knew the situation, but weren't able to stick up for us. It was a very sad situation in out hospital, and it sounds like it is the same way everywhere really. its all a business, not a caring profession anymore! When are people going to wake up and realize that its not the nurses fault, its the money-making business owners that make the rules!

We would have new grads come to our floor, we'd do the buddy system with them for a month, and then after about 2 months with us they would tell us they're not putting up with this crap working here and they would leave. So it would put such a strain on us training them and having to do all our work, but they were the smart ones really, they were young and wouldn't put up with it and look for a better place to work! so they thought!

Oh well, next time I'll tell you of my work injury that ended my nursing career as a cardiac nurse! Watch your backs!

wildcherry · Feb 14, 2006

I just started working as an RN on a telemetry unit and there are 6 RN's for 6 pts on a good day, on a bad day there are 4 RN's and 8 pts. There are no LPN's on our unit and we have 2 nursing attendants, one for each side of the unit. I hate when the nurses call out because you know your day is going to be hell.

Have I got this right? 6 RNs for 6 pts?? 4 RNs for 8 pts???? That is heaven! Where in NY do you work.........I wanna sign up :chuckle

At my hospital it's usually 4-6 pts per RN, usually covering a SrLPN for 1 or 2 folks....on days. Lucky when we have 3 techs for VS, BGs, baths, foleys.....usually we have 2. Eves the ratio is 7-8 pts to RN, nights the same.

Good luck to us all!