Tele

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Couple questions.

1. Is it legal to have a patient on Tele and have it go unmonitored for periods of time?

2. Is it legal to decrease pay (night differential) without written warning?

Specializes in SICU.

I don't think either of them are illegal, and it probably has more to do with your facility's policy than state law. However, failing to monitor tele patients obviously carries a very heavy risk, both for the patient and legally. I would suggest the obvious next step of looking up your state law on the subject, or reviewing your company's policies. Why are tele patients not being monitored where you work?

1.) I don't know if it's a legal matter but on my Tele unit, patients that are stable can come off for baths, etc for a short amount of time. If they need it off longer than 15ish minutes to go to MRI for example, then we need an order.

2.) I'm not sure and it may vary by state?

The hospital I'm at will assign the RN the tele pt along with 4 other pts. You cant physically do both. I was thinking there was a law against it but I will have to look more into it.

The hospital I'm at will assign the RN the tele pt along with 4 other pts. You cant physically do both. I was thinking there was a law against it but I will have to look more into it.

Why on earth would there be a law? There are not "laws" regarding patient tele monitoring. While the medical field has many, many regulations, they are not laws.

I would look up the definition of what a law is.

The hospital I'm at will assign the RN the tele pt along with 4 other pts. You cant physically do both. I was thinking there was a law against it but I will have to look more into it.

This is not illegal. Hopefully you have good teamwork on your floor. You can alert your coworkers to the fact that you have a tele patient and ask them to alert you if they catch something on the monitor.

Specializes in ICU.

So as the nurse with a tele patient you are responsible for watching the tele? Or does your hospital have a centralized tele system or someone remotely watching the monitors? If not then it seems like they are not adequately being watched. There is no law against it, but I would be wary of any possible liability issues associated with this. I don't think the excuse of having other patients and not having time to watch their tele would hold up in court if something were to happen to the patient.

Specializes in Critical Care; Cardiac; Professional Development.

I am confused when you say the nurse cannot do both. Telemetry usually is monitored by a telemetry technician, who alerts the nurse to any sudden changes. However, the nurse should also be looking frequently at the tele monitor to assess for rhythm changes. It is not uncommon at all in most places to have both patients on telemetry and not on telemetry.

Specializes in Critical care.

My old hospital didn't have a monitor room or monitor techs- the nurses did all the monitoring. We all kept an ear out and checked for any alarms in addition to carrying pagers. We had screens throughout the unit where we could see all the patients' rhythms. We interpreted our own strips every 8 hours and reviewed the monitors for missed events. Nurses on all shifts had 5 patients each and could potentially have all 5 patients with tele orders.

Specializes in SICU, trauma, neuro.
The hospital I'm at will assign the RN the tele pt along with 4 other pts. You cant physically do both. I was thinking there was a law against it but I will have to look more into it.

Well considering some hospitals have entire tele floors, clearly they can assign one RN many pts on tele. Heck when I worked in LTACH, I would routinely have 4-5 pts on tele and on ventilators!

I am confused when you say the nurse cannot do both. Telemetry usually is monitored by a telemetry technician, who alerts the nurse to any sudden changes. However, the nurse should also be looking frequently at the tele monitor to assess for rhythm changes. It is not uncommon at all in most places to have both patients on telemetry and not on telemetry.

Not all hospitals have tele techs, but the monitors (usually near nurse's station) can usually be programmed to beep if a certain rhythm is picked up.

Specializes in Vascular Access.
The hospital I'm at will assign the RN the tele pt along with 4 other pts. You cant physically do both. I was thinking there was a law against it but I will have to look more into it.

I'm guessing your hospital does not have a central monitoring system? If there is a central system the tele should be monitored and/or recording. In any case, what the other guys said: policy.

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