Telemetery reading in the ER

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I work in a small rural hospital in Texas. Our hospital is taking the telemetery monitering ,for the floor patients, out of Icu and putting it in the ER. It will be staffed by a tech 8 hours a day uncertain about the other 16 hours. I am worried about the liability for me as the Charge nurse. Anyone have experience in this.

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How many monitors are there to be watched and will they be located in a central area? I would talk with management for sure. There's supposed to be a monitor tech for a reason, TO MONITOR! Lol, seems ludicrous that they would expect y'all to monitor rhythms along with everything else that goes on in the ER.... Our monitors are located in the ED but they have there own little corner of the world all closed off... I don't even know the names of the techs that work there lol..

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Specializes in Critical Care, Education.

OMG - I just hate the fact that this is still such a common way of "reducing expenses" in smaller hospitals. (full disclosure: I have been around for maaaannnny years). Another favorite ploy is to eliminate the PBX operator after 5 pm & route calls to the ED unit clerk

If you are the charge nurse, you need to be comfortable with the monitor tech's level of competency. Set up your 'rules' and boundaries ahead of time re: your expectations & when you MUST be informed. For instance, anytime the tech has to make a judgement call (e.g., alarm was triggered due to artifact), she must run a strip and show it to you for validation ASAP, changes in rhythm must be reported immediately, etc). Hopefully, you will be able to work together very confidently.

It also helps to have some protocols set up so that if a tele patient's rhythm is "acting up" and requiring frequent nurse responses to assess, you have the authority to temporarily transfer him to a higher level of care until the situation is stabilized.

Make sure you are VERY familiar with Tx NPA rules for delegation. There are a bunch of delegation resources on the BoN site that can be applied to any situation, including yours. Delegation Resource

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