Telemetry Monitoring Procedures

General E. Speaking, RN, RN · Feb 16, 2005

Not sure about the training the Monitor Tech's get, but that's what we use on our MS/Tele floor. We have a computer screen at the nurse's station so we can look at our own rhythms but we are unable to print out strips. The MT is located in ICU. If the patient is doing something "funky" we get a phone call and the message is relayed to the appropriate nurse. If it is an emergency rhythm, the charge nurse will high tail it down to the patient's room to assess the situation. Of course, anytime the patient is taken off tele, we are supposed to give ICU a courtesy call and let them know (ie: pt in shower, in Xray, etc.) Sometimes, however, the radiology tech's just pick the patient up w/o the nurse even knowing. The only way you find out they are gone is when the MT calls to ask you why the pt's tele is off. Occasionally, an ICU nurse will have to act as MT if needed.

DutchgirlRN, ASN, RN · Feb 16, 2005

We have been begging for a central monitoring station with a telemetry tech for several years. We've been told we'd have one by Jan 05. We don't. The US and CN have to keep their eyes on the telemetries. When I do charge I'm lucky to be able to pay attention to the telemetry when I hear an alarm go off, alot of the time I'm not at the desk, I have to leave to push meds for the LPN's or go start an IV that no one can get, etc. The US in not trained in any rhythms. I think it is a very dangerous situation. It will take someone dying and the hospital getting sued before they take us seriously. That's sad. Congratulations on getting your central station, I'm jealous.

HappyNurse2005, RN · Feb 16, 2005

I've done clinicals on two tele units, at different hospitals. hospital #1, the tele monitor came up on a computer screen in the middle of the nurses station, with a trained monitor tech sitting there to watch. you could print rhythms. this worked out well-the nurses station was directly in the middle of the u-shaped unit, the monitor was right in the middle, etc. the tech was trained.

hospital #2-the monitors are near the nurses station, but off in an alcove, making them difficult to see unless you go looking for them. there is a monitor tech there, i am just not sure how trained they are (not been at this facility too long).

i think the visibility of the main monitors makes a difference. make it easy for everyone to see.

newadventure · Feb 16, 2005

I currently work as a monitor tech (student RN). Where I work the CNA's get 6 hours training on reading the monitors, then two days sitting at the station with another tech. Monitor watching is rotated among the CNA's. The monitors are located in a remote corner of the tele floor. We monitor 3 floors, for two floors we get a list of assigned aids, and RN by patient. If there is problem we can call or page the assigned person. There are "stat" phones on each floor for emergencies. One floor we call the stat phone for anything. I will say 70 percent of the day is spent calling aids to find out why the monitor is off. On one of the floors is another set of monitors, so I can tell the RN to please look at the monitor, if I feel something is not quite right. For the other floor, we print strips twice a shift and send them down. I convinced no one ever looks at these strips (no one ever calls for them if you forget). We also tube down any arrythmias we see during the day.

I think the biggest flaw with this is that the station is isolated. If I have a question I have to call someone over. I have seen where the monitors are at a nursing station, which is nicer because if you see something that did not come up in the 6 hour training, it is likely there will be someone around who knows more that you do. Anyway that is how we do it.

MQ Edna · Mar 7, 2006

I have been a monitor tech for 6 years now. Actually we are called speciality techs. We had to go to two four hour classes and sit with an experienced tech for eighty hours before we can sit alone. Our monitors used to be at the nurses station and the "powers that be" decided that we were being destracted by everything that was going on. We have been put into a room at the back of the unit. We monitor all of the telemetrys in the hospital we have the capability for watching 46 monitors and since we have moved into this room, there are two techs at all times. We work 12 hour shifts and rotate around with the techs that are on the floor (unit secretary, aide). We interpret strips every four hours. We do our measurements on the computerized screen and save them. At 7am, 3pm, and 11pm we print all of our saved interpretations, a nurse from ccu signs them, and they are put on the patients chart. Each floor has a specific phone that is just for telemetry. If we call them they have to pick it up in a certain amount of time. If someone on the floor picks up this phone it dials directly into the tele room. Every thing in our tele room is color coded. Each floor is assigned a color and their tele number is in our speed dial. Beside the number for each floor is a piece of tape with that floors color on it. When we have to call the floor about a change in a rhythm we push the button by that floors number and ask for the nurse taking that patient. If the unit secretary doesn't pick it up after 3 rings it transfers to the charge nurses cell phone. Sorry if I went on and on. I hope this helps/