Telemetry monitoring

[capnnikkiRN]

Hello all, I am hoping this forum can help me do some fast and convincing talking to my CEO.

Here goes, up until about 6 months ago we had 2 fulltime monitor techs that watched the monitor for 16 hours a day and assisted with unit secretary work. This left night shift as the only shift without a designated monitor watcher. Six months ago we had layoffs and cut many positions...including Monitor Techs and CNAs.

I am concerned about the safety issues with not having someone designated to watch the monitor. Perhaps if we still had CNAs it wouldn't be quite as bad, but without CNAs my Charge Nurse is going to have to leave the desk to help the 2 LPNs working on the floor. (It would help to insert I work at a 25 bed critical access hospital and our census ranges from 8-15.) My CEO thinks the nurses need to watch the monitor and in theory this can happen, but out in the real world there are always patient needs that can't be anticipated and the nurse is forced to weigh the patient safety of leaving the monitor versus going to the patient.

We made the transition to a fulltime Monitor tech several years ago based on a state inspectors ruling that we fell below the standard of care. My CEO takes this ruling as an interpretation and wants to see in writing where it says there must be a designated person to watch the monitors. I know all the arguements, but I am having a hard time finding it in writing that a designated person to watch the monitor is the standard of care.

I have found several articles and position statements that recommend this practice, but I haven't found something that I think could clinch the arguement.

How are these things handled at your hospital? Do you know of any articles, position statements, etc. that support a designated monitor watcher?

Any help is appreciated.

[DutchgirlRN, ASN, RN]

Unfortunately I think something fatal has to happen on your floor before they will wake up and get a telemetry monitor. Sad, but so true...

[capnnikkiRN]

I am afraid that may be the case, but I would like to prevent anything bad from happening.

[vamedic4, EMT-P]

capnnikki....You are correct, and while your CEO is concerned about his bottom line, he should be more concerned about his bottom - and losing it in a lawsuit because you all hadn't caught something that, in theory anyway, would easily be caught by a monitor tech.

At my facility, the monitors are watched only on one floor (inpatient pediatric cardiology) because, outside of ICU and ER, we have more than our share of arrhythmias/adverse events due to our specialty patient population.

Not to have monitor techs is an inherently dangerous precedent to set, but you'll hear it from others on here "we don't have any" and so forth. That's all fine and well until you miss the VT that my mother has because her trach. was plugged up and no one caught it - I know you understand.

Best of luck with your fight...and good for you for being such a patient advocate!!!

vamedic4

it's nice here in Texas