Published Aug 28, 2005
ccurn1
3 Posts
I work in an 18bed CCU in a very busy medical center. We have 2-3 patients most days with at least 1 new orientee with us during the day. We are under new management who has made the brilliant money saving decision to take away our telemetry techs. Of course we do not solely depend on the techs to do all the monitoring, but it does come in quite handy whe your are busy in one of your rooms and your other patient decides to misbehave. We currently have at least 6 phones attached outside rooms which the techs immediately call on when a patient has an arrhythmia. A few of us in the unit have been wondering what is the monitoring situation in other hospitals. Most of us find this upcoming change not to be for the better good of our patients. Is this common practice in all CCU's?
CCU NRS
1,245 Posts
Well I work in a CCU where we monitor our own tele and it is scary!
We used to have monitor tech I guess, before I worked there, but when I started the techs on tenth floor that monitor house wide used to watch ours too but 2 years ago the hospital enlarged and they added tele room and it was decided that CCU would monitor their own.
It is pretty scary when it really busy and then someone just happens to catch a VTach pop up and yell "Is anybody in A he is in VTach & the code ensues!
sirI, MSN, APRN, NP
17 Articles; 45,819 Posts
In large units as yours, I believe this is an unsafe practice to do away with them.
PIURN
2 Posts
This is an accident waiting to happen. You can't be in 2 places at once and it took a code in our unit and an angry cardiologist to intervene before our concerns were finally taken seriously. If you can't have your pt's monitored remotely, then would it be possible to cross train a secretary? If not, please take this to your quality control officer for a resolution. Good luck!
hrtprncss
421 Posts
ok don't everyone jump on me on that HIPAA thing and I'm not suggesting or condoning it I'm just saying it's an option. We usually get adjacent rooms as much as possible so we could just roll the chair from one spot to the next in front of the patients room, when we have two patients......now for what i was saying earlier, how bout if your patient is intubated, you can piggyback two simultaneous graphs on one screen in a patients room - the patient in that room and another patient that's in the same unit. You can omit the patient's name on the screen monitor and still not have a problem with full disclosure on the main monitor at the station. REMEMBER I'M NOT SAYING DO IT, I'M JUST SAYING IT CAN BE DONE
One more thing isn't there a charge nurse in most icu's with just one patient usually the ''easiest'' patient, who sits within feet of the unit secretary where the main console for the monitors are, this is where the orders are being processed by both the charge rn at the same time. One other solution is to have the unit secretaries be sent and competencied in ekg monitoring.
DutchgirlRN, ASN, RN
3,932 Posts
We have a 10 bed ccu and no Telemetry tech. Our Telemetry floor has 42 beds and no Telemetry tech.
Nightcrawler, BSN, RN
320 Posts
I work on a tele floor at a tertiary hospital, where 'tele' includes stable drips, a-lines, chest tubes, and heart and lung transplants after they are stablized off of the vent. At night we carry up to 4 patients primary care and have one secretary that also doubles as monitor tech. They took our CNA's in May, and with 36 beds I dread the day that they decide that we no longer rate our secretary
We use to have a charge nurse out of assignment or with and easy patient.But since new management change we no longer have a charge with light assignments and our base number of 9 nurses was decreased to 8 on day shift. Also we are responsible for taking our own orders off no one else. If we train the secretary to monitor ecg what is the difference if they watch it or if the continue to let the trained tech do it?
cbkrn
We have an 8 bed unit with 8 tele (soon to be 16 tele). We staff with 3 licensed staff and a secretary. We have always watch our own and tele monitors.
TexasgirlRN
10 Posts
I work on an 18 bed (we used to have 22 beds, but ICU took over 4 of our beds due to the increased census), tele- recently renamed PCU unit- but anyway- we have never had monitor techs. We've had to monitor everyone ourselves- basically whoever is closest to the monitor while it alarms is responsible for checking on the patient. :stone
Dinith88
720 Posts
I would BY FAR prefer an extra set of CNA/tech/NAT hands @bedside to care for pt's than a tele tech who yells out rhythm stuff... for many reasons other than just cleaning puke,poop, and snot (but thats mainly it...).
The tele monitors (dont yours?? ) have alarms that work just as well as a tele-tech...
if a tele tech wanted to impress me, he/she would have to go wipe a butt...
and i would be willing to wager that those nurses who dont have/never had tele techs are better at rhythm interpretation than those who do...
(i'd wager LOTS)