Telemetry Monitoring

eclecticrn · Oct 6, 2005

I work in a 14 bed CCU at a teaching hospital. There hasn't been a tele tech in the time I've worked there (though I have worked at community hospital that tele-train their unit clerks.) I initially asked why they didn't tele train the unit clerk: They remarked they felt it was a liability to do so- the clerk could easily be tied up with phone calls, call lights, other distracting aspects of his/her job and miss key alarms, or have difficulty alerting the responsible RN of the alarm.

Their solution: When any patient's monitoring alarms for any reason (arrhythmia, low Spo2 or BP, etc.,) the alarming pt's room # and monitor stats appear on the lower half of every room's monitior screen along with the audible alarm. This way, any nurse in any room can look to the monitor and know which pt is alarming and why. Of course, the effectiveness of this method rests entirely on the staff working as a tight team (which is the case in my unit.) Obviously if you're working in a shark pool, this would be an unsatisfactory and scary set up.

Our unit staffing is also set up so that the charge nurse has a minimal, if any, pt. assignment, which frees her up to assist in the event of an emergency. We are a level I tertiary care facility and this method seems to work in all the various critical care units throughout the hospital. Then again, our facility also seems pretty committed to adequate staffing - key for this sort of system.

Spatialized · Oct 6, 2005

Our tele unit is a 28 bed unit, but not all the patients are on tele (we get med-surg overflow). We have a tele tech who watches the rhythms for us, although we do have monitors to watch ourselves. We run a 4:1 floor (no LPNs) and you will usually get a mix of tele and non-tele which sometimes prohibits us from doing our own monitoring. And like what has been mentioned, when you're in doing care you can't always see the monitor (some are on portable packs where they only show up on the main monitor).

Our step-down unit has a tele tech as well, but both CVCCU/ICU do their own monitoring ( they usually have a 2:1 ratio though).

I like have the techs as it is an extra set of eyes and anouth brain seeing what is going on.

bettyj · Nov 7, 2005

Hi my name is Bettyj I live in tn I am a nurse at a small hospital here, however this is the first time I have worked in a hospital setting since I graduated in 92 therefore I do not know what everything on the telemetry monitors mean just yet, my problem is that my aunt has just recently been sent to ccu in another town, the nurses aren,t telling us anything and it is driving my crazy trying to figure out what it all means on the montors can someone please help me i have some things that were writen down fromthe monitors if anyone could help me i would greatly appreciate it. Thank you.

FossilRN · Nov 12, 2005

We have 10 ICU beds and 10 CCU beds. We all watch our own monitors. Our monitors have alarms (of course) and pop-up screens that will pop in to the bedside monitors in the rooms of all patients if there is a lethal arrhythmia. We all watch the monitors at the main console, team work in watching each other's patients on the monitor is a given. This system has always worked for me (I have worked in both units for the last 15 years). I think that it has made everyone in my unit very proficient at reading rhythms. I think that a monitor tech in my unit would be a waste and on day shift the secretary has more than enough to do! I would much rather have an extra pair of hands to help with the non-skilled work (that is a whole other subject).

The telemetry unit in my hospital has about 40 beds and a monitor tech. I can't imagine not having a very competent tech on that floor!

BadBird, BSN, RN · Nov 14, 2005

The CCU I work in does not have techs, we monitor our own patients, there are central monitors at the nurses station and 2 in our hall, each room has a monitor that will alarm for all patients which is really annoying at times. We are a small 8 bed unit so it is workable but not preferable.

nurwlj · Dec 4, 2005

We have 6 bed icu with 12 tel monitors that presently the rn/lpn staff monitor. Is has been suggested that a monitor tech would be used, (never had one in the past.) . If there were no pt in the icu, which happens occasionally, one rn stays to monitor telemetries while the other nurse is either on med/surg or on call. With a monitor tech, the one nurse would be also floated to the med/surg floor. What are the legal ramification for leaving only a monitor tech on the floor? (nys)

vamedic4, EMT-P · Dec 4, 2005

We have a 22 bed pediatric cardiology telemetry unit, the telemetry is monitored 24/7 by an experienced paramedic. There are also monitors at each end of the unit for nurses to view their patients rhythm/rate/ectopy.

I have noticed a trend to train secretaries and HUCs (healthcare unit coordinators) to monitor telemetry...and this is a BAD IDEA!!

Okay...I fell a little better. First off, the unit secretary is many times the busiest person on the unit, working with lazies who constantly plead "can you page so and so for me so I can get back to surfing the net?" They don't have the time or the training to decide what is a genuine "alarm" and what constitutes a situation that can wait. But increasingly they are being made to split her attention between the monitor and her real job, keeping the unit from falling apart.

gwenith, BSN, RN · Dec 4, 2005

We don't have telemetry techs here - as far as I know - nowhere in Aust has them. We do all the monitoring of our own pts and those of the "telemetry" patients in a ward 4 floors away.

As for finding "stuff" out early - we rely on the old fashioned look at your patient - not terribly efficient I know - but it works.

That is not to say we would not welcome someone looking at the monitor as long as that someone could tell the difference between the patient tapping time to the radio on his leads and V. flutter (and boy did it look convincing!) or between A. Flutter and TBR (Tooth Brushing Rhythm).

Even the ward knows that they should look at the patient and not rely on us to tell them what is up. But then we do not put anyone in the ward that we think needs a higher level of care - usually it is "Passed out for investigation" or "palpitations for investigation". I suppose we really treat our telemetry like a more closely monitored halter monitor than what you seem to do.

Ariel70113 · Dec 5, 2005

the telemetry floor that I volunteer on there is a 24/hr monitor tech and a 24/hr unit secretary. Btw, its a 40 bed floor. They are pretty busy, it looks like they really do need the monitor tech.

Phishininau · Dec 6, 2005

We monitor our own. Scary but doable.

HappyJaxRN · Dec 6, 2005

We have a 10 bed ccu and no Telemetry tech. Our Telemetry floor has 42 beds and no Telemetry tech.

AH! Omgosh!:chair:

TNTsunflower · Dec 12, 2005

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?

I worked at a large hospital with a 12 bed CCU. We also have monitor techs located on anther floor that call with changes in out patients rhythms. However, if a patient is in Vtah, VFib, SVT, and of course Asytole our montior techs can anounce problems overhead and they will say "Check bed 7" or so forth. If that happens we know to run with the code cart. Our system tends to work fairly well. However, our ICU prints their own strips and has to monitor their patients themselves.