Telemetry newbie

mattcastens · Apr 30, 2002

Don't worry! You will get the hang of it. People learn at different rates, but eventually you'll be able to read a monitor or an ECG as easily as you're reading this.

Start learning now! Get some books and start studying. While the books will only give you the "perfect" versions of the rhythms, at least you'll have a grasp of what to be looking for.

Good luck!

CATHYW · Apr 30, 2002

Also, every time the alarms sound on the monitors, ask someone what it is for. Most often, it will be nothing but artifact, but that is important to be able to recognize, too. Run stsrips of anything you see that doesn't look like the usual normal sinus rhythm, and ask a fellow nurse or a friendly doc what it is that you see that doesn't look quite right. Be sure that you know the vascularization of the heart very well, as well as its' electrical conduction system. Without them, you won't understand very much. Get into an EKG class ASAP. You can get books, etc., but if you are at all like I am, you need some to "esssplain" things-the whys and wherefores of what is happening. Take care, stsudy hard, and remember-"do not nurse the monitor, check the patient" if something looks funny. A person could have an excellent rhythm, and no pulse!

Nurse_KBE · Jul 30, 2002

yup and although I don't work in the Intensive Care Unit, as a nurse working in the ward, a lot of my patients on telemetry are being monitored by ICU. And there have been times that if the leads are off from the patient, the ECG reading at ICU is not accurate or there will be no reading.In Singapore, we would always call ICU if our patient would be having a bath and would take out the telemetry so that the nurses monitoring won't be panic.This is some of the stories I knew about telemetry.Just wanna share with all of you.

RN-PA, RN · Jul 30, 2002

Hi Amyi! I'm not a telemetry nurse, but I bookmarked a site on learning ECG's entitled, "ECG Learning Center" which I think I found from reading a thread here on allnurses. It seems like a great site and you can find it at:

http://www-medlib.med.utah.edu/kw/ecg/index.html

All the best to you as you begin your nursing career!

nimbex, RN · Aug 2, 2002

hey, welcome and congrad's on the new career choice. Advise is excellent... I have one thing to add...

Don't freak OUT !!!!!

After you are told or pick up a "bad" rhythm.... go assess your patient! Are they tolerating a heart rate in the 30's? Is there a pulse with a Ventricular Tach.

In tele, a patient who is in an Atrial flutter with a rate of 120 may be more symptomatic than your patient in Ventricular tach rate 170 (with a pulse).

Become comfortable in your assessment skills to pick up small clues that the rhythm is becoming unstable for THAT patient, despite the rhythm. THIS IS THE KEY.

A second degree heart block with the rate in the 30's may be more stable than a sinus brady with the rate in the 50's.

Let your patient's symptoms, be your guide.

PS... learn to recognize how rhythms progress so you can anticipate and monitor for changes. I'm not suggesting rhythms are not of importance.... just empathizing that symptoms determine how fast you will treat.

Good luck

Carol