Telemetry?

Christie RN2006 · Feb 2, 2007

The main purpouse of Tele is so that you can closely monitor a patients heart rhythm. Tele units tend to take care of patients that are sicker and need more monitoring than basic medical floors.

TazziRN, RN · Feb 2, 2007

Tele units are sometimes called stepdown units......not sick enough to be in ICU, so they're "stepped down".

Christie RN2006 · Feb 2, 2007

Tele units are sometimes called stepdown units......not sick enough to be in ICU, so they're "stepped down".

The hospital I work at has several non ICU tele units, 2 are stepdown, the rest are just tele units. So, in my hospital, there is a difference between tele, and stepdown.

TazziRN, RN · Feb 2, 2007

What's the difference? Asking out of genuine curiosity, because I can't figure it out. "Stepdown" to me means stepped down from critical status but not stable enough for general care.

Christie RN2006 · Feb 2, 2007

What's the difference? Asking out of genuine curiosity, because I can't figure it out. "Stepdown" to me means stepped down from critical status but not stable enough for general care.

I guess you could say that usually stepdown is somewhere between ICU and tele. The majority of the patients that we transfer out of the ICU go to stepdown. Lately the acuity level of patients all over the hospital has been really high, we have had more patients and sicker patients here lately thanks to our lovely Ohio weather so all of our units have been increadibly busy.

nursejohio, ASN, RN · Feb 2, 2007

What's the difference? Asking out of genuine curiosity, because I can't figure it out. "Stepdown" to me means stepped down from critical status but not stable enough for general care.

Couple differences at my hospital. ICU pts would go to a stepdown floor before a med/surg usually. I worked on stepdown and we still had vented pts and cardizem gtts. Our staffing was 1:3-5, tele had 1:6-8. It was far from a perfect science though, somedays I'd start with 4 pts (each of whom should still have been in ICU) and ship 2 of them back to ICU because they were trying to die on me. Other days I'd have 5 pts, with only 1 being appropriate for our unit and the rest should have been in med/surg or even home. I guess there would be 4 levels at my hospital. ICU to stepdown (which is still in the 'critical' cluster, we'd get floated to ICU and CICU) to tele to ms and then home.

CaLLaCoDe, BSN, RN · Feb 2, 2007

Tele is not STEP DOWN. Step Down is Step Down. Too tough for my bones! lol NOT my Planet!

Step down is a halfway house from ICU to the general floor or from the general floor to ICU...its own planet (out there!)

Tele pts are not on vents, not q1-2 hour fingerstick, and the ratio is not 1nurse/4pts as can exist in Step Down.

Tele pts are heart monitored and are treated for dysrythmias of diverse types by way of pacemaker, controlled drips that are not titrated as in a Step Down unit, prepared for surgery (cbbg, angioplasty etc) and received back again after a stint of post op in ICU...to name a few. And we keep very good track of cardiac enzymes, BNP for CHFers, magnesium, phosphorus, K+ and such...cause if that rythm goes wacky...we want none of that on nights!

Tele patients may have had problems in the past with their heart, such as MI or PE and may come to the hospital not specifically for their heart but for things like pneumonia, abd bleed, sincope. So since they have a history of cardiac isues ie MI arrive on TELEMETRY.

My hospital for Tele nurse/pt ratio is 1/5 unlike Florida 1/8 LOL!!!!!

PS. Tele pts do not, most of the time, stink so badly as STEP DOWN pts (the stink of DEATH). When I worked as a CNA in STEP DOWN I felt like burning my scrubs when I arrived home. OK OK not all the time stink of DEATH, but sometimes OMG...death row conveyer unit lol. SDU redubbed by this nurse DRCU!!!

Jennifer, RN · Feb 3, 2007

Where I work there are 2 types of tele floors. An interventional tele floor, which is where true acute heart pts usually go. This floor takes care of pt's with stents, pre and post CABG, MIs, cardiac arrthymias, etc.... The ratio is usually recommended to be 1:4. The other type of tele floor is a medical tele floor. This usually consists of pts with problems such as very low or unstable H/H without obvious active bleeding or symtoms, CHFers on IV Lasix, septic pts, detoxing pts, stable drug ODs, pneumonias, syncopes, and pts with other d/o's or diseases with underlying heart problems. The ratio on this floor usually recommended to be 1:6.

Either way, on a tele floor the nurse is responsible for checking and posting an EKG strip every so often and to continously monitor heart rate/rhythm for changes t/o her shift. Pts should be vitaled more often and checked on more frequently than on a medical floor. In my hospital, tele is stepdown. We do not have a separate step down floor. The pts stay in ICU until stable to come to tele.