tips from tele nurses?

[lorabel]

Hi all. I have been offered a job on a tele floor......finally back in a hospital after nightmare first experience as anew RN. Does anyone have any tips or pointers such as most important things to remember? Any advice at all is greatly appreciated! I'm really nervous......I have no experience reading EKG strips. they will send me to classes for that. At my other hospital we had a "heart room" that monitored all the flexes and would call and tell us so and so had a so many beat run of afib or pvcs or whatever and fax us a strip. We would then call the MD, etc........in this new hospital the nurses read the strips.....scared but so very excited!

[tampaflrn6]

I am currently working on a cardiac tele floor for a month now. With technology now, some monitors can read the rhythm. When there is a change in rhythm, always look at the patient first. They may be asystomatic with the rhythm change. Know the policy of the cardiac floor... such as the documentation of the rhythm, vitals, and status of patient every four hours. Know dysrhythmia meds like amiodarone drip set at a rate for 8 hours then decrease rate to half and the possible side effects. They will expect you to be ACLS certified. With the EKG... the tele box will show you a picture to place the leads. Or know this White is for right, across white is black, red over fire (red under black), brown in the mid chest, and green under white. With the 12 EKG, again sometimes there's a picture diagram to place leads... start with the 4th intercostal space and work your way around and down. Two leads on the lower extremities... Also place these leads on MEATY places or else it will not able to read. Monitor labs esp. K and Mg. Monitor and draw Cardiac enzymes when timely needed. ALways ask questions when you dont know, the tele nurses will tell you what to do.

[JoMom4]

Tele is a popular area right now. If you know tele, you will be marketable and can move on to ICU if you want to later. I've worked Tele for 2 years. My advice, get familiar with EKG strips before the class. Otherwise you'll be lost. Skillstat.com was a lifesaver for me. Check it out.

Will your unit have interventional cardiology? Angios, pacemakers, cardioversion.Will you be pulling sheaths? Will you have post op CABG and vascular surgeries? Some tele floors are a glorifeid med-surg, while others are fast paced, high acuity with drips. Be familiar with the common drips like Tridil, Amio, Cardiazem, Dopamine, Dobutamine. Understand cardiac enzymes and the chest pain protocol for your unit.

Good luck!

[JoMom4]

Forgot to say one other thing. I wanted to simplify what Tampaflrn6 was saying about leads: white-right, smoke over fire. (means black over red on the left side) Brown stands for chocolate-near to our hearts! ( mid-chest). If you remember white-right, you can also think clouds over grass (white over green)

[lorabel]

thank you so much for you wisdom! I'm not sure at this point what our responsibilities on the unit are. i'm waiting for the call to shadow. That way i will see what it's like. It is med/surg so I would think we will be hanging drips and getting post op CABGs. i will look at the common meds you mention and i will also brush up on reading strips! Problem is...the patient's strips rarely look like the textbook! I'll keep you all posted. thanks again!

[evstarks]

This is such an awesome website. It is like a class all intself!

I appreciate this website and will use it accordingly.

Cardia tetel sounds interesting and so challenging. Good luck to you all!

(I should be applying to nursing school in the Spring of '09 or a BSN:heartbeat).

I cain't wait to really be apart of this family of Nurses.

[evstarks]

help. trying to edit what I just typed and um.. is this how i edit. retyping my response?

[evstarks]

U caint believe my msg is still up here. It is now years later and then I was talking about becoming a nurse and now I am a nurse!