Turning off Monitors

[Amanda Houtz]

18 year veteran nurse, mostly ICU and ER.  We have an ER physician that will write in the comments of a chart to the effect of 

"EKG, meds, turn off monitor"

This is mostly for patients being seen for high blood pressure or low risk chest pain patients. It's also never written as an order just in the comments.

I have a hard time turning off any monitor let alone for a patient I just have anti hypertension meds too.

what are your thoughts?  Would I be covered if something bad happens. I venture to guess no.  But there are not really good guidelines or protocols for HTN patients.

[FiremedicMike, BSN, RN, EMT-P]

What's the rationale for turning off the monitor?

[Corey Narry, MSN, RN, NP]

This is something that should be addressed with this attending. Telemetry use is an order the provider writes. I agree with some physicians that we overuse the order for telemetry and in many places there are specific indications for its use and as providers, we are always reminded to discontinue if the indication is no longer active. HTN and low risk chest pain per se do not need telemetry unless there are other issues that make it required but patients are not always the perfect "protocol" so I would approach this personally on a case to case basis.