What Constitutes a Telemetry Unit

[Pudnluv]

Are there any guidelines for what constitutes a telemetry unit? I work on a 35 bed unit, 24 beds which are tele beds. Our nurse to patient ratio is up to 6:1 days, 9:1 eves, 10:1 nights. We feel this is too much. The accepted standard for telemetry is a 4:1 ratio. When my NM presented these guidelines to management, she was told that we are not a telemetry unit, we are a med-surg unit and our patient ratios are acceptable. We are the only floor, aside from the ICU that does tele. All the nurse are required to be basic coronary certified and ACLS certified. We are capable of pushing emergency meds and have standing orders in place for these. When patients on other floors are having problems, they end up on our floor. When patients come out of the unit, most likely they are transferred to our floor. So what is it that actually constitutes a telemetry floor. We do not have a monitor tech, the charge nurse watches the monitors ( but does not take patients). I'd like to find some type of guidelines that we can work with. I should also mention that we are also the oncology unit in our hospital and the nurses are also required to be chemo competent as we do run chemo.

[mama_d, BSN, RN]

nursing is 100% only about keeping from getting ourselves and our patients smooshed between rocks and hard places.

amen to that!

your ratios are freaking ridiculous. i work tele/oncology and the absolute highest we'll go is 6:1 with one tech for 25 patients on nights. ideal staffing for nights is 5:1 with two techs. we do watch our own monitors.

even our medical floors don't do 10:1 except in extremely rare circumstances...and those are the nights when codes get called repeatedly at shift change as nurses do their hand-off rounds.

is there any way that you and some of your cohorts can do some research into evidence-based practice, mortality rates, fall rates, med error rates, etc. as it applies to staffing with the acuity of patients that you get, and compile it all into a nice package and forward it on to upper management?

additionally, much as i'm reluctant to say this, it may be time to start ramping up the incident reports. we have been having issues with staffing recently where i'm at, and the number of errors have obviously increased...each incident report that i write i notate as a contributing cause that "staffing was at critical level". bury risk management in paperwork, create a paper trail of evidence that high ratios are directly contributing to less than optimum patient outcomes, and things may eventually change.

[swirlygirl]

Your ratios sound scary!! I work on a surgical/telemetry floor and our ratio is 1:5 on days and evenings, and 1:7 on nights. And that's only if the floor is full. And not all of our patients are on monitors!! I worked a general med/surg unit for 5 years before this current unit and we were considered the dumping ground for the hospital and our ratios were never 1:10. I would be spending my days off looking for a job before my license was jeopardized. Good luck!