Cardiac/Telemetry
EBJ926
I am a little bit embarrassed asking this question, but I guess it is
always good to go right to the source. I am a new grad, and I haven't even
taken my boards yet. I am going on a job interview in 2 weeks for a
position on a cardiac/telemetry unit. I would like to sound like I know a
little bit about what goes on in this type of unit. I am researching right
now. Is there anyone out there who works on a cardiac/telemetry unit that
could tell me a little bit about what type of client you get, what the
tasks are etc. Any info would be appreciated
ellen (boston)
CaverShack
Ellen,
First of all, good luck with your boards and congrats on graduating
nursing school. By me working in the ER I can tell you that the types of
patients that you get in a Tele unit will vary from hospital to hospital.
They are typically your post CABG (days after ICU), r/o syncope, new onset
arrythmias, stable angina, etc. I do strongly suggest that you take an
ACLS course or at the very least an EKG recognition course. Good luck and
welcome to the profession.
David
GSMRN
Congrats on graduation!!! My first position after graduation was on a
Cardiac Step-Down unit. All patients where on telemetry. Their Dx ranged
from USA (unstable angina) to R/O MI. However, this was considered a
specialty in my hospital.
Most hospitals with 'telemtry' units take your run of the mill COPDers,
Chronic AFib, and others when the MD wants to be a little extra cautious.
In other words the telemetry is secondary to something else, and any
arrythmia is already controlled.
There are at least two Golden Rules with telemetry:
1) Listen to the alarms, they are there for a reason!! (I worked as a
SWAT Nurse for a few months where I went from unit to unit on the 7p-7a
shift and helped out) and I can't tell you how many times I walked on a
unit and found everyone ignoring a telemetry alarm. Now usually it was
nothing, but how can you tell if you don't check.
2) Treat the patient and not the monitor. I have seen many a patient in
VTach with a pulse and talking away. Now granted they may not last long
this way but keep your cool and know and follow your unit specific
protocal.
As far as I know (and I don't profess to know much), all hospitals have
some type of ECG interpretation class that all nurses who work on a
telemetry unit must take, or test out of. I came from a school that
included strips into clinical/lecture and if you didn't pass the strips
you didn't pass the class. I still had to go through the 40 hour strip
class prior to starting on the telemetry floor. This was also the
experience of many of my friends, even the ones who started at the same
hospital we graduated nursing school.
As far as taking ACLS at this point as David recommended, I wouldn't
recommend it. While it looks good on a resume, it is not expected nor
encouraged for a new grad. Most hospitals want you to learn the basics
first so that during a code you can look at the whole picture and not just
follow an algorythm. Also, it is very expensive and many hospitals will
pay for you to attend after you have worked for them a certain amount of
time. Additionally, you will get a lot more out of it if you wait. -I
know this from experience-
Finally, be honest in your interview. If you don't know something tell
them you didn't have that experience in school but you are very willing to
learn. Most managers remember what it was like to just out of school and
don't expect (and can't expect) you to know everything. However, they do
expect you to be open and willing to learn as much as possible.
Good Luck on boards,
Gerry (GS...@aol.com)
caver...@aol.com
CMiller162
I don't work on a telemetry floor (I graduate in Dec. 97) but I did one of
my clinicals on the telemetry floor.
You can expect to get all types of patients just like a med/surg floor but
these patients have an underlying cardiac problem. My first day on the
floor I had a patient who had cancer and had recently had chemo. He
developed complications and was admitted. I was not ready to walked into
his room and see three IV pumps, two piggybacks, TPN, NG to suction, foley
cath and compression devices on his legs. I just wanted someone who had a
simple heart monitor. It was the best experience I have gotten during
school. I had major meds, IVs and IV push meds. I became very confident
I could handle this type of patient. I also had a dialysis pt, a severe
asthmatic and a pt in traction while I was there.
It seems like a great place to keep up with all of your skills. Good
luck.
Laura Acker
CMiller162 <cmill...@aol.com> wrote in article
<19970517170...@ladder02.news.aol.com>...
I work on a 40 bed telemetry unit in a New Jersey hospital, and yes most of
my
patients have multiple medical problems, only one of which is cardiac in
nature.
I missed the original post here, but you mention here that a telemetry unit
was
one of the best experiences that you had during nursing school. In fact,
that
may be true, but in my professional opinion, new grads should not be hired
on
a telemetry unit. On my unit we have an eight patient assignment and the
acuity
and patient load together are too much for the new grad. One to two years
on a med/surg unit and ACLS should be a requirement to work on these types
of units. Once your time management skills are in order and you have some
experience under your belt then go for ACLS and then think about a
telemetry
unit. I have seen many new grads attempt to orient on telemetry units and
unfortunately most do not make it.
laura...@worldnet.att.net
Pfeifette
may be true, but in my professional opinion, new grads should not be hired
on
a telemetry unit. On my unit we have an eight patient assignment and the
acuity
and patient load together are too much for the new grad. One to two years
on a med/surg unit and ACLS should be a requirement to work on these types
of units. Once your time management skills are in order and you have some
experience under your belt then go for ACLS and then think about a
telemetry
unit. I have seen many new grads attempt to orient on telemetry units and
unfortunately most do not make it.
I think this applies to acute intensive care units but not basic telemetry
units!!! I believe that telemery/ekg strip interpretation should be a
basic skill that every RN has. Any med/surg patient could suddenly have a
cardiac problem and what if their nurse is only able to place them on the
portable heart monitor but then can't tell sinus rhythm from a deadly
arrythmia?! I have seen this happen so many times you wouldn't believe
it. Basic telemetry floors with 8 patient assignments are excellent ways
to learn. Save the Coronary Special Care Unit, SICU, MICU, etc. until you
have at least a year under your belt. It is here that a rare new grad
makes it.
Pfei...@aol.com
Laura :D
tra...@bright.net
I worked on a telemetry unit (stepdown) for 18 mos before going to CICU. I saw
many new grads come in, orient, and be too stressed out to continue working
there. In fact, most of the new grads I saw did not make it. Those who did had
worked as techs prior to graduation.
There's a lot of heat in that kitchen, and anyone who goes in should be
adequately forewarned. I think being an adrenalin chaser helps. We had 7-10
patients per RN, unless of course, we were short. Which,a s everyone knows,
never happens.
I agree that all nurses should be able to recognize basic cardiac rhythms. They
taught those in my ADN school. Ideally, too, all nurses should be able to run a
code and intubate. But learning fresh all of this material right out of school
-- I'd just encourage anyone to take careful stock of their knowledge and
skills, as well as their persistiveness, before trying it. Med-surg floors are
a lot more new-grad-friendly.
True, there is a huge variety of patients -- renal failure, caths, surgery,
TURPS, MIs, HTN, angina, DM, COPD, cellulitis/septicemia, HIV, HBV, TB, MRSA,
VRE, teenagers, elderly, drug overdoses/toxicity, ARDS, etc. It helps to elarn
to work with these types of patients before working with these patients who
also have cardiac involvement.
Good Luck!
big RoN
In article <01bc653a$9ffb8220$2a6574cf@micron>, "Laura Acker"
<laura...@worldnet.att.net> wrote:
>that may be true, but in my professional opinion, new grads should not be hired
>on a telemetry unit. On my unit we have an eight patient assignment and the
>acuity and patient load together are too much for the new grad. One to
two >years on a med/surg unit and ACLS should be a requirement to work on
these >types of units. Once your time management skills are in order and
you have >some experience under your belt then go for ACLS and then think
about a
>telemetry unit.
Granted, the above is your opinion, but I disagree. While a telemetry
unit may not be appropriate for some new grads, I do not like a blanketed
statement that new grads should not be hired on a telemetry unit. I do
agree that all nurses on a telemetry unit should be required to have taken
ACLS. I'm still fairly new at nursing, I graduated last June, got my
license in Sept. took ACLS during October and got my first job at the end
of October. I was hired by a registry, pretty unusual for a new grad, and
was first assigned to a few SNFs... That was the biggest mistake. I then
had my chance to work in hospitals, I had a few challenges, especially
since I had no orientation, but I quickly adapted. Shortly there after I
was offered some ICU shifts. I like it in the ICU. I felt at home. I
was on top of all pending problems. I don't work ICU very often, but when
I have, I haven't let anyone down. I usually work either tele or M/S. I
personally don't see much difference between M/S and tele at most of the
hospitals I go to. I have quickly learned to adapt to heavy patient
loads. I have learned to swim like a pro when thrown into boiling water.
I'm not claiming I am the best nurse, but I am sure as hell not the
worst. I believe a new grad can fit into nearly all areas of nursing if
that is their desire. I spent all my time in nursing school focused on
becoming first an ICU nurse and then an ER nurse. Luckily, I have done
both of these with the registry and did a good job at it when I did,
unfortunately, hospitals don't realize that new grads, if focused, can do
it. Maybe they'll need a little orientation, but they can survive.
PS. After reading through what I just wrote, I can see my brain was
wandering a bit, but I think you can understand the intent on my message.
--
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