Written by Sara Egnatz, BSN, RN-BC
Walking onto the unit, coffee in hand to fuel the 12-hour shift ahead, you hear a symphony of bells and beeps emanating in the background. Suddenly, a harsh shrill rises above the cacophony; tension in the air is palpable as nurses race towards the loud sound to intervene for the critical cardiac change. This is how your day begins as a telemetry nurse.
What is telemetry?
Telemetry is a monitoring device that records the rate and rhythm of electrical conduction in the human heart. The telemetry unit or “box” is attached to the patient using leads, and the portable box transmits the heartbeats to a bedside or central monitoring unit. From the medical-surgical to the intensive care unit, telemetry is used to monitor the cardiac function for patients who have cardiac symptoms and many other diagnoses. If you work in the inpatient setting, you ARE a telemetry nurse!
What are the top 3 things to always remember when caring for patients on telemetry?
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Make sure the telemetry is attached and functioning! This may seem obvious, but one of the first checks you do should be to make sure that all equipment works, and you can see the patient’s cardiac rhythm on the monitors at the nurses' station. If the monitoring occurs in a central unit, check in with the technicians to make sure they can see the continuous rhythm.
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Do a deep dive into the patient’s overall picture, including the telemetry. Assess vital signs, perform a complete physical assessment, and analyze the rate and cardiac rhythm. Is it consistent with the patient’s history and current diagnosis? Have there been any changes from the previous analysis? These are all questions that need to be at the forefront of your nursing practice during the shift.
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Pay attention to the beeps! A telemetry nurse must be well-versed on what is normal, and why something is not normal. Also, a nurse working on the telemetry unit must be astute to changes in rhythm, which may easily become life-threatening. You will want to notify the provider of any changes, and be prepared to perform a more detailed electrocardiogram (ECG) to confirm changes. This enables appropriate interventions to be ordered.
So, how do you become proficient with telemetry readings if you are just getting started? As with anything, you will get up to speed quickly with practice. A great website to gain confidence is to practice with SkillStat, where you can learn important rhythms and quiz yourself in real-time. You will be a master before you know it!
As you walk out of the unit 12 hours later, the songs of the heart fade into the background, and you are thankful for the technology that aids in the care of your patients.
References:
https://nationaltelemetryassociation.org/5-benefits-of-cardiac-telemetry-monitoring/
https://www.skillstat.com/tools/ecg-simulator/
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