What Is Pediatric Telemetry Nursing? The Ultimate Guide
If you are a newly graduated nurse, telemetry nursing is an excellent option since it is generally considered an entry-level position. Furthermore, if you love working with children, a job in the pediatric telemetry unit of a children’s hospital might be the perfect job for you.
Read on to learn all you need to know about pediatric telemetry nursing: job description, certifications, salary, and more!
What Does Pediatric Telemetry Mean in Medical Terms?
The definition of telemetry is monitoring remotely, and pediatric refers to anything related to or affecting infants, children, and adolescents. Therefore, pediatric telemetry nurses specialize in monitoring children remotely.
Telemetry nurses are trained to use and analyze medical monitoring devices, which provide information on a patient’s vital signs such as blood pressure, oxygen saturation, respiration, and heart rhythms. The most common telemetry machine is the electrocardiogram (EKG), which monitors the electrical activity of the heart. Therefore, telemetry nurses are experts in monitoring and interpreting changes in a patient’s heartbeat.
Wireless monitoring is an important innovation in telemetry because patients no longer need to be confined to heavy equipment or a bed. In fact, patients can even be monitored from their homes. This technology is especially helpful for patients with unexplained heart palpitations or arrhythmias since healthcare professionals can anticipate a cardiac incident or understand these incidents more fully. In addition, wireless monitoring can help with other health conditions, such as sleep apnoea and sleep patterns, weight management, blood pressure management, etc.
When a child is in a cardiac telemetry unit, their heart rate is monitored continuously through a portable battery-powered device called a telemetry unit. This device collects data to display on a bedside hospital monitor as well as at a central staff station. If their physician allows it, a child can carry the telemetry unit in a bag and move around the hospital unit.
In children, cardiac telemetry is generally used to monitor the following:
- The pattern of a child’s heart rhythm pre- or post-surgery
- Abnormal heart rhythms
- The effect cardiac medications have on a child’s heart rhythm
Although telemetry has mostly been used for monitoring cardiac patients, telemetry nurses now care for a more diverse group of patients, including patients with diabetes, gastrointestinal diseases, and other conditions requiring acute care.
It is important to note that telemetry is a technology, not a level of care. Therefore, a patient requiring telemetry is not necessarily at a higher level of care than a patient in a medical-surgical (Med/Surg) unit. Similarly, many patients in intensive care units (ICUs) require telemetry.
What Is a Pediatric Telemetry Unit in a Hospital?
Both in general medical surgical hospitals and children’s hospitals, a cardiac telemetry unit generally has several patient rooms with vital sign monitors continuously transmitting data, such as a child’s heart rate, breathing, and blood pressure. A pediatric telemetry nurse monitors a child’s vital signs and can respond to any changes signaling a potential problem with the child’s health status.
In a telemetry unit, a pediatric telemetry nurse may apply the following vital sign sensors to a pediatric patient:
- A blood pressure cuff on the child’s arm to continuously monitor their blood pressure
- An oxygen monitor (pulse oximeter) on their finger to measure the amount of oxygen in their blood
- EKG leads on their chest to monitor their heart rate and rhythm
Although most patients in telemetry units suffer from cardiac conditions, others may suffer from renal failure, respiratory conditions, or cancer.
Generally speaking, patients in telemetry units can be classified into three different groups to help coordinate their care:
- Class I patients are the most common group of patients in telemetry units. They have cardiac issues that warrant telemetry monitoring.
- Class II patients have more specific needs. They often have chest pains, and many have pacemakers.
- Class III patients have the most specific needs. They have undergone cardiac surgery, and many have a low risk of arrhythmia.
Once a child’s heart stabilizes, the care team will discharge them home or transfer them to a regular hospital room.
What Is the Role of a Pediatric Telemetry Nurse?
As nurses, part of a pediatric telemetry nurse’s role is to care for pediatric patients who are sick, injured, convalescent, or disabled using the nursing process of assessment, planning, intervention, implementation, and evaluation. It is also part of their role to collaborate with other healthcare professionals to guarantee the best possible patient outcomes, as well as interact and collaborate with patients and family members. That said, the main role of a pediatric telemetry nurse is to provide care by connecting pediatric patients to machines that measure blood pressure, heart rate, breathing rate, oxygen levels, and electrocardiogram information. Telemetry nurses interpret the data provided by these machines to guide patient care.
What Does a Pediatric Telemetry Nurse Do?
The responsibilities of a pediatric telemetry nurse may vary from one hospital to another. However, the following are typical duties of a pediatric telemetry nurse:
- Coordinating with other healthcare team members to assess, plan, implement, and evaluate care plans
- Providing basic bedside care
- Recording patients’ medical information and vital signs
- Preparing equipment and aiding physicians during the examination and treatment of a patient
- Preparing, administering, and recording prescribed medications
- Reporting adverse reactions to medications or treatments to physicians
- Monitoring and adjusting telemetry equipment used on patients
- Interpreting and recording electronic displays
- Identifying irregular telemetry readings and notifying appropriate medical team members
- Initiating corrective action whenever information from monitoring equipment shows adverse symptomatology
- Responding to life-saving situations based on nursing standards and protocol
- Recording all care information accurately and in a timely manner
- Initiating the patient education plan, as prescribed by a physician, by teaching patients and family members how to manage their illnesses/injuries
How to Become a Pediatric Telemetry Nurse
Pediatric telemetry nurses are registered nurses (RNs) experienced in telemetry with pediatric patients. An aspiring pediatric telemetry nurse must complete an associate’s degree in nursing (ADN) or a bachelor’s of science in nursing (BSN)—although it must be noted that many employers prefer hiring nurses with BSNs.
How Long Does It Take to Become a Pediatric Telemetry Nurse?
Completing an ADN takes approximately two years, whereas a BSN requires about four years. After completing a nursing program, nurses must pass the National Council Licensure Examination (NCLEX-RN) to become licensed RNs.
Generally speaking, positions are available for newly graduated nurses in telemetry units.
Pediatric Telemetry Nurse Certification
All nurses should complete Basic Life Support (BLS) certifications since this credential is a requirement for practically all nursing jobs. Nurses working in telemetry should also obtain the Advanced Cardiovascular Life Support (ACLS) certification. Furthermore, pediatric telemetry nurses should also complete the Pediatric Advanced Life Support (PALS) certification course and may also consider pursuing the Neonatal Resuscitation Program (NRP). All of these credentials are available through the American Heart Association (AHA).
Additionally, the National Telemetry Association (NTA) offers the National Telemetry Certification and the National EKG Certification.
How Much Does a Pediatric Telemetry Nurse Make?
Many aspects influence a nurse’s salary. One of the main factors is location; for example, whereas RNs in California earn $124,000 on average, RNs in South Dakota earn $60,540 on average—less than half! Another significant aspect contributing to a nurse’s salary is level of education. While the average salary of a licensed practical nurse (LPN) is $51,850, the average salary of a nurse practitioner (NP) is $118,040. Since most telemetry nurses are RNs, according to the US Bureau of Labor Statistics, they can expect to earn, on average, $82,750 annually.
That said, according to the National Telemetry Association, the median salary of a telemetry nurse is approximately $58,500 annually. This is probably due to the fact that most telemetry job openings are for entry-level positions.
What Is Pediatric Telemetry Nursing Like?
Pediatric telemetry patients need around-the-clock care, which is why telemetry nurses are required 365 days of the year. Regarding patient-to-nurse ratio, it varies with each facility. That said, the following testimonial of a telemetry nurse on Reddit helps paint a picture of what it is like to work in a telemetry unit and what this ratio might be:
“Telemetry may not be what you think it is. It’s like medsurg but more complex patients with heart problems. Depending on open bed availability , you may just get a pt that’s supposed to be in the ICU. My telemetry floor had a bunch of “stepdown patients” but our patient ratios were 5-6 on days and 6-7 on nights in the Midwest.”
Corroborating the perspective of the previous nurse, this telemetry nurse shares that there isn’t a standard level of acuity or type of patient in a telemetry unit, an aspect that can make pediatric telemetry nursing hard.
“Tele is a step down for ICU, but it’s also a step up for general med surg .. so we end up with a lot of medsurg .. somehow we also end up with pallitative and patients for which doctors don’t really have any orders for .. they’re just in limbo .. family doesn’t want to D/C .. Doctors don’t want to continue to treat .. so yeah naturally take up a bed in a cardiothoracic telemetry ward, why not!”
Why Choose Pediatric Telemetry Nursing
Although varying degrees of acuity and different types of patients make telemetry nursing seem challenging, these aspects also make a telemetry unit an excellent place for new nurses to expand their knowledge and hone their nursing skills.
“I started on a PCU because I was interested in cardiac. I worked there for about 4.5 years and decided I was ready for a change and moved to ICU. The pluses to tele: you learn some great skills with cardiac monitoring, ACLS, cardiac meds, drips, and depending on the type of hospital you’re in, you can get a wide array of patients.” – Reddit user NurseDani39
What Makes a Good Pediatric Telemetry Nurse?
Like in an intensive care unit, in a telemetry unit, a patient’s condition can change rapidly. Therefore, pediatric telemetry nurses must be quick thinkers and problem solvers and must be able to deliver critical care when necessary. The following description of a telemetry unit helps illustrate this aspect of the telemetry specialty:
“In a telemetry floor you will probably get dynamic patients where patients can go from walking around talking to a rapidly decompensating cardiac tamponade. Hopefully you won’t see too many of these. But remember that early intervention is worth everything in the world. When it comes to progressive/critical care a stitch in time saves nine.”
Additionally, telemetry nurses must be good communicators, have good attention to detail, and remain calm in high-pressure situations. New nurses interested in pediatric telemetry should bear in mind the following tips from an experienced telemetry nurse:
“I think the number one thing an RN should get good at is bedside assessment. For the most part you will be discussing patient situations over the phone and your description of the situation will make all the difference to the prescribing physician so try and be specific and use descriptive words: pale, boggy, diaphoretic, dry, edematous, erythematous, purulent, febrile, pulseless, irregular… etc.”
Final Thoughts on Pediatric Telemetry Nursing
If you are a newly graduated nurse looking for your first nursing job, a telemetry unit is an excellent option. Furthermore, if you like caring for children, then a pediatric telemetry unit in a children’s hospital could be your dream job.
That said, another option all new nurses should consider is working PRN. PRN stands for the latin term “pro re nata,” which means “as needed.” In this type of work, different healthcare facilities can post PRN nursing jobs to cover their staffing needs, and PRN nurses can request the jobs that interest them and that fit their schedule. For new nurses, this type of work is a great way to gain experience, which helps them not only build up their resume but also get a feel for the type of nursing work they enjoy.
Which option sounds better to you: applying for an entry-level full-time job or picking up PRN shifts in different facilities and working with different patient populations? Follow your intuition, and remember that you can always change your career path down the road. Would you like to learn about other nursing specialties? Click here!