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What is Telemetry? Ultimate Guide to TELE Jobs for RNs

Telemetry (TELE) Nursing Jobs Ultimate Guide

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The thoughtful and efficient use of technology is essential for improving patient care and reducing healthcare costs. Telemetry is an indispensable aspect of healthcare, and its increasing prevalence demands professionals with particular skills and knowledge.

In this ultimate guide, registered nurses (RNs) working in telemetry and those aspiring to enter the specialty will find the answers to some of their most pressing questions, from the most basic questions, such as “What is telemetry?” to the more technical ones, such as “What is an idioventricular rhythm?”

Are you already an experienced TELE nurse? Discover high-paying, flexible PRN nursing jobs in telemetry

What Is Telemetry Data?

Merriam-Webster defines telemetry as “the science or process of telemetering data.” A telemeter is “an electrical apparatus for measuring a quantity (such as pressure, speed, or temperature) and transmitting the result especially by radio to a distant station.” Numerous industries use these devices, including software development, meteorology, intelligence, and healthcare.

What Does Telemetry Mean in Medical Terms?

Now that the meaning of telemetry is clear, let’s translate this definition to the healthcare setting. Healthcare professionals can monitor patients’ vital signs, such as blood pressure, oxygen saturation, respiration, and heart rhythms, through telemetry or medical monitoring devices.

To monitor a patient remotely, a healthcare worker places electrodes on the patient’s body. A wire connects each electrode to a device that transmits patient data to a computer. Healthcare professionals see, interpret, and assess the data on the computer. The accuracy of telemetry data requires proper skin preparation, electrode and lead placement, and equipment maintenance. Patients must also understand why they need telemetry monitoring to decrease their anxiety about wearing the devices.

nurse holding portable device to monitor telemetry data
Some facilities provide portable devices for viewing telemetry status.

What is an EKG or ECG?

One of the most common machines used for telemetry is the electrocardiogram, known by the acronym EKG or ECG. An EKG monitors the electrical activity of the heart. Telemetry professionals have extensive knowledge and expertise in monitoring and interpreting the heart’s electrical patterns, recognizing even subtle changes in a patient’s heartbeat.

Wireless monitoring is among the most valuable technological advancements in telemetry because patients no longer have to be confined to their beds. A telemetry pack can often fit in the pockets of patients’ hospital gowns, allowing them to move freely while still being monitored by healthcare professionals. This light exercise usually benefits patients and gives them greater autonomy, such as going to the bathroom unassisted. 

Furthermore, healthcare professionals can continue to monitor patients who have returned to their homes. For example, healthcare providers can monitor patients with unexplained heart palpitations or arrhythmias, alerting them to impending cardiac incidents and helping them understand the causes.

Besides monitoring patients with heart conditions, remote telemetry monitoring can assist healthcare professionals in assessing various other conditions, such as sleep apnoea, sleep patterns, and weight.

What’s a Telemetry Unit Like?

Hospitals have telemetry units for patients who require constant electronic monitoring. These patients are generally considered stable but require continuous monitoring in case their situation changes. Hospitals may move more stable patients to telemetry units to address the shortage of beds in other departments.

Working in a telemetry unit can be challenging since nurses must monitor multiple patients, admit new patients, and prepare others for discharge. Additionally, although some shifts may be uneventful, patients’ conditions may worsen in others, requiring fast action and teamwork. 

Despite the potential stress, telemetry nursing jobs can also be gratifying since this nursing care and monitoring are essential to patient recovery. It also offers valuable experience for nurses interested in working in units with higher-pressure situations.  

What Is a Telemetry Nurse?

Telemetry nurses work in telemetry units, monitoring patients’ vital signs and assessing changes in patients’ conditions. They provide primary oversight over critically ill patients in telemetry units or patients who have been discharged but require constant monitoring. Typically, telemetry nurses monitor and analyze heart rhythms, interpret EKGs, note arrhythmias, and intervene in emergencies. 

Although telemetry nurses traditionally care for cardiac patients, these nurses now care for patients with more diverse conditions, including gastrointestinal diseases, diabetes, coronary disease, and other conditions requiring acute care. Telemetry RNs typically care for four to five patients at a time. This role can sometimes be intense, requiring telemetry nurses to make quick decisions.

Depending on the job setting, TELE nurses may work with specific populations, as with pediatric telemetry. Telemetry nurses may also work remote nursing jobs to monitor patients.

What Do Telemetry Nurses Do?

Although policies regarding the duties of a telemetry nurse may vary across state lines and from one hospital to the next, the following are typical responsibilities of a telemetry nurse:

  • Interpret and treat cardiac rhythms
  • Provide basic and advanced life support
  • Calculate drug dosages
  • Initiate IVs
  • Administer IV medication
  • Observe patients for the effects of medication
  • Monitor patients before, during, and after surgery and other procedures
  • Recognize the signs of cardiopulmonary and respiratory emergencies
  • Begin standard interventions

Besides monitoring patients remotely, telemetry nurses also work at the bedside—administering drugs, performing EKGs, and educating patients and family members.

What Is a Telemetry Report in Nursing?

According to the American Heart Association, hospitals typically expect telemetry nurses to monitor and document the following:

  • Rhythm
  • Rate
  • PR interval
  • QRS duration
  • QT

Telemetry nurses must also document whether these measurements are within established parameters. Some hospitals may also require QTc documentation for all patients. Furthermore, telemetry nurses typically must document a patient’s waveform strip on admission, upon transfer to a monitored unit, and every four hours (typically). 

Any significant change in the patient’s rhythm or hemodynamic status, including before and after cardioversion, also requires documentation of a waveform strip. All healthcare providers should have access to waveform strips.

For example, in the case of a significant arrhythmia, telemetry nurses must document events before and during the arrhythmia (defibrillation, insertion of subclavian central line, etc.), possibly related signs and symptoms, vital signs, and interventions with patient response. This report must be promptly available to all healthcare providers, allowing a consulting cardiologist, for example, to access the electrocardiographic waveform to guide the patient’s care.

How to Become a Telemetry Nurse

The first step to working as a telemetry nurse is to become a registered nurse (RN). The most common pathways to obtaining RN licensure are a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN). After completing their respective RN programs, graduates must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) and meet state-specific requirements. Fortunately, telemetry nursing jobs are often available for new graduates. 

Many hospitals prefer hiring RNs with BSNs to work in telemetry. Therefore, RNs with ADNs may consider completing RN-to-BSN bridge programs to increase their job opportunities. Furthermore, telemetry nurses need technical and data analysis skills, so taking courses in information technology can be helpful.

The following are essential nursing skills to work in telemetry units:

  • Monitoring EKGs
  • Monitoring echocardiograms
  • Detecting vital signs
  • Dressing wounds
  • Administering medications

Since telemetry nurses typically care for patients with cardiac conditions, they need extensive knowledge of cardiovascular health to understand and interpret the data received from the telemetry devices.

Telemetry Nurse Certifications

Most telemetry nursing jobs require an ACLS certification.

Most nursing jobs require Basic Life Support (BLS) certification. Therefore, this certification is virtually a given. However, certain nursing jobs, including telemetry, require nurses to have more advanced life support skills. With this in mind, nurses interested in telemetry should also obtain an Advanced Cardiovascular Life Support (ACLS)a certification. This course is meant for healthcare professionals who direct or participate in managing cardiopulmonary arrest or other cardiovascular emergencies and for emergency response clinicians. It covers all of the following:

  • Basic life support skills, such as effective chest compressions, use of an AED, and use of a bag-mask device
  • Recognition and early management of cardiac and respiratory arrest
  • Recognition and early management of peri-arrest conditions, including symptomatic bradycardia
  • Airway management
  • Related pharmacology
  • Management of acute coronary syndromes (ACS) and stroke
  • Effective communication as a resuscitation team member or leader

The American Heart Association also offers an ACLS certification for experienced providers. This course is designed for healthcare providers proficient in BLS and ACLS skills, reading and interpreting EKGs, and understanding ACLS pharmacology and for providers who regularly lead or participate in emergency assessment and treatment of pre-arrest, arrest, or post-arrest patients. This course teaches the following skills:

  • Demonstrate proficiency in providing BLS care, such as integrating the use of AEDs and prioritizing chest compressions
  • Recognize and manage respiratory arrest
  • Recognize and manage cardiac arrest until transfer of care or termination of resuscitation, including post-cardiac arrest care

Additionally, the National Telemetry Association offers nurses a Telemetry Certification. The exam lasts 180 minutes and requires a minimum passing score of 80 percent. The National Telemetry Association provides candidates with preparation materials and offers test-takers two attempts. Upon passing, nurses receive the distinction of Telemetry Nurse Specialist certification with a sew-on patch, hard copies of the certification, and letters of completion. 

What Are Tips for Nurses Training in Telemetry?

Nurses working in telemetry must be skilled in operating monitoring devices and reviewing and interpreting EKG cardiac rhythm strips. In addition, according to the National Telemetry Association, telemetry nurses should strive to develop the following soft skills:

  • Effective communication
  • Ability to think quickly and solve problems under pressure
  • Organization and attention to detail
  • Ability to remain calm in stressful situations

Furthermore, telemetry nurses must be prepared to deliver critical care to patients with diverse healthcare needs.

What’s the Average Telemetry Nurse Salary?

Based on our research, the average salary of a telemetry nurse is $77,663 annually. Although this income is impressive, RNs with telemetry experience can significantly increase their annual incomes by picking up PRN nursing jobs.

Telemetry FAQs

If you are applying to your first TELE RN job or haven’t worked in telemetry for a while, you’ll need to brush up on your cardiac telemetry terminology to help you recognize different heart rhythms. Read up on some of the cardiac rhythms that TELE nurses need to know.

What Is Normal Sinus Rhythm (NSR)?

As its name indicates, a normal sinus rhythm is a regular heart rhythm at 60–100 beats per minute (bpm) (or the age-appropriate rate in children).

The following are variations of the sinus rhythm:

  • Sinus tachycardia: A sinus rhythm with a resting heart rate above 100 bpm in adults or above the expected range in children (by age)
  • Sinus bradycardia: A sinus rhythm with a resting heart rate below 60 bpm in adults or below the normal range in children (by age)
  • Sinus arrhythmia: A sinus rhythm with an irregular ventricular rate 

What Is Junctional Rhythm?

A junctional rhythm is a type of irregular heartbeat or arrhythmia. In people with junctional rhythms, their sinoatrial (SA) nodes—the hearts’ natural pacemakers—aren’t working correctly. 

Typically, the SA node sends electrical signals that control the heartbeat. However, in people with junctional rhythms, the SA nodes send slow or weak signals or may stop working altogether. In these cases, the heart responds using backup pacemakers, which keep the heart beating but may make the heartbeat slower or faster.

The following are the heart’s three pacemakers that normally work together, sending electrical impulses through the heart.

  • SA node: This group of cells is in the heart’s upper right chamber (right atrium) and usually serves as the first-line pacemaker.
  • AV node: These cells are in the junction, or center, of the heart, between the atria and ventricles. They typically take over when the SA node isn’t working correctly. Therefore, most junctional rhythms occur in the AV node.
  • His-Purkinje system: This group of thin fibers is also near the center of the heart and includes the bundle of His and the Purkinje cells. This group of fibers conducts electricity in the heart and serves as a backup pacemaker.

A junctional rhythm can be further classified into the following types according to its rate: 

  • Junctional bradycardia: A rate below 40 bpm 
  • Junction escape rhythm: A rate of 40 to 60 bpm
  • Accelerated junctional rhythm: A rate of 60 to 100 bpm
  • Junctional tachycardia: A rate above 100 bpm

What Is Idioventricular Rhythm?

An idioventricular rhythm is a heart rhythm in which the lower heart chambers beat more slowly than usual. The heart’s lower chambers or ventricles may start the heartbeat if the natural pacemaker in the upper chambers cannot. An idioventricular rhythm is less than 50 bpm; an accelerated idioventricular rhythm is 50 to 110 bpm.

Idioventricular rhythms can typically occur in people who have or have had the following health conditions:

  • Advanced or complete heart block
  • Sinus arrest or sinoatrial nodal block
  • Heart attack
  • Congenital heart problems

Certain medications and illegal drugs may also cause an idioventricular rhythm.

What Is a PVC Heart Rhythm?

Premature ventricular contractions (PVCs)—also called premature ventricular complexes, ventricular premature beats, or ventricular extrasystoles—are common types of arrhythmia. PVCs are extra heartbeats that begin in one of the heart’s two ventricles, disrupting the regular heart rhythm. A person with PVCs may report a feeling of fluttering or a skipped beat in the chest.

Not all PVCs require treatment. Occasional PVCs in people without heart disease are generally not cause for concern. On the other hand, people with frequent or bothersome PVCs or with underlying heart conditions may require treatment.

What Is an SVT Rhythm?

Supraventricular tachycardia (SVT), also called paroxysmal supraventricular tachycardia, is another type of arrhythmia. It is an irregularly fast or erratic heartbeat that affects the heart’s upper chambers. A typical heart beats 60 to 100 times per minute. During an episode of SVT, the heart beats about 150 to 220 times per minute. Not all cases of SVT require treatment; however, some people may need lifestyle changes, medication, and even heart procedures to control or eliminate the rapid heartbeats and related symptoms.

What Are Shockable Rhythms?

EKGs can help determine whether a cardiac arrest is shockable or non-shockable. Two shockable rhythms are ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). Non-shockable rhythms include sinus rhythm (SR), supraventricular tachycardia (SVT), premature ventricular contraction (PVC), and atrial fibrillation (AF).

Healthcare providers may reverse cardiac arrest with shockable rhythms through cardiopulmonary resuscitation (CPR) or by using a defibrillator to shock the heart and restore a normal heart rhythm within minutes. 

Final Thoughts

There is no question whether telemetry nursing is necessary and valuable; it is also undoubtedly well-compensated and a relatively easy field to enter. However, the ideal nursing specialty ultimately depends on personal factors, including interests, personality traits, aptitudes, and time constraints, among many others. Also keep in mind that many hospitals that require a MedSurg nurse, might seek a Med-Surg TELE nurse who is able to handle either type of job.

If telemetry has caught your attention but you’re still unsure whether it’s the perfect fit, learn more about cardiac nursing careers.


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