Telemetry Nurse Interview

Today's nursing specialty interview is very near and dear. ❤ Not only is Kandis a close friend, but she is a former coworker of mine! She has worked on a Telemetry floor for several years now and it has been so neat to watch her learn and grow there from a new nurse to a leader and strong team player. 

What type of nursing do you do?

I do inpatient cardiovascular telemetry nursing. (That's medical jargon for hospitalized patients with heart problems.)

Can you tell me a little bit about yourself and why you chose that specialty?

I graduated from a technical college with my ADN looking forward to working in material nursing, either labor and delivery, mom/baby, or even antepartum. I had done my practicum on a mom/baby unit about an hour away from my house, and didn't feel the Lord was leading me all the way back out there full time on nights, so I applied for several positions at hospitals closer to me. Those maternal/infant positions remained closed, so I applied for other things like pediatrics (I love kids!) and the ER (I am a bit of an adrenaline junkie). I felt I didn't want to do med-surg, and started thinking through all the other body systems, and since cardiac was my favorite in school, I also applied for those. Through a series of events, the Lord opened the door for my current position.

How is your specialty unique to other types of nursing? Challenges? Rewards?

Every one of my patients are really unwell. So I may have one patient unable to breathe due to CHF, one patient that is having an NSTEMI, one that has A-fib RVR related to sepsis, and one that has such a low heart rate that they may have to be externally paced at any given point in my shift, where in other units (such as the ER) all the patients do not have as high acuity. That is definitely one of the biggest challenges, but it is also a reward to know that you're able to help these really sick people get better. One of the other great rewards is getting to talk to or getting notes from patients I've helped code (resuscitate). There is nothing quite like reading a thank you note from a patient that starts with, "I died on February 11th, but thanks to your team, I was able to..." or getting your patient assignment for the shift and realizing one of your patients is the guy you "met" by compressing his lifeless chest last week.

Did you work in another specialty before going to this one? If so, how did your prior experience help you prepare for what you do now?

I had done an internship with a pediatric clinic, and as I mentioned earlier, I had done my practicum on mom/baby, but I had not worked anywhere else as a nurse.

Is your current job a step towards a bigger goal?

Yes and no. Yes, in the respect that it has grown my overall working medical knowledge which helps me be a better nurse no matter which field I may want to move in to in the future as well as it helping me be more useful on medical missions trips.

No, in the respect that if I ever go into higher education, I  would want to pursue nurse midwifery.

Did you need special certifications to work where you do? If so, how did you get them?

ACLS is the only required extra certification for my floor. It is similar to BLS, just more in depth and includes the emergency medications like epinephrine, atropine, bicarb, etc.

What is a "typical" shift like?

A typical shift for me runs something like this: come in early and write down my assignment, do a cursory review of the nursing orders, skim through the MAR checking to see what IVs are  running continuously and what medications may have recently been given that would affect heart rate or blood pressure, jot down first round medications (8p-10p), go to huddle at 1845, get bedside report from dayshift, meet my patients and start their assessments. Often, I will either have a femoral or radial arterial puncture site from a heart catheterization or a pacemaker site that requires Q15 minute site checks and VS monitoring or a new admission coming. I may also be dealing with titrating a cardiac drip like Cardizem for heart rate control, or Nitroglycerin for chest pain management. Thankfully,  being on night shift, I often have the time to spend several minutes discussing medications and procedures, lifestyle and diet adjustments, and anything the doctors or dayshift nurses may have mentioned during the day, but just not had time to elaborate on with my patients. My philosophy is that since none of us medical staff are going home with the patients, I need to equip them to take the best care of themselves as possible and the pace of nightshift allows time for the patients to ask questions and talk through all of that. Assessments are approximately every 4 hours, so midnight rounds and then the pace picks back up around 0345 as I prepare for my 0400 rounds and reassessments, as well as placing new IVs as needed for anyone going for certain procedures,  drawing labs off PICC or central lines as ordered, then doing the before breakfast med pass just before dayshift arrives.

What would you tell a nursing student interested in your specialty?

A telemetry unit is one of the best places to start! You get to focus mainly on one system - so getting familiar with the cardiac medications, how blood pressures and heart rates/rhythms are intertwined, the rhythm strips, various cardiac procedures, etc.- but you also get experience with so many other things because patients are often transferred there for IV drip medication for A-fib, secondary to things like fractured hips, small bowel obstructions, GI bleeds, pneumonia, or even serious cellulitis. This has helped keep my nursing school knowledge (you know all those chapters that you study just to pass a test😉) from growing dormant as I suspect it would have, had I gone straight to maternal infant nursing where other organ systems are not so much involved.

Any thing else you would like to share?

For any nursing student out there whose end goal is to work in a limited specialty (e.g. mom/ baby, OR, etc), please consider a year on a med-surg or telemetry unit first because you will not regret the critical thinking nursing skills you will develop. It has taught me to think about the body as a whole with each organ system closely integrated with each of the others. Also, if you are interested in medical missions like I am, not being limited to medical knowledge in just one specialty area is super helpful.

Can't you hear her passion for nursing!?! Kandis is seriously one of my favorite nurses because of her love for the field and how she pursues excellence in everything she does! If you would like to contact Kandis to learn more about telemetry or any other topics, you can reach her at transformedbythechiefshepherd@gmail.com