Telemetry nurse monitoring an elderly patient

After experiencing a heart attack or stroke, doctors monitor patients round-the-clock to ensure they stabilize and gain insight into what may have caused their condition. 

Patients who have experienced cardiac events usually wind up in the hospital’s telemetry unit, undergoing 24-hour electronic monitoring. Many patients with severe conditions or in intensive care need ongoing observation through medical devices.

Telemetry nurses provide coronary care to patients in a telemetry unit, providing constant supervision and assessment.

These nurses are a type of critical care nurses who closely monitors the respiratory and cardiac health of their patients, as well as provides any necessary treatments and medications. They can also provide life-saving intervention if any of their patients need it.

Telemetry is short for “telemetric,” which refers to using remote technology to monitor patients’ health. Nurses in the telemetry unit work closely with doctors to ensure patients on life support and in intensive care become stable enough to progress to a step-down unit.

What is the difference between a telemetry nurse and an ICU nurse?

Telemetry and ICU nurses work in critical care, but a telemetry nurse works exclusively in the telemetry unit, and an ICU nurse works in the intensive care unit (ICU). Telemetry and ICU nurses undergo additional training to perform their jobs; most have several years of experience in med-surg nursing before being accepted into critical care positions.

What qualifications does a telemetry nurse need?

All telemetry nurses must have an associate’s or bachelor’s degree in nursing and a valid license to practice as an RN in their state. They will also likely need certifications in telemetry and cardiac nursing.

The National Telemetry Association provides certification for RNs and LPNs; the ANCC offers certification as a Cardiac Vascular Nurse (CV-BC). To become a certified cardiac nurse, you will need at least two years of full-time nursing experience and 2,000 hours of cardiac-vascular nursing within the last three years.

What work does a telemetry nurse do day to day?

Telemetry nurses provide 24/7 care to patients in hospitals or skilled nursing facilities. They monitor various health data, such as heart rate, temperature, muscle function, blood pressure, and other vital signs.

Nurses in the telemetry unit record data about a patient’s cardiovascular and respiratory function and update information regularly to inform physicians.

Telemetry nurses also administer medications as prescribed in a patient’s treatment plan or when ordered by an emergency physician. They document all of their interactions and treatments and maintain updated patient charts and medical records using digital systems.

Nurses must communicate well and coordinate care across multiple shifts. They have to respond to phone calls from physicians, as well as family members and perform a variety of nursing tasks.

These responsibilities include the following:

  • Airway management for patients with ventilators or tracheostomy tubes

  • Performing central line insertions and administering medications intravenously

  • Performing basic cardiac rhythm monitoring, recording and reporting results

  • Conducting stress tests to assess patients’ pulse, breathing, and blood pressure during exertion

  • If certified, perform electrocardiograms (EKGs) on patients

  • Drawing blood samples or collecting lab specimens for diagnostic tests

  • Managing medical equipment, such as EKG, EMG, and SpO2 devices

All telemetry nurses must also be open and responsive to their patient's needs. While some cannot speak, others are alert and have many questions and concerns about their care. Their family members also rely on telemetry nurses to help put their minds at ease. They look to telemetry nurses to help them better understand their loved one's condition, limitations, and the best way to play an active role in their care. 

Where do telemetry nurses work?

Telemetry nurses work in hospitals, long-term care facilities, nursing homes, and hospice care centers. They can work anywhere that needs nurses who are skilled at monitoring vital signs and providing critical care support to patients.

How much do telemetry nurses make?

The average salary of a telemetry nurse is $97,884 per year, with salaries in the U.S. ranging between $70,321 to $138,054. Having advanced certifications, skills, and experience will increase a nurse’s earning potential. Where you live and work also influences how much you can earn as a telemetry nurse.

Advantages and disadvantages of choosing a career as a telemetry nurse

Before diving into a telemetric nursing career, here are some pros and cons to consider. As with any nursing specialty, telemetry has its own unique benefits and some drawbacks to be aware of.

Advantages of choosing a career as a telemetry nurse

Major impact on patients’ lives

Telemetric nurses get to work closely with their patient's thanks to a low nurse-to-patient ratio (usually 1:3 or 1:4). It’s a demanding job, but it also lets you provide direct care that saves lives. You know that your work with your patients tremendously impacts their well-being.

It’s a huge responsibility but also a great honor and source of pride to see them improve, thanks to your care. In addition, this patio-to-nurse ratio allows you to bond with your patients and their families, oftentimes more so than if you were working in the ER. 

Certifications create job opportunities

Nurses who want to work in the telemetry unit need certification, which makes them more eligible candidates for other nursing jobs. Certification in Telemetrics means a nurse is highly skilled at critical care monitoring. You continually learn a great deal about cardiology, emergency care, and intensive care, which makes it a great field for those that want to advance their careers.

Strong emergency room preparation

Working in the telemetry unit can be completely peaceful one minute and chaotic the next. Most of the patients brought to the telemetry unit from the ER have cardiac problems, which allows you to work with people who need both intensive and acute care. The fast pace, dynamic caseloads, and unique skills of telemetry nursing make it a great starting point for nurses who want to transition to the ER or another ambulatory setting.

Disadvantages of choosing a career as a telemetry nurse

Time constraints

Managing multiple patients who have drastically different needs can be difficult. You will also have tests to run, physicians requesting information, and a constant feedback loop between your unit and others. It’s a demanding role that can keep you on your feet, moving nonstop for 12 hours at a time. The time management aspect is often challenging, even for experienced nurses.

Lots of paperwork

Telemetric nurses have to not only chart patients, but update medical records, sift through lots of vital signs, monitor medical equipment, and compile information for physicians. Inpatient documentation is crucial for patients with cardiac complications; the data you record and provide can save lives.

Advanced knowledge is a must

Telemetric nurses must be able to interpret complicated graphs and readings from medical equipment, such as EKG strips and Holter monitors. The garbled lines on an EKG can reveal cardiac abnormalities, such as irregular heartbeats (arrhythmias) or baseline changes that a physician needs to know about immediately.

You have to put in a lot of work to learn telemetry nursing and all the possible conditions and complications your patients may experience.

High-stress levels

Telemetry nursing isn’t easy, and most nurses in this unit must constantly work with high stress. There is often a high turnover and patients in critical condition, so you must always be 100% engaged and think one step ahead. You also need to be able to think on your feet and not let high-stress situations prevent you from providing life-saving treatment.

How to become a telemetry nurse

Interested in working in the telemetry unit? Here’s what you can do to start your career:

  1. Earn a nursing degree from an accredited nursing school

  2. Pass the NCLEX-RN exam

  3. Get an RN license in your state of residency

  4. Gain experience as a nurse

  5. Study for and earn telemetry certification

  6. Consider critical care certifications

  7. Apply for telemetry nurse jobs

Most employers will look for 1 to 3 years of general nursing experience before hiring someone to work in the telemetry unit. Additional certifications through the American Association of Critical Care Nurses (AACN) can help you further your career.

Telemetric nurses may further specialize in neonatal, pediatric, and adult intensive care, cardiology, or pulmonology.

Frequently asked questions about becoming a telemetry nurse

What should I know as a telemetry nurse?

You must be able to provide comprehensive critical care and cardiac nursing to patients in the telemetric unit and perform various electronic medical tests and telemetric interpretations. 

In addition to setting up and monitoring a variety of medical equipment, telemetry nurses also have to be able to provide intensive care to their patients.

Is telemetry nursing easy?

If you are looking for easy nursing specialties, telemetry isn’t it. Nurses who specialize in telemetry must learn an extensive amount of knowledge and unique clinical skills. They have to be experts in critical care, as well as specialists in cardiology and pulmonology.

How is telemetry different from med-surg?

Telemetry patients have more critical care needs and require constant cardiac monitoring. Nurses in the telemetry unit must be able to perform cardiac assessments, interpret and chart EKG findings, and rapidly respond to their patients. The type of equipment you work with and the medications you administer are also different in the telemetry unit.

Is telemetry good for new grads?

New grads can benefit from developing skills in telemetry, and they can become even better nurses on other floors after working in the telemetry unit. However, telemetry is a high-stress nursing field that requires a specialized skill set. Many new grads could find it overwhelming.