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What Does a Telemetry Nurse Do?

Jul 29, 2020
Shawna Kratochwill, RN, BSN

Are you a nurse who geeks out over technology but also loves connecting with your patients? Telemetry nursing may give you the perfect balance. It involves a highly technical expertise (like ICU) as well as conscious patients. I’ve been a telemetry (“Tele”) nurse for seven years, and I’m here to tell you all about it. 

Telemetry is the remote monitoring of a patient’s cardiac rhythm. The system uses electrodes adhered to the chest to record and produce a continuous tracing of the heart’s electrical activity. It is a critical tool for monitoring patients with cardiac risk, as it can detect changes before symptoms start. 

While this process may sound intimidating, it’s actually quite simple. Telemetry measurement and interpretation follows a structured pattern and with continuous practice, it gets easier and easier. I can tell you what a rhythm is just by looking at it, and can report the PR and QRS intervals without even measuring!

According to the National Telemetry Association, a tele nurse earns a median salary of $58,500 per year, or $30.98 per hour. The income falls between $48,100-84,900 each year, depending on the location and organization. A certified telemetry nurse can typically expect higher pay. 

What are the typical responsibilities of a Tele Nurse?

I am responsible for providing complete care for my patients, as well as closely monitoring their cardiac rhythm and responding to any changes. Some organizations have central or remote techs that manage continuous monitoring and communicate with the nurse. 

The nurses’ station has a monitor, where I can visually see the telemetry tracing in real-time. At scheduled intervals (such as every 6 or 8 hours,) I analyze a six-second “strip” of the tracing. Using measurements, I determine the heart’s rate and rhythm and identify any abnormalities. 

It’s mind-blowing how much information can be gathered from some lines and micro measurements. The tracing can also be reviewed from the monitor, which allows for precise timing of changes. My typical patient has had an acute cardiac event or surgical intervention and has been stabilized or downgraded from the ICU but still requires close monitoring. I also have patients who are experiencing chest pain and being observed for cardiac events. 

What should nurses entering this specialty expect to encounter on a regular basis?

  • A fast-paced unit where anything can happen; be ready for Codes
  • Evolving technology and ongoing specialty training 
  • Collaboration with doctors and support staff built on trust and open communication 
  • Sharp assessment skills as cardiac changes can occur quickly, the signs can be subtle, and monitors aren’t always accurate
  • Rapid changes needing an immediate response
  • Complex patients with serious co-morbidities who are frightened and anxious

To learn more about telemetry nursing and certification, check out the National Telemetry Association, linked at the top.

plastic fake heart on rock faded background telemetry nurse


Introduce your experience as a Tele Nurse

I first took a telemetry position because it was the only position I could find. I ended up falling in love with the role and have been doing it ever since. 

As a nursing student, I was thoroughly intimidated by the heart and never expected to care for cardiac patients. Once I understood it, my fascination grew and my knowledge deepened. 

What are some of the benefits of working as a Tele Nurse? 

  • Real-time impact on patient outcomes 

[I had a newly admitted observation patient who was decompensating and the doctor couldn’t figure out why. I decided to analyze her telemetry and found a third-degree block that had been missed by an EKG as well as the ER providers. We notified the cardiologist, and she went to the OR and a pacemaker was placed. She recovered and discharged home a couple of days later.]

  • Fast-paced, variable environment
  • Constantly advancing technology and education
  • Monitors provide a visual idea of patient status
  • Develop skills to holistically care for complex patients
  • Develop time management and prioritization skills
  • Connect with and support patients during a stressful time
  • Stepping stone to ICU or ED

What are some of the not-so-great parts of working as a Tele Nurse? 

It can be challenging to juggle regular nursing care and monitoring telemetry. 

  • Time management and prioritization are challenging
  • Learning curve can be intimidating
  • Turnover as nurses move to ICU or ED
  • Caring for high-risk patients can be too stressful for some nurses
  • Technology does not always function as expected

Share your favorite piece of advice for nursing new grads or students looking to become a Telemetry Nurse

Learn everything you can about the structure and electrical activity of the heart and constantly practice interpreting strips. We have a mantra in telemetry: 

If you know what IS normal, it’s easy to identify the ABNORMAL. 

If you love technology and connecting with patients, consider diving into telemetry nursing. It is an exciting specialty with the opportunity to learn continuously, interact with advancing technology, and become an expert nurse. 

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