Question: Can you please tell me the acceptable standards for use of a telemetry technician?

Complete Question: Can you please tell me the acceptable standards for use of a telemetry technician? I have reviewed an issue where the technician is not trained in reading rhythms but would alert the RN if an alarm rings. I am concerned about the RN’s liability in that circumstance.

Some RNs are asked to be responsible for the monitors plus charge responsibilities so cannot watch the monitors consistently and could easily miss an early change in rhythm. Some floors have the secretary or an aide "watching" the monitor -- while performing other tasks.

I cannot find a standard for telemetry, and the responsibility of observing the monitor is doled out very differently in some facilities. It seems the nurse is ultimately responsible for a change in the patient's condition but is not afforded the help s/he needs to be able to properly assess that patient. Do you have any guidelines?

Answer: The standard of practice is that telemetry technicians are trained either through a hospital-based program or an institutional program (such as those credentialed by the Commission on Accreditation of Allied Health Professionals). Facility based programs include didactic courses, on-the-job clinical training, and successful completion/validation of rhythm recognition courses.

We did not find one specific credentialing program to recommend, as these vary as will the needs of organizations seeking education for their staffs. The role of the technician is not one that can be passed on to non-skilled employees to "watch the monitor".

Rhythm recognition is a skill and can only be performed by person trained to do so. Accurate observation of the monitors, reporting of rhythm changes, and detailed record keeping are key components of the technician role.

The R.N. is capable of these skills if also trained in rhythm recognition. The R.N. would assume increased liability only if delegating a task to a person untrained for that task.

You will want to refer to your state’s nurse practice act where delegation should be clearly outlined.

(Published 2013)