Clinical nurse specialists and nurse practitioners may choose to sub-specialize in telemetry under a primary specialization in a particular patient population focus, and often in combination with other sub-specializations such as acute or critical care. Telemetry nurses work with critically ill patients who require the use of monitoring devices, such as those that measure heart rates, breathing rates, blood pressure, and oxygen levels. Nurses may monitor patients at their bedsides and provide medications and other support as needed, or provide remote telemetry services in which monitors for telemetry devices are in a central location, such as a nurses’ station.
Telemetry nurses fall under the category of progressive care nurse, as defined by the American Association of Critical Care Nurses (AACN), which supports nursing professionals, including telemetry nurses, who care for acutely and critically ill patients.
Progressive care/telemetry nurses work in hospital units that go by various names, such as telemetry units, intermediate care units, direct observation units, step-down units, or transitional care units. These units provide critical care to patients who require constant monitoring for a range of reasons, including recent surgery, heart attacks, congestive heart failure, renal failure, COPD, and advanced cancer.
Monitored patients may be those who are progressing from a more critical state to a less critical one, as is the case with post-operative patients, or from a less critical state to a more critical one, as would be the case with patients being prepared for surgery or those with a progressive life-threatening condition. Progressive care/telemetry units have become more common as hospitals experience a shortage of ICU beds, creating more demand for progressive care and telemetry nurses.
Skills required of telemetry nurses include:
- Basic cardiac rhythm monitoring techniques, interpretation, and treatment
- Basic and advanced life support
- Calculating drug dosage, administering continuous medication infusion, and monitoring patients for effects of medication
- Monitoring patients before, during, and after invasive procedures
- Recognizing the signs and symptoms of cardiopulmonary and respiratory emergencies and knowing how to start standard interventions to stabilize the patient
As a sub-specialization for advanced practice nurses, telemetry skills are typically gained on the job, as there are no graduate programs or post graduate certificates specific to telemetry. Employers hiring telemetry nurses typically look for a minimum of a bachelor’s degree in nursing along with technological and data interpretation skills. Nurses working in cardiac telemetry units often get there by taking courses that help them gain advanced electrocardiogram (EKG) skills. Employers looking to hire RNs to fill director of telemetry nursing positions will show preference to MSN prepared candidates.
Most hospitals require that telemetry nurses have certification in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) before they are hired. BLS training is available through various organizations, including the American Heart Association. It’s a short course that covers recognition of life-threatening emergencies, providing CPR, using an automated external defibrillator (AED), and relieving choking. ACLS picks up where BLS leaves off. Certification requires taking an ACLS course and passing an exam. Certification is valid for two years.
Telemetry nurse can become certified through the AACN Certification Corporation. Certification applicants must have a current, unrestricted RN license. Certifications available to telemetry nurses include the following:
- The Adult, Neonatal and Pediatric Acute/Critical Care Nursing certification exams award the designation Critical Care Registered Nurse (CCRN). Candidates must have 1,750 direct bedside care practice hours working with acutely or critically ill patients during the two years prior to applying (875 hours in the past year). Two separate exams are available: one for adult CCRN and one for pediatric/neonatal CCRN. Nurses who work with both adult and pediatric patients can choose to take both exams. Each exam contains 150 questions, of which 80 percent focus on clinical judgment and 20 focus on professional caring and ethical practice.
- The Tele-ICU Adult Acute/Critical Care Nursing Certification (CCRN-E) is specifically designed for nurses who remotely monitor adult patients in tele-ICUs. Candidates must have 1,750 hours of experience caring for acutely/critically ill adult patients during the two years prior to applying (875 hours in the last year). Tele-ICU or combined tele-ICU and direct bedside care hours are acceptable.
- The Adult Progressive Care Nursing Certification exam awards the designation Progressive Care Critical Nurse (PCCN). Candidates for the PCCN exam must have 1,750 hours providing direct bedside care of acutely ill adult patients during the past two years. Of those hours, 875 must have been in the past year. Eighty percent of the 125-question PCCN exam focuses on clinical judgment related to caring for adults and the other 20 percent covers ethics and professional caring.
All three certifications are valid for three years. Renewal of certification requires accumulating 100 Continuing Education Recognition Points (CERPs). CERPs are accumulated through continuing education classes, professional activities, and experience.
The AACN Certification Corporation also certifies advanced practice nurses in critical and acute care:
- Critical Care Nurse Specialist (CCNS) certification is for clinical nurse specialists who care for acutely and/or critically ill patients. There are separate exams for nurses who work with adult, pediatric, or neonatal patients.
- Acute Care Nurse Practitioner (ACNPC) certification is for acute care nurse practitioners who care for adult patients with complex acute, critical, and/or chronic health conditions.
The American Board of Cardiovascular Medicine and Credentialing offers certification for Cardiovascular Telemetry Nurses.
The 2011 ADVANCE for Nurses salary survey found the following average salaries for all critical care nurses by region of the U.S.
For acute care nurse practitioners, the 2011 AANP National NP Compensation Survey found the average base salary was $96,580.