Always Admit to TELE

2 Jul

At the end of my last shift………The ED calls to give report. The diagnosis: peri-prothestic hip fracture, male in his 50s. The nurse tells me that the orthodude tells her to “admit the patient to where we normally admit”   So I stopped her immediately. I says to her “This is tele not ortho…Don’t ya think the orthodude wants the patient admitted to the ortho floor?”  She actually admitted that her and the ED doc figured the patient should be admitted to tele for the high blood pressure with no history of HTN. What? The patient had 10/10 pain and a blood pressure that normalized after the administration of morphine!

This is one example of a totally inappropriate admission to telemetry. We are not even “set up” for ortho! So of course when the patient required traction–it took hours to get the equipment and then find and ortho nurse to come down and set it up for us.


I’m sticking to:  TELEMETRY/PCU

Ortho patients should go to the ortho floor.

It just seems unfair to us! Imagine the ED nurse calling the ortho floor to give report on a patient in a rapid A fib on a cardizem gtt and heparin gtt. ! All hell would break loose! The cool nurses on ortho would not manage that so why should I have to deal with bucks traction on a patient that is now normotensive with no cardiac history?

The bottom line is this: The ED nurse entered the admit to telemetry orders into the system before she got the order from the attending orthopedic surgeon: and the high blood pressure was the excuse to cover it. The bed was paged before she even got the order!! UNBELIEVABLE ! 

Admit to tele. Admit to tele. Admit to tele.

Don’t ever send me to ortho……….pleaaaaaaaaaase. It scares me!!!


8 Responses to “Always Admit to TELE”

  1. Wanderer July 2, 2009 at 10:36 #

    Don’t even get me started on that whole ball ‘o wax. GIB? Admit tele. Weakness? Admit tele. AMS/UTI? Admit tele. CHF exacerbation? Admit medicine. WTF?

    All true…

    The worst is when the confused LOL who has an ORIF of the hip then goes into AFib w/RVR post-op and gets sents to us. Then gets delirious on top of the dementia. It’s fun all around!

    • seejanenurse July 3, 2009 at 00:51 #

      Oh yaa! Or the post-op patient that gets transfered to tele for sinus tachycardia from the med/surg floor with orders to give Lopressor q 4 hours and a STAT cardio consult…the patient arrives white as a sheet with a hemoglobin of 6! screw the Lopressor! Didn’t anyone bother to get some labs post-op blood loss. duh.

  2. chiara July 5, 2009 at 01:37 #

    Hi dear! I’m Chiara, a nurse from Italy! Sorry for my English! I find your amazing blog bacause I was looking for an image about a nurse…strange life! I read your topic and I think: all the nursing word are the same!!! Where can I find more info about you? Where you live for example!
    A lot of CIAO CIAO from Italy and from the UCIC (unit for intensive coronaric care)

    • seejanenurse August 6, 2009 at 14:46 #

      Hello Chiara nurse from Italy! It does seem that we speak the same language that is medical language! 😀 Capiche? Thanks for the nice comment, I am so happy you like it! I live in the north east part of the states. What part of Italy are you in? Well you can always send me an email to ! :love: !

  3. Wanderer July 5, 2009 at 01:56 #

    Or worse, the patient who has a pH of 6.12 in florid metabolic acidosis gets sent to tele instead of the ICU (or at least step-down) where he proceeds to become hypotensive and altered, who then ends up in the unit anyways…

  4. Katheleen Roepke June 14, 2010 at 04:54 #

    Good wordpress post, I will save this post in my StumbleUpon account. Have a awesome evening.

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