How to Become a Telemetry Nurse

What is a Telemetry Nurse?

Telemetry nursing is an acute care specialty where bedside nurses use high-tech equipment to monitor patients' vital signs and overall health while admitted to a healthcare facility. 

Most telemetry nurses work in hospitals where they can monitor and manage acute disorders such as heart failure, diabetes, neurological problems, or other health issues.

Telemetry nursing is a challenging and high-stress environment. However, many nurses thrive working in the environment and derive great satisfaction from work. 

What Do Telemetry Nurses Do?

Telemetry nursing involves monitoring and collecting a patient’s vital signs and transferring that information to an electronic medical record (EMR) for healthcare providers to review.

Telemetry patients are typically at higher risk than those on a typical med/Surg floor. Therefore, telemetry nurses must be able to respond quickly to any physiological and neurological changes. 

Patient acuity in a telemetry unit is typically higher than in a Med/Surg unit. But telemetry patients are also not as sick or need as much monitoring as those in the intensive care unit (ICU).

Types of Patients Telemetry Nurses Work With

Examples of the types of patients who may need telemetry monitoring may include:

1. Patients with heart disease, heart failure, or an arrhythmia
2. Patients recovering from a cardiac procedure or other surgery
3. Patients with neurological illnesses, recovering from stroke or other neurotrauma
4. Patients with renal or liver failure
5. Cancer patients

Job Duties

Some of the tasks that telemetry nurses perform regularly include:

1. Patient assessments
2. Record medical histories and symptoms
3. Checking vital signs every four hours (or less if needed)
4. Monitoring patients very closely to observe for any changes in health status
5. Using medical equipment such as EKGs to monitor cardiac activity
6. Monitoring and recording vital signs such as temperature, heart rate, respiratory rate, and blood pressure
7. Monitoring and managing blood sugar when needed
8. Administering IV, oral and other medications
9. Providing patient education on their diagnosis and treatment modalities, medications, and other medical information
10. Assisting physicians in bedside procedures
11. Ensure patient's care plan and follow through with physician orders
12. Diagnostic testing
13. Explain how patients can care for themselves after discharge

Skills Needed

Telemetry nurses must have excellent critical thinking skills and enjoy working in a high-stress and bustling environment. 

Work Environment

Telemetry nurses most commonly work within the hospital setting. They most commonly work with patients who are not quite ill enough to need ICU care but still need more constant monitoring than a med/Surg unit could provide. 

Most telemetry nurses provide 3:1 care for patients. Most telemetry nurses have up to three patients at a time. However, nursing ratios vary significantly by state, with some telemetry nurses reporting that they take up to 4 or 5 patients at a time. 

Depending on the hospital and location, telemetry nurses may be found working in several types of hospital units:

1. Step-down units
2. Telemetry units
3. Med/Surg units
4. Emergency departments
5. ICUs
6. Pediatric floors
7. Oncology floors

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How to Become a Telemetry Nurse

You will need to go to school for a minimum of 2 to four years and become licensed to practice as a telemetry nurse. Here are the steps you’ll need to take. 

Step 1: Get a Nursing Degree

Obtain an associate of science in nursing (ADN) or bachelor’s of science in nursing (BSN) from an accredited nursing program. Your nursing program must be approved by your state’s nursing board and be accredited by the following accredited bodies:

• Commission of Collegiate Nursing Education (CCNE)
• Accreditation Commission for Education in Nursing (ACEN)

Failure to attend an accredited program will hamper your ability to take your nursing boards, get a job, and advance your education later on. 

Step 2: Pass the NCLEX

Upon graduation, you must pass the National Council Licensing Examination or NCLEX-RN.

Step 3: Gain Experience

Apply for a new nurse graduate program and gain valuable work experience. You can apply to work in a telemetry unit directly upon passing your NCLEX-RN. Some specialties that have telemetry areas include:

1. Cardiac
2. Liver and renal transplant
3. Neuro/trauma and stroke
4. Pediatrics
5. Oncology

Some hospitals also have combined med/Surg and telemetry patient units.

Step 4: Get Certified

Become certified as a telemetry nurse through the National Telemetry Association.

After working as a telemetry RN for 1-2 years, you can take your experience and study to become a certified telemetry nurse. Becoming certified lets your colleagues, managers, patients, and families know that you are a specialist in your field. Many institutions also over a wage increase for nurses who become certified. 

The Telemetry certification exam is in 180 minutes and has 303 questions. Students need a score of 85% or higher to pass. If you do not pass, you can retake the exam a maxim of 3 times within six months.

You may also consider earning your Progressive Care Certified Nurse (PCCN) certification.

Requirements to take the PCCN exam include:

1. At least two years or five years of experience (depending on what exam you wish to take).
2. Employment as an RN or APRN for 1,750 hours with acutely ill adults. 875 of those hours must be accrued in the most recent year before the exam.
3. The exam is $195 for American Association of Critical-Care Nurses (AACN) members and $300 for non-members.

Telemetry Nurse Salary 

According to the BLS, registered nurses of all specialties earn a median salary of $75,330 annually or $36.22/hr. While the BLS does not differentiate between different specialties of nursing, ZipRecruiter reports that telemetry nurses earn an average of $109,061 /year or $52 /hour. 

Keep in mind that many factors contribute to your salary as a telemetry nurse. Some factors include the cost of living in your city, the type of medical facility, and whether you work full-time or part-time.

How to Earn More as a Telemetry Nurse

You can try to increase your salary by:

1. Becoming certified 
2. Working nights or weekends, where you are paid a higher per-hour wage
3. Advance your education by earning a master’s of science in nursing (MSN) or higher
4. Work per diem or become a travel telemetry nurse
5. Train to be a preceptor for new hires on the unit
6. Become a charge nurse or manager or your unit

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Telemetry Nurse Career Outlook

As life-extending treatment becomes more reliant on technology, the demand for specialized telemetry nurses is growing even faster. 

According to the U.S. Bureau of Labor Statistics (BLS), the job outlook for all RNs between 2020-2030 is 9%, with an additional 276,800 nurses needed to fill jobs. The BLS does not provide a percentage specifically for telemetry nurses. However, telemetry nurses make up a large portion of nurses in the US. 

What are the Continuing Education Requirements for Telemetry Nurses?

The requirements for continuing education units (CEUs) for licensed registered nurses vary per state. Renewing your RN license in your state will be the same for all nurses, regardless of specialty. 

Some states may require that parts of your required CEUs be on specific topics, such as infection control, reporting child abuse, or pain management.

In most states, RN licenses must be renewed every two years, and a specific amount of CEUs must be submitted to your state's nursing board before the two-year deadline. Remember that CEUs don’t accrue, so you can't bank them for future use. 

Nurses generally must complete between 15-50 CEUs every two years for license renewal, depending on their state.

Renewing a telemetry nurse certification through the National Telemetry Association requires

• Renewal every two years
• Studying for and taking the original exam again
• Candidates can also renew their telemetry and EKG certifications by retaking the two exam

Renewing your PCCN certification requires:

• An unencumbered RN license
• Completing a minimum of 432 hours of direct care of acutely ill patients in the 12 months before the renewal date.
• Completion of education (called SERPs) in the following areas:
  • Clinical judgment and clinical inquiry
  • Advocacy/moral agency, caring practices, diversity, facilitation of learning
  • Collaboration and systems thinking

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Where Can I Learn More about Telemetry Nursing?

If you are interested in learning more about telemetry nursing, you may find the following links useful:

1. National Telemetry Association (NTA)
2. American Association of Heart Failure Nurses (AAHFN)
3. American Association of Critical-Care Nurses (ACCN)s 
4. Academy of Medical-Surgical Nurses (AMSN)

Telemetry Nurse FAQs

• what does a telemetry nurse do?

  • Telemetry nursing is an acute care specialty where bedside nurses use high-tech equipment to monitor patients' vital signs and overall health while admitted to a healthcare facility. This type of nurse monitors patients closely using medical equipment such as EKGs and telemetry monitors. Telemetry nurses keep a careful watch for any health status changes in their patients.

• how long does it take to become a telemetry nurse?

  • You will need to go to school for a minimum of two to four years and become licensed to practice as a telemetry nurse. The two routes include obtaining a 2-year associate of science in nursing (ADN) or a 4-year bachelor’s of science in nursing (BSN) from an accredited nursing program.

• is telemetry nursing easy?

  • Telemetry nursing is a challenging and high-stress career. Many nurses say that telemetry nursing is one of the most demanding specialties because it requires excellent critical thinking skills and intense focus to make sure your patient's health status remains stable. In addition, telemetry nurses work twelve-hour shifts and are on their feet most, if not the entire shift. However, many nurses thrive working in the telemetry environment and derive great satisfaction from the work.

• how do I become a telemetry nurse?

  • After earning an ADN or BSN, you will need to take and pass the NCLEX-RN to become licensed to practice in your state. Upon graduation, you must pass the National Council Licensing Examination or NCLEX-RN. Then you can apply for a new nurse graduate program and gain valuable work experience in telemetry nursing. You can apply to work in a telemetry unit directly upon passing your NCLEX-RN.

• is telemetry is the same as icu?

  • Telemetry and ICU nurses are both registered nurses with the same licensure. However, their roles are slightly different. Telemetry nurses take care of more stable patients who require constant monitoring to ensure that their health status remains stable. An ICU nurse’s patients are significantly more ill or have more severe injuries. Both specialties use telemetry equipment; however, the roles vary because of the difference in patient acuity.