When a patient is admitted to the hospital with a heart problem, a telemetry nurse takes care of them. In a medical setting, telemetry refers to a cardiac monitor with five electrodes stuck with adhesive to different areas of the torso. The telemetry monitor captures electric signals coming from the heart muscle and can provide valuable clues as to how well a patient’s heart is functioning. Telemetry nurses must also be able to perform and interpret electrocardiograms (EKG or ECG), which involve more electrodes and a fuller picture of cardiac events.
Patients of any age may be monitored by a telemetry unit, so telemetry nurses can treat newborns, children, teenagers, adults, and older adults. Telemetry nurses use their strong knowledge of the heart and telemetry readings to collaborate with their patient’s medical team and are often the first to notice a change in a patient’s condition.
Where Do Telemetry Nurses Work?
Telemetry nurses typically work in hospital units, but with the emerging availability of telemedicine, some nurses can work from home to monitor telemetry device outputs. In the hospital, many different units have patients on telemetry, but some units are devoted to heart health.
A cardiovascular intensive care unit (CICU) offers a higher level of care. In a CICU, the telemetry nurse will have fewer patients. These patients are at a higher risk of cardiac events, so the nurse needs to be able to focus on their telemetry changes.
After a patient becomes more stable, they may be moved to a cardiac floor. In a unit like this, the telemetry nurse may have 4-6 patients. These units usually have monitors set up in the nurse’s station, showing each patient’s telemetry readout in real time. Some hospitals also have telemetry techs to provide a second set of eyes on these live results.
If a telemetry nurse works in telemedicine, they will have a computer or other monitoring device that connects with each patient and delivers their telemetry results live or at scheduled times throughout the day. In telemedicine, the telemetry nurse may work in an office setting with other telemetry professionals or may be permitted to work from home.
What Does a Telemetry Nurse Do?
A telemetry nurse’s number one responsibility is to monitor their patients’ cardiac electrical activity. They work closely with physicians, nurse practitioners, physician assistants, telemetry technicians, and patient care associates to provide well-rounded care for each patient. As they collaborate with this team, they can catch problems early and act fast when needed.
Telemetry nurses in the hospital have many of the same responsibilities as any other registered nurse (RN). These include:
Administering medications
Collaboration with physicians, nurse practitioners, patients, and families
Coordinating care with other departments
Collecting laboratory samples of blood and other bodily fluids
Dressing changes
Emergency resuscitation
Head-to-toe assessment
Keeping patients clean and comfortable
Managing central lines like ports and PICCs
Managing foley catheters
Monitoring and taking vital signs
Patient and family education
Starting and accessing IVs
Transporting patients
A typical day could start with a quick round to each patient, “eyeballing” them, and addressing any urgent needs. Most hospitalized patients have scheduled morning medications, and the telemetry nurse may do their assessment as they deliver morning meds.
Telemetry nurses have to stay alert to any new symptoms, and any changes to their telemetry monitors. If the telemetry shows something concerning, physicians will often order a STAT EKG–to be done right away. The telemetry nurse will attach 12 leads to the patient at different points all over the patient’s body, and run the test. Then, the nurse and physician decipher the results and plan a course of action.
Depending on the unit, the telemetry nurse will need to print out a telemetry strip–a short sample of each patient’s heart rhythm–and analyze it for their chart. This shows the nurse is watching and provides a baseline of cardiac activity. If a patient has a certain rhythm, like a bundle branch block, for example, this record can let the oncoming nurse know that this is normal for that patient.
How Do I Become a Telemetry Nurse?
To become a telemetry nurse, candidates must first graduate from an accredited nursing program with their Bachelor of Science in Nursing (BSN). After graduation, nurses can apply to a telemetry unit as new graduates. A graduate nurse (GN) on a telemetry unit will work alongside an experienced preceptor, who will teach them important telemetry concepts and orient them to the flow of that unit.
To become a fully-qualified RN, nurses must pass the state licensing exam: the NCLEX-RN. A series of multiple-choice questions, this standardized test shows a nurse’s clinical knowledge and capability to begin practicing solo.
After a telemetry nurse passes the NCLEX, they may have more orientation to complete, or they may be ready to take patients on their own. After a few years of experience, telemetry nurses may want to seek out specialized certification.
No one entity manages telemetry nurse certifications, so candidates must research their options and decide which certification would be best for them. Often, their unit may have suggestions, or may even offer certification through the hospital.
The National Telemetry Association (NTA) offers several paths to certification. Their full telemetry certification course costs $529 and allows two examination attempts. Telemetry nurses who feel confident in their clinical knowledge may take the exam without the course for $199, and they also offer review courses. The NTA does not require any experience before taking the course or exam.
PCCN(Progressive Care Certified Nurse): for nurses who provide direct care to acutely ill adult patients in any setting.
CMC(Cardiac Medicine Certification): for nurses who provide direct care to acutely/critically ill adult cardiac patients.
CSC(Cardiac Surgery Certification): for nurses who provide direct care to critically ill adult cardiac surgery patients in the first few days after surgery.
To apply for any of these certifications, a nurse must be licensed as an RN or APRN (advanced practice registered nurse). Additionally, nurses must show evidence of 1,750 hours of direct care of critically ill patients during the previous two years, with the last 875 in the past year. They can also have 2,000 hours of critical care experience from the past five years, with 144 of those hours obtained in the past year. The cost for examination is $200 for AACN members and $305 for non-members.
How Much Does a Telemetry Nurse Make Per Year?
A telemetry nurse makes the same amount as a registered nurse (RN), averaging $81,220 per year as of 2022, according to the US Bureau of Labor Statistics (BLS). This amount can vary depending on your work setting and the cost of living in the area. The low-end average was $61,250, and the high-end was $129,400. Depending on where you work, your employer may be able to offer higher or lower compensation:
General Medical and Surgical Hospitals: $90,600
Telehealth: $95,179
Salaries also vary depending on which state a telemetry nurse practices. The west coast generally pays nurses the best, but they also have a higher cost of living.
The west coast, New England states, Minnesota, and Alaska pay telemetry nurses the highest wage, but the cost of living in these areas can also be high. The lowest paying states are in the Midwest and some southeastern states.
The top paying areas for telemetry nurses include:
Federal Way, WA: $114,802
Santa Clara, CA: $112,774
San Francisco, CA: $112,461
Washington, DC: $110,194
Los Angeles, CA: $109,885
San Jose, CA: $109,620
Fremont, CA: $108,916
San Buenaventura, CA: $108,294
Oakland, CA: $108,215
Marysville, WA: $107,742
Certified telemetry nurses can be paid more than a nurse who is not certified, depending on the facility. In general, the more experience and proof of expertise, the more a telemetry nurse will be able to earn.
What Are the Benefits of Being a Telemetry Nurse?
A knowledgeable telemetry nurse stands in the gap between good and bad outcomes for cardiac patients. They get to look at their patients’ heartbeats throughout the day and are often the first people to notice a change for the better or worse.
As a telemetry nurse, you can:
Become proficient in reading telemetry strips and EKGs
Easily pivot to emergency medicine or other ICU roles
Gain experience with emergency management like ACLS
Help save lives
Work in telemetry units, cardiac ICUs, or cardiac step-down units
Telemetry nursing is fast-paced and challenging. Nurses who take a telemetry route learn a lot, and fast. Being able to interpret telemetry and EKG results is a coveted skill, and can allow a nurse to work in just about any other nursing role if they want a career change later.
Are Telemetry Nurses in High Demand?
According to the American Heart Association (AHA), every 34 seconds, an American dies from cardiovascular disease. Incidence of heart disease rose 8.5 percent for adults ages 45 to 64 between 2010 and 2020, according to the American Association of Retired Persons (AARP). With an increase in heart disease, telemetry nurses will only become more in demand.
The United States is facing a major nursing shortage. According to the US Department of Health and Human Services, 24% of US hospitals have reported critical staffing shortages, and at least eight states have had to call in help from the military for staffing. Telemetry nurses hold a very specific skill set that will stay in high demand for years to come.
Additional Resources About Becoming a Telemetry Nurse
To learn more about becoming a telemetry nurse, these additional resources may help:
NursingEducation strives to provide information that is up-to-date and unbiased. By engaging professionals from multiple healthcare perspectives, we ensure our content contains accurate information that helps our readers.
We have combined decades of experience teaching, publishing research, and working with patients in all fields of medicine to create accurate and straightforward online education. Once written, each article undergoes a rigorous peer-review process to bring you the highest quality, most comprehensive content possible.
Our writers receive feedback from reviewers to clarify content, prevent misleading statements, and identify areas that would benefit from more information. Our subject matter experts and reviewers generally work full-time in their professions and work for NursingEducation part-time.
