Telemetry Nurse Job Description Template

Job Overview

The Telemetry Nurse provides continuous cardiac monitoring and clinical care for patients with cardiac diagnoses or at risk for arrhythmias, reporting to the Telemetry Unit Charge Nurse or Nurse Manager. Telemetry units sit at the intersection of medical-surgical nursing and critical care: the patients are too stable for the ICU but too unstable to be left without continuous monitoring. The nurse who thrives here is one who can recognize a rhythm strip that has shifted from benign to dangerous, notify the team before the patient feels the difference, and manage a complex medication regimen for a post-cardiac-catheterization patient while simultaneously managing 4-5 others. Success is measured by cardiac event response times, unplanned ICU transfer rates, and length-of-stay compliance with cardiac pathway benchmarks.

Key Responsibilities

• Continuously monitor cardiac telemetry waveforms for all assigned patients, interpreting rhythm changes and escalating per unit protocol within defined response timeframes.

• Identify and document cardiac arrhythmias including atrial fibrillation, SVT, heart block (first, second, third degree), PVCs, and life-threatening rhythms requiring immediate intervention.

• Administer and titrate cardiac medications including antiarrhythmics, anticoagulants, beta-blockers, and vasopressors per physician order and unit protocol.

• Perform comprehensive assessments of patients with ACS, CHF exacerbation, post-cardiac catheterization status, and electrolyte abnormalities at defined intervals.

• Manage post-procedure care for patients following cardiac catheterization, cardioversion, pacemaker insertion, and EP study, monitoring access sites and maintaining hemostasis.

• Respond to and lead cardiac arrest calls within the telemetry unit, initiating BLS/ACLS until the rapid response or code team arrives.

• Interpret 12-lead ECGs and report findings to the provider, recognizing STEMI patterns and escalating per chest pain protocol without delay.

• Manage external pacemakers, temporary transvenous pacemaker leads, and cardiac monitor settings per cardiologist specifications.

• Administer IV heparin drips per weight-based protocol, monitoring PTT results and adjusting infusion rates per titration guidelines.

• Educate patients and families on cardiac diagnoses, medications, lifestyle modifications, and follow-up requirements prior to discharge.

• Collaborate with cardiology, pharmacy, respiratory therapy, and case management for complex cardiac patient management and discharge planning.

• Document all rhythm interpretations, interventions, and provider notifications accurately and in real time in the EHR.

Required Qualifications

• Active, unrestricted RN license in the state of practice; BSN preferred.

• Current ACLS (Advanced Cardiovascular Life Support) certification required.

• Current BLS certification.

• Basic arrhythmia interpretation certification or demonstrated competency in cardiac rhythm recognition required at hire.

• 1-4 years of telemetry, progressive care, or medical-surgical nursing experience with direct cardiac patient management.

• Demonstrated ability to interpret common cardiac rhythms and 12-lead ECGs independently.

• Experience managing anticoagulation therapy and post-cardiac procedure care.

• Proficiency with telemetry monitoring systems and EHR documentation (Epic, Cerner).

Preferred Qualifications

• PCCN (Progressive Care Certified Nurse) from AACN.

• Advanced arrhythmia interpretation certification.

• Experience in a Level I or Level II cardiac catheterization program.

• ICU or step-down unit experience caring for hemodynamically unstable patients.

• Temporary transvenous pacemaker management experience.

Essential Skills and Competencies

Technical Skills

• Continuous cardiac rhythm interpretation and arrhythmia identification

• 12-lead ECG acquisition and interpretation

• Cardiac medication management: antiarrhythmics, anticoagulants, vasoactive agents

• ACLS algorithm execution and code team participation

• Heparin drip management and PTT-based titration

• Post-catheterization and post-cardioversion care

• External and temporary pacemaker management

Soft Skills

• Pattern recognition alertness over long shifts without alarm fatigue

• Rapid, clear provider notification using SBAR format

• Calm leadership during cardiac emergencies in patient rooms

• Patient education on complex cardiac conditions at accessible health literacy levels

• Collaborative communication with cardiology and multidisciplinary teams

Salary Range and Benefits

Salary Overview

Telemetry nurses earn $78,000 to $100,000 annually across most U.S. markets, anchored by the national RN median of $86,070 (BLS, May 2023). The PCCN certification from AACN commands a measurable premium, typically 6-10% above base. Night shift differentials add substantially to total compensation. Hospitals with active cardiac catheterization labs tend to pay toward the upper end of this range for nurses with post-cath experience. Source: U.S. Bureau of Labor Statistics, May 2023; PayScale, 2025.

Top-Paying Areas

• San Francisco Bay Area, CA ($106,000 - $128,000)

• Seattle, WA ($98,000 - $119,000)

• New York Metro, NY ($97,000 - $118,000)

• Boston, MA ($95,000 - $115,000)

• Los Angeles, CA ($93,000 - $112,000)

Benefits Package

Telemetry nursing positions typically offer medical, dental, and vision coverage, 401(k) with employer matching, 3-4 weeks PTO, and ACLS/PCCN recertification support. Night and weekend shift differentials are standard. Most facilities offer tuition assistance and clinical advancement programs for nurses pursuing BSN or MSN degrees.

Warning Signs When Evaluating Telemetry Nurse Candidates

• Cannot distinguish between second-degree Type I and Type II heart block on a rhythm strip: These rhythms have very different clinical implications. A candidate who cannot tell them apart presents a monitoring risk on a unit where rhythm recognition is the primary safety function.

• Describes themselves as comfortable with "basic rhythms only": Telemetry patients present with complex and rapidly evolving arrhythmias. A self-limited arrhythmia interpreter will require excessive supervision and is a poor fit for independent telemetry practice.

• Has never managed a heparin infusion protocol independently: Anticoagulation management is a daily telemetry nursing responsibility. Candidates without this experience will need substantial bridge training before independent practice.

• No experience with post-cardiac catheterization care: Most telemetry units receive post-cath patients. Candidates without this experience require more orientation time and closer supervision during the learning curve.

• Cannot describe alarm management strategies or the risks of alarm fatigue: Alarm fatigue is one of the leading contributors to preventable cardiac events in monitored units. Candidates who have not considered this risk have not thought critically about telemetry safety.

Frequently Asked Questions

Q What does a telemetry nurse do?
A A telemetry nurse continuously monitors cardiac rhythms for patients at risk of arrhythmias, identifies rhythm changes requiring intervention, administers cardiac medications, manages post-procedure care after catheterization or cardioversion, and responds to cardiac emergencies. They care for 4-5 patients simultaneously in a progressive care setting.

Q What qualifications do you need to be a telemetry nurse?
A You need an active RN license, current ACLS and BLS certifications, and demonstrated arrhythmia interpretation competency, typically through formal certification. Most facilities require 1-4 years of experience in telemetry, progressive care, or med-surg nursing. The PCCN credential from AACN is the recognized specialty certification.

Q How much does a telemetry nurse make?
A Telemetry nurses earn $78,000 to $100,000 annually, anchored by the national RN median of $86,070 (BLS, May 2023). PCCN certification adds 6-10% to base compensation. Night shift differentials and experience in active cardiac catheterization programs push total compensation above the median.

Q What skills are required for a telemetry nurse?
A Telemetry nurses need continuous cardiac rhythm interpretation, 12-lead ECG recognition, ACLS competency, cardiac medication management (antiarrhythmics, anticoagulants), and post-procedure care expertise. Equally important are pattern recognition under alarm-heavy conditions, rapid SBAR communication, and calm leadership during cardiac emergencies.

Q What is the career path for a telemetry nurse?
A Telemetry nurses advance to charge nurse, cardiac catheterization lab nurse, or step-down unit lead. With PCCN and additional experience, they can transition to ICU, cardiac ICU, or electrophysiology settings. Management paths include Progressive Care Unit Manager and Cardiovascular Services Director roles.

Q What are the biggest challenges facing telemetry nurses today?
A Alarm fatigue is the most pervasive safety risk in telemetry nursing, contributing to desensitization to legitimate monitoring alerts. Patient acuity on telemetry units is rising as ICU capacity constraints push more complex patients to progressive care. Staffing ratios above four patients per nurse compromise the monitoring vigilance the unit depends on.