Serves as a Medical Technician (Telemetry) on a Medicine/Telemetry ward with surgical overflow. Responsible for performing duties relating to cardiac monitoring, EKG monitoring and miscellaneous clerical duties under the supervision of a Registered Nurse (RN) or the NCOIC. Provides status reports to nursing staff at regular intervals and as requested; maintains appropriate records and reports.
1. Observes cardiac/EKG monitoring of patients continuously during assigned work period; interprets a variety of conditions and elements such as patient condition, medication or instrument performance to be sure of test results; monitors and records findings; and provides status report to charge RN.
- Obtains and posts rhythm strips on admission in patient records every 4 hours and more frequently if ordered by physician or nurse. Interprets rhythm strips to include rate (atrial and ventricular), PR interval, QRS interval, rhythm, ectopic beats and ST parameters. Documents the interpretations on the strips and posts in patient records. Seeks promptt assistance from appropriate staff for rhythm interpretation beyond expertise. Records and identifies all changes occurring in the patients? baseline cardiac rhythm and notifies nursing staff of changes as they occur.
- Identifies life threatening arrythmias, and takes immediate action. Alerts nursing staff, checks patient, if necessary, and calls a ?code blue? to activate the emergency response team. Connects patient immediately to the emergency equipment such as the cardiac defibrillator, and assuring proper lead placement and settings of the defibrillator.
- Records cardiac rhythms during cardiac arrests and resuscitation, cardioversion and during the administration of intravenous push medications such as digoxin, verapamil, adenosine, etc.
- Performs 12 lead EKGs, routine or emergency. Instructs, positions and prepares patients; attaches electrodes to patients? chest and extremities to record prescribed heart tracing. Manipulates the controls and programs information into the electrocardiogram computer to provide tracing. Checks recording and highlights any abnormal tracing caused by external action or conditions. Determines when an EKG is required, and notifies the nurse.
- Reviews arrhythmia sheet and parameters every shift and retrieves trends after review, if requested by physician or nurse.
- Operates/utilizes monitoring system to full capacity. Admits patients to the monitoring system, setting alarms per nursing staff directions or based on protocol, adjusting gain, and setting proper lead(s). Responds appropriately to all alarms IAW unit policies.
- Identifies and analyzes factors related to equipment operation and patient responses to discern their interrelationships. Varies procedures to adjust for patient medical condition or upon sudden onset of physical signs or symptoms of distress by the patient.
- Communicates with the nursing personnel when changes in the monitoring parameters are required for a particular patient, and when changes in electrode placement are required.
- Performs complete system check at the beginning of every shift to include alarms, dysrhythmia analysis and patient identification.
2. Performs various support duties:
- Notifies supervisor of equipment problems. Initiates action to correct problem. Writes necessary work order to Medical Maintenance and communicates problem to them. Maintains adequate stock of monitor supplies: paper, batteries. Initiates orders as needed. Maintains cleanliness of transmitters and monitoring station per manufacturer and unit guidelines. Instructs new employees on complete monitor use, and signs off their orientation paperwork.
- Performs clerical duties to include but not limited to answering the telephone and call bells (at the desk), recording messages, organizing patient records, stamping forms, putting packets and charts together, taking charts apart. Uses automated systems to create/delete files, search files and records, store or extract material.
Performs other duties as assigned.
FACTOR 1. KNOWLEDGE REQUIRED BY THE POSITION, Level 1-3, 350 points
Knowledge of the anatomy and physiology of the heart and conduction system, to include location and function of the organs and structures.
Knowledge of the common diseases and their effects associated with the cardiovascular system. Understands terms used to describe electrocardiographic findings. Interprets heart rhythms and has the knowledge and understanding of what action is necessary; identifies normal heart rhythms and dysrhythmias.
Knowledge of pharmacology and chemistry to understand drug action, effects and method of administration, especially cardiac/vasoactive drugs used, in order to observe for desired and undesired effects.
Knowledge of blood chemistries/electrolytes and their effects on the cardiovascular system.
Knowledge and skill to use specialized equipment such as, but not limited to, cardiac monitoring devices to include telemetry units, EKG machines and cardiac defibrillators.
Knowledge of lead placement for each type of specialized equipment and the ability to change from one system to another.
Ability to evaluate the quality of rhythm strips and determine appropriate machine adjustments or lead placement changes. Determines when equipment needs maintenance or repair.
Knowledge of and skill to start emergency cardiac arrest procedures and monitor vital signs during emergency situations.
Interpersonal skills to communicate monitoring findings to staff and to work with patients and families experiencing cardiac illness.
Verbal communication skills to convey technical aspects of work to students, technicians, new employees, contract employees, interns and residents. Ability to provide progress report on patients? conditions relative to cardiac rhythm and electrocardiogram.
Knowledge of cardiopulmonary resuscitation.
Knowledge of and ability to use computer systems on the unit such as Composite Health Care System (CHCS), Uniform Chart of Accounts Personnel System (UCAPERS), Clinical Information System (CIS) and Microsoft Office.
FACTOR 2. SUPERVISORY CONTROLS, 2-2, 125 points
Performs duties independently under the general supervision of the Head Nurse/Charge Nurse or NCOIC. Receives information concerning what conditions can be anticipated, possible problems, quality and quantity of work expected, priority of assignments and applies methods to be used, adapting to each specific case. Independently carries out assignments referring deviations from regular procedures, unanticipated problems and unfamiliar situations not covered by instructions to supervisor for decision or help. Uses judgment and initiative in selecting procedures, observing if instruments are functioning properly and choosing the best test results. Work is reviewed by supervisor's evaluation of the efficiency of the operation of the service and on spot-checks of employee's performance with individual cases.
FACTOR 3. GUIDELINES, Level 3-2, 125 points
Guidelines include pertinent Army Regulations, Womack Army Medical Center Regulations and Memos, JCAHO Accreditation Manuals for Hospitals, instrument manuals containing instructions for the assembly and maintenance of the medical instrument, and unit level SOPs. Within the established guidelines, uses independent judgment in the performance of duties and whether or not to repeat, modify or immediately notify staff of monitoring results. Identifies and selects the appropriate guideline, reference or procedure; makes minor deviations to adapt the guidelines in specific cases and resolve problems.
FACTOR 4. COMPLEXITY, Level 4-3, 150 points
Exercises independent judgment involving the various duties associated with monitoring cardiac/EKG rhythms, changes and abnormalities of critically ill and potentially critically ill patients. Recognizes significant changes and/or abnormalities, adjusts procedures and takes appropriate action. Identifies and analyzes factors related to equipment operation and patient responses to discern their interrelationships. May change procedure based on sudden onset of physical signs or symptoms of distress by the patient. Responds to emergency situations. Identifies life threatening arrythmias and takes immediate action by alerting the team, observing the patient, and if necessary calling a ?code blue? to activate the emergency response team.
FACTOR 5. SCOPE AND EFFECT, Level 5-2, 75 points
The work involves performance of varied procedures and treatment techniques in providing continuous cardiac/EKG monitoring for diagnosis and treatment of patients with cardiac disease and other medical problems. The monitoring results affect the accuracy and reliability of physician's diagnoses and treatment and thus the quality of patient care; the monitoring results provide patient information which may ensure timeliness of life-saving interventions.
FACTOR 6. PERSONAL CONTACTS, Level 6-1, 30 points
FACTOR 7. PURPOSE OF CONTACTS, Level 7-a
Contacts are with hospital personnel?doctors, nurses, technicians and students, patients and their families, normally within a structured setting.
Personal contacts with nursing and medical staff are to provide continuous reports of monitor patterns on all patients, including any changes or abnormalities. Other contacts with staff include teaching use of the monitoring system, counseling, training and administrative issues. Additional contacts with patients or family members may occur at the nurses? station/central monitoring station.
FACTOR 8. PHYSICAL DEMANDS, Level 8-2, 20 points
The work requires regular and recurring physical exertion to include walking, bending, reaching and stretching to set up and take apart equipment; lifting and positioning patients; retrieving and filing documents and patient charts; and carrying, pushing or pulling moderately heavy objects.
FACTOR 9. WORK ENVIRONMENT, Level 9-2, 20 points
Work is performed in a hospital environment setting involving regular and recurring exposure to infectious and contagious diseases, odors and other risks which require special health and safety precautions such as wearing protective clothing such as gloves, masks, etc.
Total Points: 895
Point Range: (855-1100) = GS-05
1. Availability Pay Exemption - (e.g., Criminal Investigators, U.S. Customs and Border Protection pilots who are also Law Enforcement Officers).
2. Foreign Exemption - (Note: Puerto Rico and certain other locations do not qualify for this exemption See 5 CFR 551.104 for a list of Nonexempt areas.)
3. Executive Exemption:
a. Exercises appropriate management responsibility (primary duty) over a recognized organizational unit with a continuing function, AND
b. Customarily and regularly directs 2 or more employees, AND
c. Has the authority to make or recommend hiring, firing, or other status-change decisions, when such recommendations have particular weight.
4. Professional Exemption:
a. Professional work (primary duty)
b. Learned Professional, (See 5 CFR, 551.208 ) (Registered Nurses, Dental Hygienists, Physicians Assistants, Medical Technologists, Teachers, Attorneys, Physicians, Dentists, Podiatrists, Optometrists, Engineers, Architects, and Accountants at the independent level as just some of the typical examples of exempt professionals). Or
c. Creative Professional, (See 5 CFR, 551.209 ) (The primary duty requires invention and originality in a recognized artistic field (music, writing, etc.) and does not typically include newspapers or other media or work subject to control by the organization are just some examples of Creative Professionals). Or
d. Computer Employee, (See 5 CFR, 551.210 ) ( must meet salary test and perform such duties as system analysis, program/system design, or program/system testing, documentation, and modification). Computer manufacture or repair is excluded (non-exempt work).
5. Administrative Exemption:
a. Primary duty consistent with 5 CFR 551 (e.g.; non-manual work directly related to the management or general business operations of the employer or its customers), AND job duties require exercise of discretion & independent judgment.