Any Advice for a New Grad RN starting at a Post Cardiac Surgery Unit?

bklynbaby · Nov 9, 2009

Hey and Congratulations on your job

I spent three years working in a CT surg stepdown fresh out of school. So I remember having that anxious feeling.

First of all I hope you have a good orientation with a knowledgeable nurse educator that will give you all the necessary classes that you will need.

Another factor is your preceptor. A preceptor can make or break you. If you find that for whatever reason things are not working out with the preceptor do not be scared to talk to the nurse manager about the situation. I have seen so many good nurses with bad preceptors who end coming off orientation not adequately prepared. I have also seen good nurses who do not get along with their preceptors and they end up leaving halfway through. I hate to say it but nurses do tend to eat their young.

I would suggest you brush up on everything cardiac. You will probably get classes but they may not cover everything. Surgical procedures like CABG, valve replacements, valve repairs, aortic aneurysm repair these are things you will see. Depending on your hospital you may also get heart transplants. Patients will have chest tubes, and drains. Know your ECG readings, arrythmias, both the causes and treatments for arrythmias. Certain meds like beta blockers, inotropes, antiarrythmics, and anticoaugulants like coumadin. I am not saying you should spend hours reading up. But every now and then open a book and refresh your knowledge.

I would also suggest that you take ACLS even if your unit does not require it. A critical care course and definitely a telemetry course should be part of your orientation.

Another thing is to keep a little note pad and write things down that your preceptor may tell you. There are many things you will learn that are not taught in school. Another thing to jot down is hospital phone numbers, doctors pager numbers, extensions for when you need that chest xray, number to the lab etc..

Take your time do not rush. There may be days when you will leave late but thats ok. Rushing leads to mistakes. Try to stay organized write things down if you have to. I remember I used to write my pts names and then write what I needed to do for them with little check boxes (ie. meds, labs, dressing changes), and then as I do it I check it off. After awhile it will be second nature and you won't need little memos to remember things.

Another important thing to remember is good charting. If it was not charted then it was not done.

Be confident in what you know but please do not be afraid to ask questions. Do not fake the funk so to speak by pretending to know something that you dont. Thats how mistakes are made.

CT surgery is defintely a good way to start your nursing career. You learn so much. GOOD LUCK. :specs:

DominiRN09 · Nov 9, 2009

WOW thanks for some great advice. I really do appreciate it! I have been brushing up on cardiac and studying my meds, but it is great you told me exactly what I should focus on. I will be studying more. I start next month so I have time. Also, They told me after 6 months I will get my ACLS from them. They like to wait after the 6 month period just in case I decide to leave and I basically got that for free from them. They don't want to waste money on me to find out that I leave them, you know? Anyway I think I will learn how to juggle things starting off as an RN because I was a CNA for many years and I have an idea what to expect. I am not saying that I will be an expert as a new gred, but I think my skills that I have as a cna will really help me in the beginning compared to other new RNs. I will definitly carry a little notebook to jot things down until it becomes second nature to me. I am praying that I have a great Preceptor also. I am so excited to start!! Thanks again for the great advice!!!

bklynbaby · Nov 9, 2009

You are welcome. You will do fine.

niteowlrn29 · Dec 2, 2009

i was a new grad and started out on the same floor. it was very scary starting out but eventully it becomes second nature. you certaintly will learn a LOT and i am told cardiac is a GREAT foundation for nursing. i have been there for just a little over a year. your preceptor certaintly does make a difference. i got a person who just kind of does just enough to get by and it showed to me. i wish i had the nerve to speak up but didn't. i still learned the fundamentals of what i needed to like paperwork, charting..... stuff like that. but i wanted more. so i would encourage you to if it just isn't working out with the preceptor to let them know. another piece of advice is trying to figure out a worksheet is the basis of having an organized day. it has taken me almost a year what works for me. so keep experiementing with different sheets until you find what works for you. good luck with your new job and congratulations!!!

DominiRN09 · Dec 3, 2009

Thanks for the great advice. I am very excited to start! I start Dec 14th and I am anxious! I have been studying all cardiac meds/EKGs etc and I feel pretty ready because I have been working as a home care RN for a month now. Also, having been a nurse aide in the past also makes me feel more comfortable. I can't wait! :yeah: