0Jul 28, '12 by atomic_pedalHello everyone I'm a charge nurse on a CV-PCU unit and am currently working on a project to improve our CABG teaching. I will be redoing our CABG video that will be on a channel that they can flip to (instead of an old VHS tape lol).
I am thinking of beginning with an introduction by one of our CV surgeons and then follow through the process from the day/night before surgery all the way through outpt cardiac rehab. I want to show nurses from each area (Tele, PreOp, ICU, PCU, Cardiac Rehab) I have an employee who recently had a CABG that has agreed to be our "actor". Not every section will be acted, ex. the cvor nurse will just be talking and telling what will happen the morning of surgery, where the family can wait and how and when they will be contacted. The ICU nurse will be shown in the ICU room talking about the experience of coming out of anesthesia and how she will assist with communication and a brief overview of the many tubes/lines etc. She will also talk about when the family can visit and general ICU visitation rules. The acting will happen as the pt comes to pcu and I want to show our actor doing cardiac rehab (chest tube and all) and how to get up from the bed/chair (sternal precautions) and goals: IS, pain mgt, wound care etc. Also I want one of our Cardiologist to discuss the percentage of patients that go into an irregular rhythm and how we manage this. Finally I want to show outpt rehab with the nurse giving a brief description.
I am looking for any suggestions for the video. What does your hospital use to help with CABG teaching?
1Jul 29, '12 by kayernGreat idea. Please emphasize that everyone has their own tolerance for pain, heals at their own rate, the importance of deep breathing and coughing, ambulation but frequent short walks in lieu of one long lap around the unit and talk about discharging planning from the beginning. Our LOS = 5-7 days postop. Good Luck.
0Sep 25, '12 by echoRNC711Sounds like you have a well thought out plan.
I worked CVRU for several yrs and gave post op class. The book "Moving Right Along " was very simple and proved the most user friendly. There is so much info to give it can be difficult not to overload the pt
Patients have a short attention span r/t fatigue. I kept classes short. Reviewed material with family who tend to be receptive and fearful. I invited them to call me as questions occurred at home. I also encouraged them to go to cardiac rehab about 1-2 weeks post d/c. They will not be ready to exercise but are now strong enough to actually "hear " (this can save pt getting re admitted )
By far the most important is preparing them for the vent. I encourage them if they wake up with ET in to ask themselves "Am I ok in this moment" . As regards teaching on tubes/iv/equip I repeatedly use the phrase "that this is normal". Many pt dont respond well to seeing graphic films or other pt post op. Pt family members do though. Can't emphasize enough get them on the Incentive Spirometer pre -op they get off the vent in a couple of hrs.Last edit by echoRNC711 on Sep 25, '12 : Reason: typo
0Feb 21, '13 by dt70This is an old thread but I found it while researching information about switching careers to nursing.
I had a CABG procedure. It went very well. Had great nurses both male and female in icu, cardiothoracic icu, and pre/post heart surgery wing.
I am easy going, have high pain tolerance, but cardiothoracic icu was tough after waking up. definitely kept that nurse busy.
I was very grateful for her effort
I wish I had been advised before the procedure to breathe in through nose and out mouth, except when using the incentive spirometer of course. With chest tubes in, there was extreme back pain that was exacerbated by solely using mouth for breathing.
Also using Dilaudid at least once before bedtime to suppress coughing even if there's no pain during day. Even after discharge.
If done during winter, and have to go outside, do extra exercises with incentive spirometer to fight effects the bitter cold air has on the lungs.
All of these issues were fairly minor. I thought patient feedback added to the thread.