New nurse on cardiac stepdown unit

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    Does anyone know of a good book for a 1st year nurse and also a cardiac nursing book? I am a new nurse on a cardiac stepdown unit. I have recently began my first job and needed some ideas on books that could help me on this unit. Thanks.
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  3. 7 Comments so far...

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    Are you not receiving extensive orientation at your hospital? In a stepdown or ICU in particular this is very important. I don't know of any books that will necessarily help you out, but you should definitely look up the various drips you might be expected to manage e.g. diltiazem, NTG, nitroprusside, inotropes, amiodarone, etc. Additionally you really need to brush up on your EKG interpretation including 12 leads. Get comfortable with these on paper not just looking at the monitors. The monitors will constantly put out alarms for something that is not true, for instance if the patient is moving around a lot it may look like V Tach to the monitor when in fact it is just artifact. You need to learn to tell the difference (one example of why it is important to look at other leads). You should fairly quickly learn to tell an approximate rate by looking at the spacing on the R's. Sometimes the monitor will say one rate but you can tell it's clearly wrong just by looking at the strip, and you may have to make some adjustments to the interpretation of the monitor.
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    hi...i am student nurse that will be graduate in 6 month...i will be work at cardiac specialist hospital because i had been sponsored by them. I want to know what is the most important thing in preparation before going to work to cardiac specialist. what i need to be prepare even thought i had learned the cardiac disease during my studies. can u give me some advice from your experiences being new nurse on cardiac stepdown unit
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    My first job out of nursing school was on a cardiac stepdown floor. My hospital had a nurse residency program and trained us well. We took AACN's ECCO, and did tons of classroom stuff in addition to our hours on the floor with our preceptor. After 5 months, I was on my own with an assignment. Nothing can really prepare you for the stress and sometimes palpable fear involved in managing your own assignment as a new nurse. I was so exhausted by the end of everyday for the first year that I couldn't have read a book if you paid me to. Nursing is physically and mentally exhausting. The best preparation is to engage with doctors, other nurses and your educators and ask questions. Ask away. Think critically. Get involved with helping other nurses who have critical patients who are tanking. Be the first person to show up when a patient codes. Get your hands dirty. Experience counts. You can read books all day long, but until you're standing at the bedside watching your patient go into flash pulmonary edema, you won't know what to do.

    Good luck!
    Lovely_RN and surferbettycrocker like this.
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    Hello, 27lrn. I hope your transition onto Cardio Stepdown has been going smoothly. I am a New Grad RN who has an interview at a Surgical Stepdown next week. The recruiter told me that the patient population includes vascular, thoracic, and cardiothoracic patients, so it might be similar to your unit.

    Can I ask you what the interview with the Nurse Manager was like? I know there will be behavioral questions, and why Stepdown. But were there any NCLEX-type "what would you do" cardio questions? Were you asked about pharm?

    Any advice would be greatly appreciated!
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    experience is the best teacher to be prepared. as studyinginct said get your hands dirty. The only book I can recommend that would help on cardiac, when your not so overwhelmed read a little at a time so you do not get freaked out. Cardiovascular Nursing Practice from Jacobson,Marzlin,Weber. Think about $75 but it goes over caths, pulm, chf, valves,shock, everything you need for cardiac stepdown. You can get at AACN site. It has an explanation for what you do everyday but are so busy at work that you can't always get a good answer at the time for it.
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    Don't buy a book like others said, you will be too tired to read. Know your drugs inside and out and how they affect the heart (rate, rhythm, squeeze) and know which drips to hang for which condition. Know how to get all the emergency supplies on your floor quickly and how to start these drips quickly. Dont get bogged down in the rhythms too much, just make sure you can identify what it is (you can always call tele for confirmation). And it helps to study your doctors directory photos and know which ones round on your floor frequently so you can spot them for orders. And always, always, try to round with your doctors, especially surgeons, cardiologists and renal because you will learn a WEALTH of information from them and your fellow nurses. NEVER be afraid to ask questions and always, always keep asking. Good luck!
    not.done.yet likes this.
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    If you want to learn cardiac, pulm, renal and a little of everything else I suggest trying to get into your open heart recovery unit. You will take a lot of classes and be side by side w/ a preceptor for at least 4 months or so before you are on your own. Working on this unit provides a wealth of knowledge for just about everything. The best thing about this unit is you have 1 maybe 2 pts max. You learn hemos, drips, external pacemakers, lungs, CRRT and you learn how to actually take care of a pt and know everything about them unlike working on a floor where you have 5 or 6 pts and all you are worried about is passing your meds in time and getting that assessment charted. I have been there and done that. Open Heart nursing is rewarding because of the knowledge you gain and you actually see pts get better. Sometimes they don't, but most of the time they make it out the door to the stepdown unit and then out the front door. So, again if at all possible try out open heart recovery!!!


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