When does the "newness" go away?

[Shandy12]

Hello all,

I am new to this forum and new to cardiac nursing......very new. I recently left community nursing to go back to the hospital. I wasn't being challenged enough in the community and the working conditions were getting worse and worse.

I was hired to work on Telemetry and to be cross-trained to ICU. This is in a smaller hospital. Telemetry is 10 beds and ICU has 5 beds. I am almost finished my basic ECG interpretation course, and will then pursue 12-lead and ACLS. The manager of this area is wanting to send me on a "fast-track" cardiac course, hopefully early spring.

However, I am going to be finishing my on-floor orientation at the end of this week. We are given 8 shifts with a preceptor and then they turn us loose on patients.

I know with a nursing shortage that hospitals aren't going to find trained cardiac nurses out there, but how safe is what I am doing? My assessment skills are strong, but my knowledge of cardiac arrythmias is just beginning. Anyone have any words of wisdom, or directions for me to go?

Thanks- by the way, if it makes any difference, I'm up in Canada, province of Ontario.

Shandy

[KKERRN]

Shandy,

I'm new to this forum too! I really enjoy venting and getting replies on concerns. I went to ER without any EKG/Cardiac training and my friend and I taught ourselves with self-help books. In the ER, we always have at least an attending doc to discuss concerns and chages. I've been know to notice things which are of no concern to them too many times to count. Once I identified SVT's which were treated immediately!!

The most important things I have learned are to always listen to your patients and not to just look at a monitor...assess your patient!

Good luck!

Karen/KKERRN

[BABYGIRL_RN]

YOU WILL DO GREAT. ALWAYS LISTEN AND ASSESS YOUR PTS. REFER TO SELF HELP BOOKS, POLICIES, EXPERICENED NURSES, AND BUY CRITICAL CARE GUIDES/BOOKS FOR YOU TO USE AT WORK AND HOME. YOU ARE GOING TO DO GREAT. I KNOW, I WAS THERE A LITTLE OVER A YEAR AGO. YOU ARE GOING TO LEARN ALOT.

TAMMY

[sargent]

It sounds like you already have the important skills: assessment skills, the ability to ask questions when unsure and desire to learn!

Moving into any speciality can be very daunting, particularly an area with high levels of technology like ICU and CCU. The first thing you must do is identify what you ae good at. In your post you say that you have strong assessment skills. In my opinion, a nurse that can assess well can achieve most things with greater ease than those who don't. ECG's are always a big focus of our attention and although I am a bit of an ECG junkie(I find them fascinating!) they are only one part of our total assessment of the patient. Identifying the core arrhythmias (the life threatening ones) are the priority, once you have settled into your new role there will be plenty of time to for you to build on that knowledge.

So long as you can identify that something on the ECG has changed and are surrounded by people who can help you, you will be OK.

Good luck!

Andrew

[micro, RN]

Shandy12,

Good for you changin and learning and growin in your field.........

the day the newness in medicine and nursing care goes away is when we retire, but then we just become retired nurses......once a nurse always a nurse............

been a nurse for ten years.....went back into hospital last year after years out in LTC..........and just recently changed from med/surg unit to pulmonary(speciality) unit.........oh, my.......higher acuity.....more to learn.........

micro advice........

1)trust yourself

2)know what you know

3)know when to ask for assist

4)it is okay not to know it all

5)patient first.........assessment.........

Julie12.........go for it.........

micro

[Shandy12]

Thanks for all the great advice and the encouragement. It's not going too badly so far, but the learning curve is steep!! However, I can live through 12 hr. shifts and nights. Hate the "new" feeling, but the staff has been great. I will carry on........

Lynda

[eldernurse]

Dear Shandy,

Trust your instincts and ask questions, no matter how stupid you think they might be. Then, find a kind eldernurse who has been there, done that, who will nicely answer your questions. It never hurts to be nice to the old timers.

[ARIOSRN]

GOOD FOR YOU. I STARTED ON A VERY BUSY CVPCU RIGHT OUT OF NURSING SCHOOL. AFTER ABOUT 2 YEARS IT STILL SEEMS KIND OF NEW. THE MOST IMPORTANT THING I LEARNED IS TO USE YOUR CHARGE NURSE/ANM AS A RESOURCE. THEY ARE CHOSEN FOR THEIR KNOWLEDGE OF A SPECIFIC PATIENT POPULATION. GOOD LUCK AND WELCOME TO CARDIALOGY

[Tiiki]

Hey Shandy, I'm a fellow Cdn in Ottawa. I preceptored on a cardiac surgery floor where they did everything from tranplants to TCP. The advice so far has been fab! Don't feel as though you are alone. If in doubt, ask someone else. Most ecg machines today also give interpretation (but PLEASE don't rely on this). It's a guiding tool, nothing else. Good luck with ACLS. Just finished mine, was brutal, only because the instructor was one of our ER docs, I was the only person in class he knew, therefore was always calling on me!!! He also told me he expected more from me as I'd be working with him! Yippee!!

Oops, sorry for straying. Another hint? I still keep a drug book with me. You need to know your cardiac meds. Don't rely on the Dr's. They sometimes mix things that shouldn't be mixed! I also like to tell the patient what I am giving them. I never give out a med I don't know. Takes 2 seconds to look it up.

Hope you enjoy cardiology. The learning scope is endless!

Cheers! :)

Jo-Anne

[zambezi, BSN, RN]

I too am new to this forum and new to the CCU. As a new graduate RN, of course, everything is new. I was lucky to be able to precepte on the CCU unit that i was hired to work in for full time for six months as a nursing student. In this time, i was able to meet the staff and build a rapport, as well as learn the flow and acuity of the unit. I feel good about some things and so unsure about others. I am sure that you will do well in your new unit. Good luck...