advice for a new nurse starting in the cvicu

Biffbradford · May 5, 2011

Review normal lab values and memorize them. Same with normal blood pressure, CVP, wedge, cardiac outputs. Just recognizing when something is NOT normal is a big step. Then you'll learn what to do about it. Same goes for chest xrays - enlarged heart? pneumothorax? hemothorax? (BAD!) Lung sounds - wheezes? rales? how far up? Where to palpate pulses? edema? what's crepitus? pulsus pradoxus? tamponade? What does Heparin do? Insulin? Dopamine? Dobutamine? Lidocaine? Lasix? Oh, then there's the boring stuff - washing hands, keeping your stethoscope clean between patients. All little stuff, but it adds up. GOOD LUCK! :)

I'm looking for a new job and am contemplating going back to CVICU. Not sure that I want to. :lol2:

eCCU · May 7, 2011

:cheers:

have fun learning. Get a good partner at work to call on when your not sure. Remember not to freak out especially if the family is in the room and things are going south! Familiarize yourself with the AACN guidelines and your facility guidelines and policies. Have a good work life balance and mostly enjoy the process!

chocolateskye · May 8, 2011

Im currently working on a tele unit and Im new as well I wish I had the answers for you, as I need some good advice myself. My manager is aware that I did not get the best orientation and yet we have no plan in place to insure that I succeed. I am afraid and can trust no one. I love it that I have been given a chance and want to live up to the standards before me. My preceptor gave me all of the patients so I passed meds all shift now I am on my own and I am trying to balance med pass and getting back to charts to check for orders dealing with being interrupted and when is it appropriate to ignore the little phone they give you when you are in with a patient giving care or family education? Then you have to balance your emotions and not take things to personal when all of your or maybe a certain few of your co workers are complaining about the fact that you did not finish everything before there shift started and making comments to your boss like I dont think she'll make it. Where do new grads come in and run circles around nurses who have been nursing for 5 and 10 plus years? What can we do to improve on our critical thinking skills until it is second nature or where should we start it seems like you have to have five years of experience and a certificate just to work on a med surg unit now a days.........im just saying. Good luck to you on your journey and please feel free to stop back by and share what helped you through.

pnc_heartnurse · May 21, 2011

Pacep.org is a wonderful site to learn about PA catheters and hemodynamics (which you will use FREQUENTLY). You have to register but it is free.:)

meandragonbrett · May 21, 2011

As a new grad you should check out http://www.icufaqs.org. It will give you some information on the basics of critical care.

FunRun · May 22, 2011

http://www.pacep.org/ Go to this website and do as much as you can, it is a really great resource. It stands for the Pulmonary Artery Catheter Education Project and I would recommend it to anyone in Cardiology care! :redbeathe

Alias007, RN · May 22, 2011

i just wanted to say thanks to everyone for sharing such valuable and useful information!

clc007 · May 23, 2011

I would also recommend brushing up on your pathophysiology regarding not only general ICU conditions, but Cardiac specific conditions as well (i.e., Acute MI, Cardiogenic Shock, PE, CHF, DVT, Airway Management, etc.). I have always found it helpful to try to break down the patient's disease process in order to anticipate what the needs of that patient are at that particular moment & what possible adverse events could occur. Also, don't feel disappointed if you feel that you are not "catching on" to things or if you feel that others are smarter & more prepared than you are. I have worked in CVICU for over 2 years now and I still learn new things about disease processes & management every day. I agree with Biff that you need to understand normal lab values & x-ray results as well. The best advice I can give to you is to be interactive with your providers to understand the provider's rationale & stay motivated to learn as much as you can. If you have an Itouch or Iphone, some apps I have found helpful have been Medscape (provided by WebMD) and Libermann's Radiology app. Both are free (last time I checked) & they provide useful insight & study tools for drugs, disease processes & management, labs, & assessment findings.

Good luck with your career in the CVICU!

Chris :)

ccure · May 25, 2011

I started straight out of school in CV too... be patient and try not to get overwelmed.. there's alot that'll be thrown at you.. ask questions... ask questions.. ask questions.. especially to your preceptor.. learn your basic hemodynamics and you will build from there fast.. pacep.org is a great website.. good luck

Maxmatlock · May 25, 2011

Read "Martin's" Cardiac anesthesiology book. It will give you a great baseline of knowledge to start your CVICU experience. I have worked in a CVICU for the last 3 years and wish I had of read it as soon as I started. You can find it on amazon.