I started in a CVICU in January. I came from tele/med/surg in a community hospital. I would say the hardest thing in the beginning was that it sounded like everyone spoke a foreign language with all the abbreviations and terms I wasn't familiar with. Don't get overwhelmed, ask questions! Ask your colleagues to define terms and abbreviations for you. Make a binder with info that you get during orientation so you can reference it down the road, because you won't remember it all! It will get easier with time and you will fond your reference nurses to go to. I LOVE my job and have learned a ridiculous amount since I've started. Have fun and good luck!