Is the CVICU for open hearts the most acute ICU?

Biffbradford · May 10, 2014

Well, I think all ICUs have some patients that have one foot in the grave and are trying to slide in, and you can't get any sicker than that. :dead: However, I do agree that CVICU has a higher percentage of uber sick, sicker than snot, and unstable patients in general. When that ticker is irritated, it can turn on you in a flash, and all the patients have irritated hearts, so they all need to be watched like hawks. PLus, I think you'll have more drips and machines in CV than you'll see anywhere else. Is that good training for flight nursing? Got me, but you won't be lacking for challenges in CV, THAT's for sure! :nailbiting:

Nurse_ · May 11, 2014

If you want to be a flight nurse, trauma/surgical ICU will be the best training for you. Most of the time, patients who get airlifted are from accidents. CVICU, while presenting a different kind of beast, is not the same as trauma ICU nursing. CVICU patients have their hearts damage by age or disease. Trauma patient's heart usually isn't the one that's sick, the heart could be affected but it's secondary to the trauma. CVICU patients do not get a lot of fluids, in fact, most of them have fluid restriction. Trauma patients are often hyper-perfused. CVICU patients wither before they pass on, trauma patients don't linger as long (if the injuries are really severe).

Vanilla101 · May 11, 2014

EVERY ICU in the hospital gives you something to learn. All ICU patients are sick, their illness, medical, surgical, trauma, etc., requires a higher level of nursing care. Any ICU will sharpen your assessment skills, increase time management skills, and teach attention to detail. I have worked in all the ICU's at one time or another, my preference is Coronary Care. Personally, I don't like to see blood unless it's in a bag going into a patient. That's why I don't do trauma/surgery. That said, if you want to be a flight nurse, the SICU or the ED/Trauma unit would be good. Please also realize that ED/Trauma is MUCH different than any ICU. So is flight nursing. These areas require good ICU skills, plus the ability to super-multitask in a crazy environment. I have a few friends who have been flight nurses who are also RN's and certified paramedics. This helps, as it is difficult to get flight nursing jobs.

RNdynamic · May 11, 2014

The flight services in my state require a paramedic license and ICU experience, but they don't specify the type of ICU experience.

francoml, ASN, RN · May 11, 2014

I really think it just depends on the day and what going on in the unit. I work at a level one regional hospital in MICU. I am also rapid response and float to the other ICUs. Open heart is super critical and can go bad very quickly (CICU), multiple casualty MVAs can be very stressful (SICU), >60% burns are sicker than sick (BICU), and a post code patient who is on hypothermia, 5 pressors, and paralytics is also crazy (MICU) oh and the ruptured esophageal varices BLOODY MESS (MICU). All of these ICUs will have days when we are little more than a glorified step down unit as well. That is the great thing about ICU, calm one minute, balls to the wall next.

allnurses Guide · May 13, 2014

Cardiac patients most often have longstanding, multisystem disease and are very fragile. When excrement hits the fan, it happens fast. This is possibly why this idea that CTICU is "more acute"... but having worked in trauma ICU and cardiothoracic surgical ICU, I can tell you that either is just as acute. Someone with a severe traumatic brain injury is as acute as you can get. I'd do whichever interests you. Either would be suitable experience for what you want to do - but if you want to do flight nursing eventually, I would lean towards trauma because flight nursing has a lot more trauma than cardiac patients.

Esme12, ASN, BSN, RN · May 13, 2014

As flight nurse I choose CVICU. It teaches you how to deal with fragile patients that are in shock. You will learn about PA catheters and deal with multiple drips in a compromised population. You will be transporting fragile cardiac patients to tertiary centers. Trauma is helpful as well if that is available to you.

sweetdreame, BSN, RN · May 20, 2014

Having experience in both Trauma, Medical, and CVICU, I will say that I feel like you get a little extra from CV training. Trauma and medical are monsters of their own, but I never really understood how SVR, CO/CI, SV, and all the hemodynamics worked together until I had CV training. I think that is part of seeing the big picture and serves as a good foundation. I say work in CV until you are comfortable taking a sick, bleeding heart, then go to float pool for variety. After leaving trauma, I was fortunate to work in a small ICU which did CV and medical cases...so I didn't have to choose.

I love the ICU and wouldn't trade any of my experiences. I'm sure you know this, but just work hard, find a good mentor and study at home and you will be fine wherever you end up choosing.

Phi Gam · Jun 10, 2014

I'll touch upon the "limited experience with common medical emergencies" statement. Based on the experience in my hospital I would have to disagree with that thought. I've been in the CVICU for 18 months, and rarely does a patient come in without secondary problems/diagnoses. Uncontrolled diabetics(increasing surgical infection rate), post-op stroke(from throwing a clot when coming off bypass), and sepsis(just bc multiple invasive lines and time in hospital always increases risk) are all things seen on a more regular basis than you would think. And withdrawals are definitely encountered, which is why there's usually prescribed liquor in the med fridge. CVICU can be a crazy melting pot of treatment. I've seen every organ system affected at some point or another. If you transfer there in the future you'll see.