My SICU is pretty small - 8 beds - and we take all specialties but we are pretty high volume CV surgery (I would say about 50%.) We do 1-2 CABGs and/or valves a day. Our current practice is to start putting the new orientees with open hearts right off orientation. They get two weeks or 6/12 hour shifts with a preceptor with only open heart patients in their last phase of orientation -- this is after they have oriented to everything else. We then expect them to go ahead and take a CABG independently, regardless of what their prior clinical experience was.
Is this reasonable or safe? We do try to look out for the new staff, but with 8 beds and only 5 nurses, you can imagine that often, there just aren't a lot of bodies around to resource a new nurse that is supposed to be functioning independently if something comes up suddenly -- and it often does following OHS. The last place I worked was a multispecialty ICU (medical and surgical) and had a much lower volume of CV surgery patients, and we were not allowed to orient to open hearts until we had been on the unit a solid year. I know that CVICUs obviously have all their nurses take fresh CABGs right away but I think their orientation is a lot more extensive.
Any thoughts on what is appropriate or standard for this?