relocating...ccu/csicu/or cath lab

Specialties CCU

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Specializes in Med-Surg /Cardiac Step-Down/CICU/CTICU.

hi all my fellow cardiac nurses,

i would like your feedback on my current situation. i plan on relocating by august, and have a few potential opportunities. i am currently debating over 3 positions a ccu or cicu position in a level 1 trauma-large university teaching hospital, and 2 other postitions at a well known and well ranked level 1 trauma large university teaching hospital 1 in the csicu and 1 in the cath lab. both magnet hospitals, both about 1000 beds each, where i could advance easily and increase my skills, and increase my marketbility as i continue in this profession. i have basic ekg interpretation class, critical care classes, advanced 12 lead ekg class, have precepted new grad's, and have served on unit-based committees.

my experience is

med/surg/tele-1 year and 8 months in level 1 trauma university teaching hospital, 30 beds on the floor=which was basically med/surg (anything) and a mix of tele patients, ratio about 6-8:1.

cardiac step-down-2 years 9 months=all monitored patients, some vasoactive drips, only a-line monitoring, ratio 4:1, and 25 beds in the unit. while in this environment, i learned immensely, but desired more skills and more critical thinking.

currently i'm in a ccu or cicu which is a 10 bed unit ratio 1:1 or 2:1. i started in jan, and i love it but am relocating for personal issues. anyways, i have really liked the exposure to the unstable patient, swans/pa cath's, iabp, temp pacers, vent's, hypothermia protocol, and everything else i continue to see and learn everyday.

i have not formally taken a cvvhd class by clinical education at my facility but have gone through the basics with my preceptor and have asked questions in regards to management and functions of therapy, and the dialysis nurse even went through the set up and gave me a good description of it all one day, but i've never had a patient with crrt. i also have not taken a iabp class but through a great orientation and exposure of the highest acuity of patients, i am comfortable taking the patient in my assignment and managing their care.

ok so back to the question at hand...i was wondering should i just stick to what i know ccu/cicu and take a job with an easier transition, and have been recently been exposed to or should i venture to cardio-thoracic surgery icu....which interests me but i'm not a surgical nurse by any means i don't think. but i would like to see other things and continue to grow professionally or a cath lab job. in the cath lab i'm not too interested in taking on-call, to get awakened to come to work, but it would also be a great experience and exposure i'm thinking, and on the downside exposure to the fluro, and missing the patient contact possibly would be the major things that i would not like. also i wouldn't have but 6 months icu experience for the cath lab, which is not much, since i know most of the nurses in the lab had a few years if not most of their career in the icu.

as you can see i'm at a cross-road and not too sure what to do :confused:. i'm hoping they offer me a chance to shadow in these units so i can get a feel of what it's like in the day-day activities. any other suggestions or comments from ccu/cicu or csicu or cath lab nurses :nurse: are appreciated ! ;)

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Specializes in multispecialty ICU, SICU including CV.

You were offered all 3 jobs? Wow!!!! Good for you!!!! That is awesome in this market!!!

I think, go with where your heart is. I work in a SICU - it is a relatively small hospital and we don't have a separate CVICU, so we have a high number of open heart surgery patients as well as general SICU patients. I love it. I would go to a 100% CVICU if there was one in my facility. You get a lot of great clinical experience there and it could open a lot of doors for you.

I think you are right about the cath lab -- it is kind of where old ICU nurses go to die (same with the PACU.) It is more of a M - F job, and it can be a dead end, especially if the management is stable. Procedure areas tend to get left out of a lot of the hospital wide initiatives and practice changes just because they don't have inpatients - change is slower there. If you are looking at building your career, I would stay inpatient.

Hope this helps you.

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Specializes in ICU, ER, EP,.

Just want to warn you, our cath lab nurses work many hours of their call. Door to intervention times are short, so they are called in frequently and have to work the next day.

OUr old ICU nurses don't go there to die... they'd be dead in a month.

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Specializes in CVICU.

If you love the invasive monitoring, PA lines, IABPs, you should really consider going into a unit with cardiothoracic surgery. Open hearts are my absolute favorite patients and it's so cool to use all the different hemodynamic principles to stabilize them. Even if I have a stable patient I just love observing trends and watching physiology at work. You can learn a ton with the open heart patients. If you can get exposure to other surgical patients that is incredibly valuable as well. To me, my favorite patients are the ones that need a lot of intervention and where I can learn the most. In my experience (which is not much) that has been with the surgical patients more often than the medical ones. So don't rule it out is I guess what I'm saying. Good luck.

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Specializes in Med-Surg /Cardiac Step-Down/CICU/CTICU.

hey all

well i have narrowed it down to 2 units in one hospital. the ccu and the csicu. i got to interview with both nurse managers and spent time on both units 1-2 hours each unit with a staff nurse. overall i think the interview went well. i of course was home in the ccu, since that is where i work now. it would be an easier transition for me since i will be new to the area. the csicu really took me by surprise how intense it was on another level, and i enjoyed it. there is alot to be learned there. the only down part of the csicu is that they have 6 nurses leaving to go to anesthesia school in the fall, when i will be starting. but they are actively hiring to fill the positions, which is good. also they csicu is offered an additional 20% on top of the base pay, i'm guessing to aid in recruition and retentment of the nurses.

anyways, i'm not sure what to do. the recruiter will be contacting me shortly i hope, and i don't know what the decisions will be, but if it is for both, what should i do. i guess i can only make up my mind and what feels right, but i would appreciate the input from others.

thanks !

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