Quote from bug2621
I just found out that my preceptorship is in the cardiothoracic ICU and I'm excited but extremely nervous. What should I brush up on to not only be at my best but also impress my preceptor and show her that I want to learn. I guess I'm looking for what drips and meds to be aware of and what post op assessments/interventions I should brush up on as well. Also any helpful advise that you can offer would be great!!! Thanks!!
15 years cardiac ICU speaking here:
Don't try to impress, just be a sponge and absorb. Don't pretend to be a know it all, because you don't know squat and we know it!
Be thorough in your work, don't take shortcuts, and if you're not sure ... ask someone.
Cardiac patients, especially surgical, can turn bad in a wink of an eye, so stay on top of things. For example, if the pt is peeing a lot, or very little ... check a K+. Bleeding? Get an HCT. Not breathing right? ABGs. Got a gut feeling that something isn't right, even though they 'appear' okay? Go with your instincts.
Need specifics? Start with the basics: EKG recognition. Review simple pressors like Dopamine, and Vasopressin. Inotropes like Dobutamine. Anti arrhythmics like Amiodarone and Lidocaine. Other common drips: Insulin, Lasix, Fentanyl.
Push drugs: Morphine, Fentanyl, Digoxin, Protonix, Zofran.
The CTICU/CVICU can chew you up and spit you out EASILY so just take it slow and don't get discouraged if you have a bad day. My first few weeks I wanted to quit every day. After a month I only wanted to quit once a week. After 5 years, nothing bothers you anymore and you're on top of the game. After that, it just gets tiring and you begin to want to quit again, but for different reasons.
It's very rewarding however, and such an eye opener ... you have no idea.