[jspacegirl]

Hi everyone,

I just got offered a GN internship in the CVICU of a teaching hospital that does heart and lung transplants, among other things. I want to work in critical care, but my first choice was the MSICU. I think I was offered the position in CVICU because they probably thought my skills and experience would be better suited for it (I'm taking ACLS and doing a clinical rotation in a heart hospital). I can't say that I disagree with their reasoning, however, MSICU just seems more interesting to me.

I certainly don't mean for anyone to take offense to me thinking that CVICU is not as interesting as MSICU. Of course, I will never know until I try it, and I am going to give it a fair chance. I could end up loving it! However, I'm having mixed emotions, and I want to get pumped up for my internship in CVICU. So please, tell me why you love working in CVICU/CCU.

I would really appreciate any insight, advice, stories, etc. Thank you!!

[jspacegirl]

So, no one here likes their job, eh?

Just kidding :-) Seriously, any awesome stories, or something along the lines of "I wouldn't want to work any other place than the CVICU/CCU because.....," would be very much appreciated and inspiring.

I'm getting more and more excited about this job as each day goes by, and I am happy that I got chosen for the position. Now that I've had time to really let it sink in and contemplate everything, I think that it will be a much better fit for me than the MSICU would ever be. But I still want to know why you all like it so much!

Thanks in advance!

[sharrie]

Hi there, I haven't worked CVICU for many years but I did find it an excellent expereince for learning, my love was always a general or neuro ICU and when I first started in critical care we rotated around all of the units.

I think the bit I liked the most about CVICU was the fact the care was fairly predictable (obviously not always) but the patients came back post op, you knew when to start weaning, what to do with the chest tubes and it was good to see these patients recovering well.

Those that didn't kept you on your toes as when they deteriorate it requred chest opening on the unit (this was many years ago so not sure if this still happens)

[ghillbert]

I love the challenge that cardiac ICU involves - there are so many moving parts that you have to coordinate. Once you get good at it, being able to look at the hemodynamics and know immediately what you need to increase/decrease/start/stop etc is fun. It's fast-paced. You generally don't have people hanging around for weeks like you can get in general/neuro/medical ICUs. Sometimes, but not often. You're mostly "fixing" people, which I find more fun than looking after say, trauma patients, who are broken and damaged.

[diosadelsol]

I really enjoy the CCU. I also find it a very good environment for learning and while you do a lot of the same things for many patients, they are each unpredictable. I like having to be on my toes at all times. The sick-sick ones may keep you busy, but like Ghillbert said, once you learn what you're doing and what needs to be done its is an exciting field. I think the heart is fascinating. I'm an adrenaline junky as well, so the codes were a plus for me in the CCU.

[nurse-lou]

Originally Posted by ghillbert

I love the challenge that cardiac ICU involves - there are so many moving parts that you have to coordinate. Once you get good at it, being able to look at the hemodynamics and know immediately what you need to increase/decrease/start/stop etc is fun. It's fast-paced. You generally don't have people hanging around for weeks like you can get in general/neuro/medical ICUs. Sometimes, but not often. You're mostly "fixing" people, which I find more fun than looking after say, trauma patients, who are broken and damaged.

Ditto! I worked in a combined CVICU/CCU/SICU/Trauma-Neuro ICU for over three years......I miss my trauma patients for sure but I am really starting to excel with the cardiac stuff.....

[SkateBetty]

Autonomy - you have to think on your feet, move quickly, and make important decisions on the fly, and you better know your stuff because it's no game. Fixing a patient on the fly with medicines is challenging and fun, and you have the power to take action, which every nurse craves. Some days/nights are like a marathon, and you better have your track shoes on, because your actions will be keeping a patients alive, no joke.

Average length of stay - They move to step-down as soon as they are extubated and stable (usually a couple days). I did trauma step-down before, as well as burn, and those patients stick around for weeks to months. Call-lights are a drag. So are food trays, active bellies, feet going over the side-rails, road-trips, and the "wuh-wuh, wuh-wuh" you hear from the moving mouths of awake patients that are taking more control of their care. I have never worked in MICU, but since they are medical and not surgical I'd think they stick around longer? Not sure.

Those are the big ones for me.

[Summitk2]

In addition to what other people said about the pros/cons, I think this decision may also come down to anatomy & physiology.

Most cardiac nurses I've met LOVE the heart (as do I). I imagine neuro nurses LOVE the brain (I have a hard time understanding the brain). If the MSICU you're talking about is in the same hospital as the CVICU, you probably won't see many cardiac problems. Maybe you enjoy endocrine/metabolism, renal/GU, GI? MSICU is just for you. There's some incredibly complex A&P, patho, and pharm going on. It's no less of a challenge than CV--any ICU is a challenge. Do Kupfer cells or pancreatic enzymes float your boat? For me, I could talk for hours about different cardiomyopathies or swan catheters. When you say heart-lung transplant, I say "gimme."

Maybe you're too young in your career to know? Try one out--the one you have a better feeling about. You'll know with a little time. I found my fascination of the heart during my senior clinical in a CTSICU, but it may take some trial and error to find your fit. Best of luck.