[bbuff]

Hello- I just accepted a position to a monitored cardiac unit. I have less than one year of med/surg under my belt. Cardiac intimidates me a little, but I am very excited to learn and take on the challenge.
Is there any way that I can better prepare myself for my orientation?
The manager told me they don't do open hearts, or balloons, or even caths or any "really crazy" procedures there-they send them to the HUGE sister hospital 5 minutes away. They do get lots of MI's, CHF, so on.

I guess I am getting nervous-when we had anyone's heart start to do weird things on us on the med/surg floor, we called and got them transferred ASAP.

Any words of wisdom or thoughts for me?

I look forward to really spending alot of time learning on this board!
Thanks in advance-

buff

[telehead]

Welome to the wonderful world of cardiac nursing, bbuff! CHF and MI's will be enough to keep you going without the mix of fresh hearts, caths, etc...

Rhythms, rhythms and more rhythms would be my suggestion... they can tell you a lot about your patient's condition, whether it's a need for some oxygen, an electrolyte imbalance or if a more urgent intervention might be necessary...

In the end, it's all nursing so I'm sure you'll be fine!

[Indy]

Welcome to cardiology! It will warp you a little I'm sure. I'm starting to think everyone dies from CHF or an MI and in some degree of respiratory distress.

Will your unit have the monitors for telemetry at the nurses station? If so, a rythym class will be good for you. ACLS wouldn't hurt, but you shouldn't need it immediately. You'll probably have more drips in cardiology that you might not have on a med surg unit, so I'd look up the unit's protocols on IV drips. Then I'd look at standing orders your physicians have and ask what they typically expect/do with people in chest pain. (ekg, ASA, NTG, vs, etc but not everyone gets all of that every time)

Be prepared for the new generation of young drug seekers who like to come to the ER and complain of chest pain for morphine because their prescriptions ran out.

Trust your gut. Anyone who looks sick as a dog, especially if they vomit fecal matter, is. Welcome to cardiology!

[bbuff]

Thank you so much for your replies Indy and telehead!
I just went for my pre-employment drug screen/physical today. I will start the 1st Monday in June.
I think they will give me classes on strips and also provide the ACLS class for me. And I think the monitors are at the nurses stations.

I'm sure I will have lots of questions in the next few weeks!
Thanks again!

buff

[Christian_SN]

i start in the cardiac intervention unit ... during the day. during the day might be a bit too much for a new grad??? the nurse manager feels confident that i will do 'just fine' but ... i question everything and pay a lot of attention to details...... Is this bad? Please give your input, and thanks

[care4ppl]

How has your first month been on the new unit. I am sure you are doing fine. Just keep looking at strip after strip. I am also new in cardiology and at times feel incompetent because I am in a cardiology dept but am not comfortable with telemetry. I am ACLS certified but still not where I need to be comfort wise. I suppose that comes with time.

[msn2008]

As a RN who receives the patients from those smaller hospitals: learn rhythms and take the first EKG class you can get to! Many times as I've gotten report from the smaller hospital, they can tell me all about the basic assessment items, but have no clue as to what the patient's ekg looks like. Their usual answer is "it looks regular"! That's not good enough for me. Basic EKG classes should be mandatory for all CCU nurses, no matter the size of your unit, no matter what procedures your hospital does or does not do.For example: I want to know if there are changes in the inferior or anterior leads and what those changes are. Also tell me what their cardiac enzymes are and when they were drawn. Also, be able to tell in your report the units/kg/hour or mcg/kg/min your patient's iv drips are running at. It does no good to tell another nurse at a different hospital that the heparin is running at 19cc/hr. I need to know how many units per hour they are recieving so I can set up my own iv bag with my hospital's concentration and have it waiting for the patient to start on arrival. Good luck in your career!
Melissa

[bbuff]

Just a little update. And I need to spend more time on this board.

I like the people I work with. I love what I am learning and how my confidence is growing. I have been on my own for a month now-and as someone posted already-it all boils down to the same basic nursing care. I am really liking cardio.

The issue I'm having is administration and management. I think the hospital is a great hospital. On our particular unit though, everyone is miserable. I came from a union hospital and felt somewhat "protected". This hospital has no union, and is a "magnet" hospital, which I am finding-means crap. I feel like the manager is all about "patient satisfaction" at the expense of his staff.
We have a ratio of 6-9:1 on nights. I was told we were a "step down" ICU.
One night, we had 2 nurses and NO aide for 12 patients. Then we got *4* admissions in an 8 hour shift.

I'm just really thinking about looking for another job already, and I've only been here for 4 months.

[RNCRNA2BE]

Originally Posted by msn2008

As a RN who receives the patients from those smaller hospitals: learn rhythms and take the first EKG class you can get to! Many times as I've gotten report from the smaller hospital, they can tell me all about the basic assessment items, but have no clue as to what the patient's ekg looks like. Their usual answer is "it looks regular"! That's not good enough for me. Basic EKG classes should be mandatory for all CCU nurses, no matter the size of your unit, no matter what procedures your hospital does or does not do.For example: I want to know if there are changes in the inferior or anterior leads and what those changes are. Also tell me what their cardiac enzymes are and when they were drawn. Also, be able to tell in your report the units/kg/hour or mcg/kg/min your patient's iv drips are running at. It does no good to tell another nurse at a different hospital that the heparin is running at 19cc/hr. I need to know how many units per hour they are recieving so I can set up my own iv bag with my hospital's concentration and have it waiting for the patient to start on arrival. Good luck in your career!
Melissa

Hi, I'm a tele nurse at a small community hospital, and believe it or not some of those things that you spoke of are simply not required for us to know per the facility, so please, feel free to elaborate on anterior and inferior leads, and any other info that you'd like to share.

Thanks

[RNCRNA2BE]

Originally Posted by bbuff

Just a little update. And I need to spend more time on this board.

I like the people I work with. I love what I am learning and how my confidence is growing. I have been on my own for a month now-and as someone posted already-it all boils down to the same basic nursing care. I am really liking cardio.

The issue I'm having is administration and management. I think the hospital is a great hospital. On our particular unit though, everyone is miserable. I came from a union hospital and felt somewhat "protected". This hospital has no union, and is a "magnet" hospital, which I am finding-means crap. I feel like the manager is all about "patient satisfaction" at the expense of his staff.
We have a ratio of 6-9:1 on nights. I was told we were a "step down" ICU.
One night, we had 2 nurses and NO aide for 12 patients. Then we got *4* admissions in an 8 hour shift.

I'm just really thinking about looking for another job already, and I've only been here for 4 months.

bbuff, I'm really sorry to hear that your experience in tele is not going how you'd like it. Unfortunately, I have seen these things happen in tele. I hope things work out for you. Good luck!