CVCURN 1,408 Views
Joined: Sep 6, '12;
Posts: 12 (8% Liked)
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I am a 1-year RN making a transition from CV stepdown to SICU/Neuro ICU at my level 2 trauma center. I am in search of a well-rounded but not-too-dense reference for general ICU concepts like sepsis, drips, etc. Any recommendations? Thanks!
We self schedule on my unit. We do 4-week schedules at a time, we must work either a monday or a friday each week unless you work that weekend as those are our busiest days. We work every 3rd weekend and a set holiday rotation that we know 3 years in advance. For each 4-week schedule we must take 1 on-call day and we are allowed to 'X' 2 days. Your X'ed days mean that you cannot work that day no matter what, so if they're rearranging people you won't be slid into that day. All the FTEs go first, and our per diems cant fill in the schedule until the last week before it's picked up. I am the newest RN on the floor and even my days pretty much never get switched around, 2 of my shifts get changed per schedule MAX and we are all happy as pie!
Our monthly staff meetings our lead by our manager. She commonly mentions changes in practice that we are planning to trial for 30 days that shared governance decided on. She also updates us on safety issues, changes in the medical center as a whole, etc.
Good point about "would a 1am meeting be easier to attend." Well no, of course not! Thank you for the night POV
I appreciate the quick responses. Our manager directly attends our shared governance meetings and is extremely open to change, we are truly blessed. The only reason we don't currently offer multiple time slots is because we have 1 chair and 1 co-chair for the committee (one who works days and 1 who works nights) and we are having a hard time finding times where they are both available multiple times a month. As far as the night shift attending the 1pm meetings, our manager will ensure that anyone who works nights and wants to be involved in shared governance can be off the night before and the night of the meeting. However, it really put it into perspective for me when you said "that's like having a meeting at 0100 for day shift" I never would have looked at it that way. I feel like the largest reason we lack participation is r/t unwillingness to change in the staff as a whole, not in management. We are considering trying the meetings the hour before our mandatory monthly staff meetings as an alternative.
We have shared governance at the medical center where I work. We have monthly hour-long shared governance meetings on our unit and then our ideas move up the chain of command to (hopefully) become practice, hence the purpose of shared governance. However, we have chronically low turn out at our monthly meetings and therefore are struggling to get things done. Any ideas on how we could increase the attendance at our meetings? We meet at 1pm on the second Tuesday of the month. We have already tried meeting in the evenings and had even worse attendance then. At our last mandatory staff meeting we had the hospital-wide Shared Governance chair come speak with the staff to explain what Shared Governance is all about and we still had only 5 people at our meeting today. We have a staff of at least 40 nurses and 10 CNAs on our 32 bed Cardiovascular Care Unit who work 7a-7p or 7p-7a either full time, part time, or per diem. Any and all input would be appreciated, we are passionate about the power shared governance gives us as practitioners and want our co-workers to see the difference they can make in the way we practice medicine.
Thank you thank you!
We use Curos caps on all our central lines in combo with the clear caps and ever since making the change hospital-wide we haven't had a single CLAB in over a year. Those Curos caps are life-changers, but they are approximately $0.25 a piece ($60 a box) and they are one-time use. We also do the general strict sterile technique with dressing changes Q 7 days and the tegaderms we use on our dressing changes have a chlorahexidine-impregnated gel in the center that is placed directly over the catheter insertion site.
I'm looking for a good general cardiac nursing reference that's not too dense just to brush up on important things and know exactly what I'm talking about as I'm a newer CV Step RN. Any suggestions?
I am a new RN on a cardiac/stroke unit. My manager didn't explicitly ask me medically-based questions. Now a days in nursing interviews they tend to be able to decide on your intelligence through the way you carry yourself. They are going to ask more questions related to the kind of person you are and your values. You're sure the get the common "tell me about a time you showed compassion to a pt" style question, and I find the answer to that one extremely important. That is a defining question on the amount of passion you have for the 'sport' that is nursing. As far as what to ask the manager...it might not be a bad idea to ask if they take surgical cardiac patients as well as medical. We take open heart patients day 1 post-CABG, and that's one of my biggest challenges at work. Also ask about continuing education opportunities within the facility. I found it to be daunting for my first position to be in a CV stepdown until I was informed about all the classes available at work to keep me up on cardiac/stroke-specific material. Good luck!
If you can find a position in a Nurse Residency type program you may be able to get a start directly into cardiology. I got hired into a nurse residency program and they essentially started us as float nurses to get our feet wet. We rotated throughout all the units in the hospital for 7 weeks (including cardiac areas) and then got to pick a top 3. I happened to get my #1 and land in the cardiovascular step-down unit. I love my job, but it is extremely demanding both mentally and physically being a new RN and trying to manage basic nursing time-management-type things as well as critical cardiac and post-op cardiac issues. Best of luck, anything is possible if you're dedicated enough!
Once hired call the education department at your facility or ask your manager if there is an EKG class available. I work in a level II trauma center and they have a WONDERFUL 4 day EKG course (that we were actually required to take to work on CV Step) and it made everything so clear to me, and I got CEUs=win-win! I used the book EKGs Made Easy by Aehlert in school and it was a great resource as long as you have time to read (HA!), but the RN teaching the class just laid out the facts about the rhythms and what was important and gave us much practice and voila! it all makes sense now! Best of luck, keep practicing
I don't know if you're still working on this project, but if so I can give you a run down on the rehab we educate our post-CABG patients on in my unit. Starting day 1 post-op they are to walk 4 times a day on the floor. Once they get home they are to continue walking 4 times a day for a total of AT LEAST 30 minutes total/day. We give them a little chart to write their daily minutes on to take to their follow up appt with their cardiologist. I tell them to make it their personal goal to be walking 1.5-2 miles three times a week by the time they have been post-op for 3 months. This is the amount of exercise any healthy adult should be able to complete without becoming short of breath. They are to participate fully in their personal care including showering, etc. At first we allow them to have a totally open diet as they commonly don't want to eat at all for a week or 2 after surgery r/t nausea etc. that the intense medication regimen makes them feel post-op. We continue this diet regimen until they are really getting strong and then their cardiologist will modify their diet, however, we do advise a no-added-salt concept from the start since that is usually a hard habit to break and takes time. And as always they are to take daily weights and their VS BID and take a record of these values to their follow-up appointments. Hope that helps!
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