Open Heart ICU

Specialties MICU

Published

How is it looked upon for new graduates to apply for work in an Open heart unit? Did any of you go directly into an open heart ICU after graduation? Do you know of a new grad who did?

I'm a senior and I have a teacher who believes that nobody should even work in the ICU without years of med-surg experience. She said, "Back in my day, open heart nurses were the cream of the crop." I think she may just be bitter that things have changed, but I would like a fair view of how you see this issue in your workplace.

Our unit also occasionally will send patients home. Now, this is a very rare happening, but sometimes we'll get a 'level I' trauma that had to be intubated for CT, but had no 'real' injuries, and we will discharge them to home when they're ready.

RE: New Grads in the Unit

I think it depends on the individual person, just like anything. Some new grads have no business in the unit, and some experienced med/surg nurses also have no business in the unit, no matter how much training you provide.

As far as orienting new grads compared to experienced med/surg nurses.....aside from a little bit of organization edge, and more experience with assessments, it still seems to take them just as much time as a new grad (most of them), to pick up the new skills needed to work in an ICU.

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Specializes in Critical Care/ICU.
I'm guessing you went straight to ICU as a new grad
Yes, I did.

And i find it odd that your unit(it was your unit, right?) does discharges home from ICU. One minute critically sick and the next ok to go home?? Does this unit double as step-down, or maybe overflow???
We are never a step-down. We are a world renowned cardiothoracic surgery ICU (there are a few great ones in this country). We have 25 beds and a staff of nearly 100 RNs. The only overflow we get is from the 32 bed med/surg/trauma ICU that has a staff of 100+ themselves. The RN's of both of these ICU float only between the two and very rarely at that.

We sometimes get post-op carotid's who need 24 hour or so observation to make sure they don't throw a clot or have respiratory compromise from swelling, etc. There are other instances when we d/c patients home but like I said, it happens only occasionally.

I really don't want to debate the new grad vs experienced nurse choosing the ICU thing to the point of being accused of being "on crack." I support anyone who takes the initiative to do what they feel pasionate about. But each person is different and learns at their own rate and style. Just because someone has some nursing experience already under their belt, doesn't make it necessarily "easier" for them to adapt to the ICU setting; just as I would never think that just because I have ICU experience, it would be easier for me than a new grad to acclimate to a step-down or different unit. Each area of nursing is different with each their own unique areas of knowledge that aren't inherent, but rather learned.

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Specializes in Critical Care/ICU.
I'm guessing you went straight to ICU as a new grad
Yes, I did.

And i find it odd that your unit(it was your unit, right?) does discharges home from ICU. One minute critically sick and the next ok to go home?? Does this unit double as step-down, or maybe overflow???
We are never a step-down. We are a world renowned cardiothoracic surgery ICU (there are a few great ones in this country). We have 25 beds and a staff of nearly 100 RNs. The only overflow we get is from the 32 bed med/surg/trauma ICU that has a staff of 100+ themselves. The RN's of both of these ICU float only between the two and very rarely at that.

We sometimes get post-op carotid's who need 24 hour or so observation to make sure they don't throw a clot or have respiratory compromise from swelling, etc. There are other instances when we d/c patients home but like I said, it happens only occasionally.

I really don't want to debate the new grad vs experienced nurse choosing the ICU thing to the point of being accused of being "on crack." I support anyone who takes the initiative to do what they feel pasionate about. But each person is different and learns at their own rate and style. Just because someone has some nursing experience already under their belt, doesn't make it necessarily "easier" for them to adapt to the ICU setting; just as I would never think that just because I have ICU experience, it would be easier for me than a new grad to acclimate to a step-down or different unit. Each area of nursing is different with each their own unique areas of knowledge that aren't inherent, but rather learned.

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Being a new grad with so much to learn is hard period, no matter where you go when you start. The 2 things I would look for when deciding where to work. (1.) Orientation length, and preceptor willingness to teach (2.) Core staff RN experience/support- you're going to lean on them a lot when you start, so you need to know you have good back up. They will start expecting you to become increasingly more independent as time goes on, but in my experience they are always willing to help and answer questions. Even experienced nurses ask each other questions, nothing wrong with it.

I can say I just graduated in May and was told the same thing about needing med surg floor experience. I knew this wasn't what I wanted, so I kept looking until I got my ICU job. I love it and wouldn't want to be anywhere else. I'm in Medical ICU, one of my friends from school is in CSICU. Honestly comparing our experiences, we've been through different, but comparable experiences as new nurses. We've both had our share of stressful, never-ending days, but this is when I find I learn the most. Bottom line, be eager, willing to learn, watchful, always asking questions, and you can do it! Good luck.

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Being a new grad with so much to learn is hard period, no matter where you go when you start. The 2 things I would look for when deciding where to work. (1.) Orientation length, and preceptor willingness to teach (2.) Core staff RN experience/support- you're going to lean on them a lot when you start, so you need to know you have good back up. They will start expecting you to become increasingly more independent as time goes on, but in my experience they are always willing to help and answer questions. Even experienced nurses ask each other questions, nothing wrong with it.

I can say I just graduated in May and was told the same thing about needing med surg floor experience. I knew this wasn't what I wanted, so I kept looking until I got my ICU job. I love it and wouldn't want to be anywhere else. I'm in Medical ICU, one of my friends from school is in CSICU. Honestly comparing our experiences, we've been through different, but comparable experiences as new nurses. We've both had our share of stressful, never-ending days, but this is when I find I learn the most. Bottom line, be eager, willing to learn, watchful, always asking questions, and you can do it! Good luck.

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What are some of the critical thinking questions you would ask your orientee, and what are some of the most frequent questions you get from them?

Thanks,

CP

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I'm guessing you went straight to ICU as a new grad as you're obviously very passionate about this issue...

If you think a nurse with a few years on a step-down does NOT have an overwhelming edge over new-grads, i think you're on crack.

And just a clarification...our nurses dont go to the 'floors' but we do float to step-down where unfortunately the load is sometimes 5 patients...

And i find it odd that your unit(it was your unit, right?) does discharges home from ICU. One minute critically sick and the next ok to go home?? Does this unit double as step-down, or maybe overflow???

How about a respectful difference of opinion? Accusing another person of being on crack, even though this is tongue in cheek, just provides fuel for the fire that nurses can't get along...

Oldiebutgoodie

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I graduated in May of this year and started in a Surgical ICU in July. We have a wide variety of surgical patients, including open heart. It has been extremely stressful, but it is possible. I feel you need to be able to grasp concepts quickly though. It is definately not for every new grad. My unit has hired many new grads recently, but not all have stayed. We do not take first day post-op open hearts, too technical and the patient can take a turn for the worst in a matter of minutes. You really need to know what you are doing. We usually take these patients 24hrs + after surgery. I have been extremely fortunate to have such supportive senior nurses. They answer all my questions, and stop to help out even if they are busy with their own patients. This is the only way I have survived. I wish you all the luck in the world. I have learned so much! It feels good when I can answer the question of a new hire with confidence!! Thanks to my senior nurses.

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I was a new grad hired into CVICU. Had to go through a 13 week critical care class that made nursing school look like third grade.

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Well put!

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Specializes in ICU.

Love this heartICU

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