First of all, I wish to congratulate you on graduating/passing your boards. ::throws confetti:: Yay!
Right then. Now that’s out of the way, let’s chat, shall we?
I will do my absolute best to speak in some semblance of order, but I warn you, I just got off a night of trauma call and I’ve had a Starbucks Venti awesomeness with three shots of ground epinephrine and I am pretty confident that I no longer have individual heart beats.
But I am awake, if not a bit disorganized.
Enough rambling. (Do you see?!)
Is the Heart Room a good place to start out as a new grad in surgery?
Well, everyone has to start somewhere, right? And to be fair, that depends on each individual. Some folks are just born with the ability to think on their feet and thrive in high stress situations. Not to say that the Heart Room is all high stress…I mean, let’s be realistic here, for about half the case the patient is technically dead…but when it goes bad, it goes ugly and how. So that is where that wonderful adrenaline junkie tendency shines. After all, you are no good to me if you are catatonically rocking the in the corner as opposed to taking over compressions/massage on an open chest cracked fresh in Cath Lab.
But back to whether or not this is the place for you, it also depends on personal preferences. You may not like the Heart Room, and that’s okay. You may not like the team dynamic or feel that you fit in with the members of the team. That is also acceptable. It doesn’t make you any less awesome or make the team a gaggle of jerks. It just means it’s not for you; try not to worry about it too much--you’ll find your place.
I cannot stress enough how important it is that you fit and work with your surgical comrades. When the days are rough, when the surgeons are having a meltdown, when the case goes to hell in a hand basket, meeting eyes with your team mates across a chaotic room and sharing an eye roll, a wink, a sympathetic crinkle at the corner of the eyes acts as a long distance pat on the shoulder and reassuring unspoken words of “I know, I see it too. Wanna get a drink later? God this is a hot mess. Ugh. You are doing awesome.”. When you have found your team, it’s like finding a long forgotten well worn pair of jeans: it just fits and feels right.
Is it possible to become a Heart Team member as a new grad and succeed? Absolutely. Give me someone with critical thinking skills and the desire to muscle through the low moments and succeed and I can turn you into a Heart Nurse.
As far as call requirement/burn out concerns, each person has their threshold of enough. I, personally, work five days a week, a least one double a week, take week spans of trauma call, at least one weekend a month of scrub call, and pick up heart call here and there. I may be unbalanced 98 % of the time, but I am not burned out. I’m a workaholic.
It’s a problem.
The call requirement you are faced with isn’t terrible, really. It’s about what, two-three days a week? Not too bad. Depending on your home life, it could be quite manageable.
Now that I’ve rambled for a while, let’s break it down in words of caution and advice:
Do you have questions prepared for when you go and shadow? You should. You very much should. Itemized list of things to consider to follow:
~~ What is the call turn-around time expectation? (Average time for many facilities is 30 minutes)
~~ On average, how often is the call team called out?
~~ How often, on average, do the various surgeon experience emergency bring-backs?
~~ How many heart cases a day are performed on average?
~~ How long does the average heart case take?
~~ How many cardiovascular surgeons are there?
~~ Will you be required to assist in Cath Lab? If yes, is there additional orientation given to this portion?
~~ Does the heart team also perform all vascular cases? If so, what are they and is there separate orientation/additional time given to master theses cases?
~~ What is expectation of your role/abilities at the conclusion of the sixth month orientation? I.e. Are you expected to fly solo and take call when it is over or will you have back up for a while?
~~ What happens if it is deemed that additional orientation time is necessary?
~~ As you are the first new graduate they have orientated to the Heart Room, what is their plan of action as far as addressing what are going to be unique needs?
~~ What does the team/team members feel makes a good heart nurse?
In a nutshell:
This is not going to be a fun transition--not in the classic sense of the word “fun” anyway. I’m laying that out on the line right now. Anyone who tells you otherwise is a liar.
It’s a different set of perceptions, practices and cultures in which you will be immersed without consideration or mercy. It will be overwhelming, at times frustrating, a touch terrifying, and it may push you to limits you didn’t realize you had. You will have mornings of nausea and anxiety, night times of tossing and turning due to an over stimulated mind and afternoons where you would offer your left arm just to have the chance at a nap. Know that this will pass.
Your back will ache and you will discover muscles you never even knew you owned. I promise you, you will break a nail to the quick at least once and not even realize it until half way though the case. You will quickly realize that the gym shoes you own don’t do @#$% for your feet and Aleve is your new best friend.
There will be days you wonder if it’s all worth it….and only you will know the right answer.
Approach this with a sense of patience and long term goals. Know that nothing happens overnight. Learn to be gentle with yourself. Get in touch with your inner humility. Never be afraid to ask questions and be diligent in receiving good, reasonable answers. Take the time to note minor victories and major improvements.
It’s a different world and an interesting opportunity. I wish you the best of luck.