advice for new cardiac nurse

vcurrent2 · Oct 20, 2011

First and formost, DON'T BE AFRAID THAT YOU DON'T KNOW IT ALL!! You don't, and you won't for a long time. Find peers on the unit and ask them to teach you, ask them if they will be willing to answer your questions, but be careful and very selective in who you choose. Use your CN. He/she is an excellent asset. Good luck

yvfair · Oct 20, 2011

Don't try to learn it all at once. Start just reviewing your cardiac and BP meds especially your beta-blockers. Familarize yourself with basic EKG strips especially the detrimental ones: 3rd degree heart block, V-Tach, V-Fib, and Asystole. That's just a start. Dont over do it, start slow.

wannabecnl · Oct 20, 2011

I'll be starting in a cardiovascular surgical unit in about 6 weeks when I am finished with school, and I share some of your worry. I would say don't be terrified, though; it's paralyzing, wastes energy, and zaps your ability to learn (remember that SNS stuff from pharmacology? yeah, that's why). Realize what you know and what you don't (and at the beginning there will be more of the latter), and like the last poster said, find people to mentor you.

There are some good threads under cardiovascular nursing where people talk about helpful books, but I would suggest you start your job first and then see what you need. I spent a LOT of money on a great PACU book to prep for my clinical immersion, and when I got there, someone offered me a free copy of the previous edition! Yikes!

My CV unit does a precepted time at the beginning, extra training courses (like chest tubes and stuff), and a hospital-wide critical care course. Not every hospital does it the same way, but as a new grad, you'll want to seek out whatever orientation and training you can get.

Good luck to you, and don't be terrified--get in there and learn and do it and you'll be fine! Keep us posted!

skyandsydneysmom · Oct 20, 2011

I too just started on a cardiac stepdown unit and it has been a bit overwhelming...how much training will you recieve? I will have at least 12 weeks of orientation with a preceptor, as well as numerous classes regarding care of the cardiac patient, dysrhythmias, etc. I graduated in December and worked in LTC for a bit, so this is very different for me but exciting. As long as you are commited to learning you will be fine! No one expects you to know much, they should see that you are provided the education that applies to this population. It will all work out fine!

WillowNMe · Oct 20, 2011

I graduated in May and I started on a cardiac floor... I would do as the others suggested - meds (BP, heart, diuretics, etc.), EKG strips and also procedures if that is done at your hospital - pacemakers, bypasses, stents, ablations, etc.

I would NOT recommend sitting in front of a book a re-reading these. At least that didn't work for me. I looked up stuff at work when I had questions and things came to mind... I re-read over time certain things that were reoccurring so I could see the big picture.

nurseprnRN, BSN, RN · Oct 20, 2011

see if your orientation will include "field trips" to special procedures-- angiograms, cardiac rehab, speech/language path, cardiac rehab, neurology clinic, etc.-- to give you an overview of the whole patient experience. ask for those chances. you'll learn a lot there that you can apply to your nursing plans of care, when you are responsible for deciding what your patients need in the way of nursing care over and above what you'll be doing to implement the medical plan of care for them.

Tait, MSN, RN · Oct 20, 2011

1. Find out if you can or will have to get stroke certified. I know at my hospital it was an eight hour course I believe?

2. Take ACLS. You will most likely never have to use it but when a patient pops a PE or any other significant code it will give you a lot of confidence to jump in there.

3. Call docs with changes in rhythms. If you have a patient who has never had runs of vtach before call it in. If it is documented and the patient is asymptomatic you may not need to inform them, but refer to your floors policy on the situation.

4. Enjoy it! I really loved working cardiac. Everything about the heart is fascinating to me and once you get used to the regular raft of meds and symptoms you can really participate in wonderful things!

Best of luck!

Tait

Tait, MSN, RN · Oct 20, 2011

see if your orientation will include "field trips" to special procedures-- angiograms, cardiac rehab, speech/language path, cardiac rehab, neurology clinic, etc.-- to give you an overview of the whole patient experience. ask for those chances. you'll learn a lot there that you can apply to your nursing plans of care, when you are responsible for deciding what your patients need in the way of nursing care over and above what you'll be doing to implement the medical plan of care for them.

if i could "kudo" this 10 times i would!! it is great to be able to say "oh yeah i have seen a heart cath before" and give them a succinct run down of the procedure and the room.

DookieMeisterRN · Oct 20, 2011

see if your orientation will include "field trips" to special procedures-- angiograms, cardiac rehab, speech/language path, cardiac rehab, neurology clinic, etc.-- to give you an overview of the whole patient experience. ask for those chances. you'll learn a lot there that you can apply to your nursing plans of care, when you are responsible for deciding what your patients need in the way of nursing care over and above what you'll be doing to implement the medical plan of care for them.

this is very helpful for orientation. my unit, a cardiology/respiratory stepdown has a great orientation with time spent observing procedures in the cath lab and post-procedure, shadow in icu and cicu, inpatient dialysis, work with rt with our vented patients, iv therapy team, and observing other unit specific procedures ie bronchs, cardiac stress tests, intubations, rr team. excellent chance to understand and explain to your pt what to expect and it is easier to fully comprehend when you observe for yourself.

wannabecnl · Oct 20, 2011

I also love the idea of field trips. My soon-to-be unit prides itself on training newbies, but I don't remember then mentioning field trips in the interview. If they don't already do it, I'm going to suggest it.

cardinalRN · Oct 20, 2011

Learn about heparin drips, Plavix, Coumadin and Pradaxa along with the other cardiac meds. Brush up on your electrolytes and how they can affect rhythms (especially K & Na). It's so important to recognize the rhythms on telemetry...SVT, Afib, Vtach, etc. Also, know about neuro checks and the NIH stroke scale. Hopefully, a lot of this will be covered in your orientation and you will have a good preceptor. But even if you don't, give yourself homework and research anything you don't understand. Good luck!