Beginning my first week off orientation in cardiac step down...

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I am a new grad and this will be my first week off orientation on a busy cardiology step down unit at a major teaching hospital. Any words of advice for me? I feel ok w/ the routine day to day stuff, but have never really had an unstable pt and this worries me! I know I am never truly "on my own", but can't help being nervous w/out my preceptor. Is there anything you wish you knew starting out, that you had to learn the hard way? Any advice is appreciated!

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Remember :systole is NOT a shock-able rhythm,

Airway Breathing Circulation!!

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You WILL have a scary rhythm, and when it happens, RUN (don't walk) to the patient and check to see if they are symptomatic. (Usually they feel fine). Get a fresh set of vitals, talk to a long time nurse on the floor and ask her opinion and if the situation warrants it (like rapid afib) call the Dr. with the symptoms and rhythm, they will likely have you start a drip. One thing, the first time I had to start an amiodarone drip the Dr. chewed me out because I asked him to repeat how many mls per hour to initially run it for and for how long and he said "follow the protocol! don't you have protocol? Your hospital established it!!""(turns out amio is 33ml/hr for 6 hrs then 17 ml/hr thereafter--that's burned into my brain lol) so I had to explain i was just off orientation and he told me I better get a nurse to help me that has done the drip before- which I planned on doing anyway.

I've been a cardiothoracic/cardiac stepdown RN for 6 months and I LOVE it. The cardiac population make for the best patients, IMO. I love that they recover so quickly (usually) and it allows us to really feel like we make a difference to them. ♥ Good luck!! :)

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