Calling all new grads, what are your thoughts?

stn2003, RN · Jan 26, 2006

I am in a new grad position on a cardiac stepdown/telemetry unit and so far i LOVE it. they put all their new grads through ACLS and a special EKG class. Our unit rotates ACLS nurses to charge position based on a schedule, and our charge nurse (whoever it may be that day) is part of the code team that responds to all the code blues in the hospital. we get our fair share of codes on our floor. I can look at the monitor and recognize the rhythm, whether it is paced, if there is a block present etc.

we get alot of COPDers and diabetics with underlying heart issues (chf, cad, a-fib). Alot of men and women in their late 30s-50s that come in with chest pain and get the whole gamut of testing. we also get whatever ICU throws at us which occasionally is surg patients who had some kind of cardiac issue during surgery, and are coming to our floor on monitor instead of back to the ortho/med-surg floor.

we do chemical cardioversions on the unit. we have a lot of drips used on the floor: cardizem, dobutamine, dopamine, integrilin, heparin, lidocaine, pronestyl, natrecor, nitro, primacor, verapamil etc.

every patient always has a ton of consults (gi, pulmonary, infectious disease, neuro, renal) and as a new grad i'm just getting the hang of identifying all these different doctors, and giving them the information that they are looking for (for example, the lung doctor may be thrilled we weaned the pt off 02 and pt has had sats >95 even while ambulating, but our infectious disease doctor could care less about that and may just want to know what the levels were on the p and t for vanco. lol)

now that i have rambled on (sorry) as far as job offers go on a unit like this, i would ask about how long their orientation is (mine has been 2 months full time on days, then another 6 weeks full time on nights- but I also worked on this floor for 1.5 yrs as a tech), if you will have the same preceptor/what type (mine has been on this floor for ten years and is certified in step-down care), what the nurse to pt. ratio is in general, whether or not they will pay for you to go to specialized classes such as EKG or advanced cardiac life support. oh yeah, and ask about pay/shift differentials, if there is a weekend committment, and what their policy is on sick time and overtime.

MeechiesRNBSN · Jan 26, 2006

How do you feel about the drips on your floor? Did you get appropriate training on how to administer them? I don't remember ever having to administer them in nursing school! Is that part of the learning in the real nursing world? Should I be concerned?

stn2003, RN · Jan 27, 2006

i dealt with a few drips while in school during my practicum portion, but always with my preceptor of course...it is definately part of the 'real-world' training you get post school. our floor has a protocol book for all the drips we use which explain each med in depth and how to calculate the drip rates for them. i am a firm believer of when in doubt, grab a more experienced nurse who is used to working with them to show you/help you do it the first few times until you are comfortable. also, some of our drips are high alert meds (like heparin) and we start them/change rates with another nurse and its nice to have that second set of eyes determining all's well.