Cardiac Observation Unit--Is this a step down unit?

[minmin11]

Hey Everyone,

I have been a MSRN for the past 7 years, and just got a job offer from a Cardiac Observation Unit. I had Tele monitor experience for about 6 months few years ago, but that's about it for my Cardiac experience.

The patients on this units include CHF, Cardiomyopathy, Pre-Post Cardiac Surgery, Dysrhythmias and Patient waiting for heart transplant.

They do IV cardiac meds drips like Lidocaine, Cardizem, Dopamine, heparin, insulin drips but they don't titrate BP.

Is this floor a Cardiac Step Down unit? When I applied for the job, by the floor's name, I thought it would be a more like an intermittent unit.

Patient ratio is 1:3 to 1:4 Orientation is a month, does this sounds typical?

Thank you for your input!

(I submitted the topic in General Discussion before I found this, sorry for duplicating).

[sugarwahine10]

Hi, I don't think is sounds like a step down unit necessarily. I worked on a telemetry floor for years and we did all those type of iv drips (cardiac tele just couldn't titrate the drips like we do in the critical care units)--we had to call dr to adjust rates with same type of patients (CHF, A-Fib, pre/post cardiac surgeries, etc) that you described. If their nurse to patient ratio is 1:3 or 4 then I would grab that job because on the telemetry floor I worked on it was on days 1:4 or 5 with nights being 1:6. The orientation of a month sounds about right and if down the road you feel you need a longer orientation then you can just request that from the manager. Good luck if you take the new job!

[Lev, MSN, RN, NP]

Given those ratios, it sounds like an intermediate step down floor. Anywhere I've worked with an "IMC" or Intermediate Care Unit had 1:3-4 ratios. My current hospital has a Step-down ICU and then IMC is under that as far as acuity. Tele is under that. Medsurg/tele is under that. Also in the places I have worked (3 total), the regular tele floors don't take insulin drips because it requires frequent fingersticks.