First time CVICU traveler

  1. I'm an experienced Medical/Surgical ICU nurse who recently took my first travel assignment, and I was placed in a CVICU. I have my CCRN and feel like I have a pretty decent level of confidence/experience with medical ICU patients who have CV co-morbidities, but it is my first time working in a dedicated CV unit. Does anyone have any resources they would recommend I purchase/obtain that might help me along? Or any tips/clinical pearls? The unit sounds like it's like 60-70% CCU patients and then the remaining % are cardiac surgical patients. Thanks!
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    About EllaBella1, BSN

    Joined: Nov '15; Posts: 268; Likes: 877

    3 Comments

  3. by   Charge200J
    Welcome to the CVICU! Hopefully it will be an awesome experience for you! I know we really appreciate our travelers. Depending on the acuity of the unit and hospital you'll see a lot of swans (PA catheters), lots of CVVH, and many different mechanical circulatory support devices (IABP, Impella, Ecmo, Centrimag, LVAD's). Read up on hemodynamics so that the CCU patients make sense. One big difference that I see between the CCU patients and cardiac surgical patients is their response to fluids. The heart failure CCU pts are often aggressively diuresed and fluid boluses are given in small amounts and very slowly. Whereas the cardiac surgical patients are often fluid resuscitated with liters of crystalloid and colloid. Another good tip is crank up the heat and grab a bair hugger/bundle up with blankets to keep your fresh cardiac surgical patients warm and toasty...they come out freezing cold from the OR and a cold patient will bleed more.
  4. by   2210485
    Quote from EllaBella1
    I'm an experienced Medical/Surgical ICU nurse who recently took my first travel assignment, and I was placed in a CVICU. I have my CCRN and feel like I have a pretty decent level of confidence/experience with medical ICU patients who have CV co-morbidities, but it is my first time working in a dedicated CV unit. Does anyone have any resources they would recommend I purchase/obtain that might help me along? Or any tips/clinical pearls? The unit sounds like it's like 60-70% CCU patients and then the remaining % are cardiac surgical patients. Thanks!
    How in depth do you want to go?

    If you wanna get into the weeds and don't mind some intense reading, I found this book for only $18! I cant vouch for the distributer/source however, it just came up on my shopping results. I own a copy and it goes deep into the pathophysiology, helped alot! It does not go as deep into some of the practical elements however (pearls for a provider). Unfortunately this is a book that could take a long time to swallow:

    Cardiac Nursing Susan L Woods Isbn 97878179286 7817928

    If you desire a book thats primarily focused on practice and interventions and not so much theory I have 4 recommendations:

    (Longer but easy to grasp conceptually, 1 - 2 weeks to read cover to cover) I am posting a link to the 7th edition, the most current is the 8th. I am doing this because honestly the changes are not significant enough to warrant spending the extra money on the book, used copies as cheap as $25. I have read all of the past 3 or 4 editions of this, I own this version. Some practices have changed a bit, but nothing that will necessarily bring harm to a patient by utilizing this edition.:

    Grossman's Cardiac Catheterization, Angiography, and Intervention: Donald S. Baim MD FACC: 78175567: Amazon.com: Books

    (Extremely short and easy, Was able to read cover to cover in 2 days) I own the newer edition, I have not seen the older one.. However, again, this will suffice I am sure. At the time of this post someone was selling one for $6:

    Textbook of Clinical Echocardiography 3rd edition: Catherine Otto: Amazon.com: Books


    (Easy and short, I read this in 1 day) Older edition selling for $5. Advanced EKG... Alot for extremely detailed information. Criteria and EKG findings you likely have never seen before. I know it's often easy to think "I've seen my share of EKGs", however I can not stress enough that this book is NOT your 'Dubins'. I'll even give an example of the type of differences here:

    Dubins wll teach you things like this:

    "A normal PR interval is .12- .20 seconds"

    This book will teach you things like:

    "V1 with RBBB pattern morphologic criteria presents as a rsr' in v1 withOUT the presence of a negative or 'true' S deflection."

    You won't be bored and you're almost certain to learn new things about EKG's. This book will absolutely help elevate your EKG skills, in fact a solid grasp on this book in addition to the next recommendation, honestly puts you at a level consistent with expectations of nurses in the EP Lab:

    Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment: David Bennett: 9783487316: Amazon.com: Books

    (Extremely short and easy.. I read this in 1 day) at $46 this book is the most expensive I am listing! But its worth every penny! With a good rainy day worth of reading you will have a grasp on clinical electrophysiology to the extent where you can communicate with an Electrophysiologist without the burden of learning irrelevant details and procedure you will never see in your unit.

    A new publication designed to give non EP's a 'crash course' in the field; it is the most straightforward and streamlined outline I've read so far. It is a friggen AMAZING publication. 10/10

    Clinical Cardiac Electrophysiology in Clinical Practice: David T. Huang MD, Travis Prinzi MD: 9781447154327: Amazon.com: Books


    (Long and difficult... "The Bible" of cardiology) older edition used running for $25. Its a textbook of cardiology... Goes without saying it will probably take a minute to read this thing fully. As a reference to fill in gaps left hy other suggestions though its great!

    Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, Single Volume, 8e (Heart Disease (Braunwald) (Single Vol)): Peter Libby MD PhD, Robert O. Bonow MD MS, Douglas L. Mann MD, Douglas P. Zipes MD: 97814164161: Amazon.com: Books


    Altogether these suggestions will run 115 + probably 35 S&H

    However for a $150 price tag (typically the price of a single book) you could leave with a wealth of cardiovascular knowledge.

    P..S All recommendations are considered to be 'Standard Curriculum' in training programs designed to train Cardiology Fellows, Cardiology Nurses and NP's and Cardiovascular Techs. They cover all of the topics mentioned by charge and the authors are considered the subject matter experts and are panelists that hold a good deal of weight at conference. You're in good hands with these.
    Last edit by 2210485 on Feb 10
  5. by   EllaBella1
    Thank you so much! Will definitely order a few of those books!

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