orientation for fresh hearts

  1. Hi All~

    I recently started a new position in CVICU. (Background is 3 years of cardiac step-down). My oreintation is 3 months long, starts with taking care of stable post-op patients that may still have chest tubes and pacer wires and progresses to taking care of patients fresh off the pump. I'm currently toward the end of my orientation and freaking out because I have not had much opportunity to take care of the patients straight out of surgery, as there are not necessarily cases always scheduled for days that I happen to be at work.

    In your opinion, how long of an orientation should a nurse have strictly taking care of these patients? My fear is that I'll really only get about 7 good days tops, if I'm lucky. I really like this unit and want to excel at my job, but the perceived lack of experience with the fresh CABG's is starting to worry me. Our hospital is very strict on orientation and will not extend it

    Any input is appreciated!
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    About tachy

    Joined: Jul '11; Posts: 16; Likes: 6
    Specialty: CVICU


  3. by   SRNA2011
    Hi Tachy,

    The CV-ICU unit that I work at also gives RN (with prior nursing experience) about 3 months of orientation. I am also a preceptor and the orientee recovers fresh post-ops in the last few weeks as well. If you are still worried that you don't feel ready or prepared to work on the unit, I would express these concerns to your preceptor, manager or supervisor. If they agree, they might be able to extend your orientation a couple of days and focus on the skills that need improvement. Even though the time limit is strict, I really don't think they should force you to come off orientation if you feel like you are not prepared- to me that seems unsafe. Also, you most likely will get assignments with stable ICU patients when you are off orientation and on your own. It can be a little nerve-wrecking and scary to think that you only had a short amount of time to train, but the understanding is as long as you understand the unit and practice safely as a RN, you should be fine. Just don't be afraid to ask other RNs for help or when you don't know something. Hope this helps & good luck!
    Last edit by SRNA2011 on Jul 22, '11
  4. by   littleneoRN
    Can you ask to schedule some of your remaining orientation days when there are cases scheduled? After you're off orientation, you shouldn't really be recovering fresh hearts right away anyway. Ask your fellow nurses what you can do to help when they get fresh patients so that you can be involved in the process and learn along the way.
  5. by   tachy
    Thanks for the replies. I'm trying my best to try and be there when cases are scheduled - I think it's just slower because it's summer, too. They will be giving us fresh hearts off of orientation, but more likely 'stable' ones so we don't drown!
  6. by   OpenHeartRN24
    when i went through my cvicu orientation we were paired with the most experienced nurses in the unit and we started recovering fresh hearts right away. it was def a nerve racking experience, but our preceptors were great. they were w/ us all the time and were more than happy to explain anything. don't be afraid to ask questions or for help. also dont be afraid to get in there and learn as much as you can. everybody was new once and guess what those nurses you work with that have experience and you want to be like... they will need your help one day. you will do fine
  7. by   Biffbradford
    Agreed. If you get a feeling in your gut that something's amiss ... ask for someone else to look at the situation. If you're about to go down in a flaming heap ... don't go down alone!
  8. by   BevRN
    I'm hoping to obtain a position in the CTIC (similar to your unit) after 2 years on cardiac step down. It sounds like I maybe in the same boat as you. You'll have to let us know how you progress!!! I'm nervous even at the thought of having that first fresh heart pt of my own and I just finished my interview!
  9. by   Biffbradford
    You can always run it by who ever makes the daily assignments that you're looking for admissions. Even after you're there for several years, you can get in a rut where you're mostly taking care of long termers and you get rusty. Then, out of the blue they give you a train wreck. Oh man! But, you work through it and all is good again. It's just the way the ball bounces some times, go with the flow.

    Also, as you start picking up more machines and taking more educational classes they offer, you'll get sicker patients also, but don't rush it. It all comes together in time.