Considering Cardiac

[OneOnOnes, ADN]

Just over a year ago I started as a new grad nurse on a very acute & busy med-surg floor which was also the cardiac/telemetry floor for the hospital. I ended up quitting on the 12th week of orientation. I felt extremely anxious all the time, depressed, afraid to talk to providers, and felt like I did not know what I was doing most of the time, and did not feel like I was properly managing patients symptoms due to fear of providers acting like jerks.

I since went to work at a nursing home in long term care and skilled nursing for a year now. I now feel much more comfortable in my role as a nurse, and not as afraid to speak to providers, however I am getting very bored of the job and feel like I just monitor when people go to the bathroom and supervise staff.

I am considering trying the hospital again to gain skills. I do not want to try medsurg again, but I am considering ortho or cardiac. I am specifically thinking of applying to a cardiac-telemetry floor at a different hospital that I have connections at.

Any tips? Should I make this career move now?

[AvaRN_ICU, BSN]

I say definitely apply for a job in the hospital if you are feeling unfulfilled at the nursing home and becoming more confident in your basic nursing skills.
But I would warn you that in my experience cardiac/telemetry units are the most hectic/dumped on units in the hospital, so be prepared for that. 
I started out on a cardiac/tele unit and that type of unit is somewhere in between med/surg and a cardiac step down unit. We got cardiac drips (nitro, cardizem, integrilin, amio, heparin etc.), chest tubes, post cath lab patients etc. that med/surg floors cannot take BUT we had the same patient ratios as the med/surg floor (1:6). It didn’t make much sense because it was clearly a step up in acuity. When you have patients that just came back from cath lab and need q15 min vitals or your deflating a TR band there isn’t much time for your other 5 patients. Or even when you start getting up to 4-6 heparin drips that you have to manage q6 hours it can be a lot. Cardiac floors also have a high turnover with patients so you will have a lot of discharges and admits!! 
On top of being a cardiac floor, they will also treat you as a med/surg floor. So, you will get every type of patient there is, it can be a good thing as a new grad because you get to see a lot and learn a lot. But when you’re working a cardiac floor and you have zero cardiac patients it can be frustrating. 
I say go for it if you are wanting to get into cardiac but just be prepared for a very high paced environment.

GOOD LUCK! And remember you can only go as fast as you can go on these crazy floors. That’s literally all you can do so just try to stay calm and tackle things one by one based on priority. 

[CeciBean, ASN, RN]

It kind of depends on the hospital. I worked in a couple of hospitals on cardiac medical units where the ratio was 4:1. In one of those, the unit was divided into pods where there were 4 rooms. The other was a standard floor and the ration was 5:1 on nights.  The first one, where I worked as a traveler, was kind of an aberration for me but I really liked it. I've never seen another one like it. Each pod had a pyxis and a supply unit. They were ranged around a central desk where the charge nurse and intake nurse were stationed and where the docs did their thing. Did I mention this was a teaching hospital? I totally loved it there and the regulars seemed to also. The other was the medical side of a dual unit that was king of attached to the CICU--the other was cardiac surgical and functioned mostly as the stepdown for the open heart post-op, but we both had post-cath cases. I liked it really well too, and the only reason I left it was that I separated from my late ex and became a travel nurse. Unfortunately that hospital was absorbed by a large corporation and is now no more. As a traveler I worked on a lot of cardiac/tele units and they totally varied. Some were stepdown and some were not. Stepdowns are the best kind and are generally less crazy. That's my experience. The other thing that will make or break you is your preceptor. Hopefully you get a good one.

[martymoose, BSN, RN]

Cecibean, that sounds like it was a WONDERFUL unit to work on. Sorry it had to go. And probably be like mine with ratio of 7-10 , 1-2 techs, and one Omnicell for 27 pts, and two hallways beds with inappropriate patients in them( this is a stepdown unit)