HDU/CCU placement, what to expect

Graynurse · Apr 1, 2005

Hiya monster

This is just my opinion, but when I first started working in the HDU (6 weekas ago) the thing I found I needed the most was to be able to read an ECG, whats normal and whats not normal, and how to interrupt this, as well as the effects drugs will have on the heart and blood pressure and when to withhold them.

Hope this gives some help

Gray

monstermunch · Apr 3, 2005

Thanks Graynurse

I've ordered some books from the library on critical care and reading ECG's so hopefully I shall be a little prepared when I turn up on my first day. :uhoh21:

gwenith, BSN, RN · Apr 3, 2005

By co-incidence I will be preceptoring a student tomorrow in a ICU/CCU- it would be more than weird if ..............:chuckle

CCU - more than anything you HAVE to learn how to recognise and treat chest pain. Learning this will take you further than reading an ECG which is one of those skills that unless it is used daily is lost.

I would go with objectives along the lines of

1) Assess chest pain and differentiate between chest pain of cardiac and (blatantly) non-cardiac origin (Don't dwell on the second part of this as cardiologists have difficulty with some pain but you need to know how to tell the difference between say angina and a pulled muscle) You need to be able to identify the different way in which chest pain can present and how to accurately assess this pain (i.e. Women more often present with back pain, diabetics may not get any pain)

2) Initiate appropriate treatment for a patient experiencing chest pain. So when to give anginine, how much, how often what assessment/evaluation should you make of the patient during this time.

3) Review the drugs commonly used to treat cardiac disorders.

4) Discuss the management of heart failure

Most of HDU is assessment at a level that you will not have experienced yet. Don't look at the equipment because that will vary from unit to unit. Look at things like management of airway, assessment of respiratory failure (in particular if you can manage to nurse a patient who is marginal to needing ventilation then you will really learn assessment of resp failure)

There is so much. And if my student turns up tomorrow with these objectives - Well............

monstermunch · Apr 4, 2005

Thanks for the advice Gwenith, you've definately given me food for thought. I must say, I am really looking forward to it but at the same time dreading it, what with it being my first hospital placement.

Gwenith, if you don't mind me asking, what sorts of things would you be expecting a student to be able to do / know about when they turn up on their first day, particularly from a student in my position of having no hospital experience. Our uni was so short of placements that they are sending students to areas that they don't normally send them to at this stage in the degree program.

Anyway thanks for the advice and I hope your day went well. :)

gwenith, BSN, RN · Apr 5, 2005

I expect you to know nothing. I never assume you have had adequate experience. Do the best you can and everything will turn out OK.

monstermunch · Apr 6, 2005

Thanks Gwenith :)

gwenith, BSN, RN · Apr 7, 2005

Tell me how it goes. I have been having a good time with my student. Poor lass first day we had a ventilated patient on dialysis and soooooo much was going on that the poor girl was like "Oh! My God!!" but she completed that and is now starting to feel more confidant. The trick is not to try and learn everything the first day.

Keep us up with how you are going won't you.

monstermunch · Apr 7, 2005

Hello again Gwenith

I actually go on my placement at the end of May, wanted to get some early preparation in. I shall let you know how I get on though.

I think your student is very lucky to have someone like you teaching them, I hope I am as fortunate with my preceptor :)

monstermunch · Jun 10, 2005

Well, I have just finished my three week placement and have absolutely loved it. I would definately recommend it to any student.

The staff were fantastic, really took their time to explain things to me which obviously helps. The Doctors were also really supportive (wanted to mention that as Doctors sometimes get a bad wrap).

Thanks to everyone who posted advice and ideas prior to my placement, I really appreciated it :)