Hearts and recovery

[aerorunner80, ADN, BSN, MSN, APRN]

I've always loved hearts and one of my dreams is to recover them. At the same time I really like working NICU a lot and don't want to leave. Our hospital finally got a pedi cardiac surgeon (the only specialty we were missing) but the plan right now is to recover hearts in PICU and not in NICU becuase they aren't expecting to have a lot of cases.

Are there many NICU's out there who get enough cases to recover their own hearts? I feel like that is the one missing piece in my career.

I know I could always apply for a PICU position but I really don't want to leave NICU. It would be perfect if I could stay in NICU and do heart recovery in PICU but I don't know if that would work out or not.

If you do recover hearts, do you mind giving me a little glimpse into what it is like?

[umcRN, BSN, RN]

Not at my hospital. In fact I think the shift in practice now is to start having primarily cardiac intensive care units. Most major children's hospitals have them now and many others are starting to move those kiddos out of the PICU's and into CICU's. I can't think of any NICU's that recover their hearts. Even at CHOP where they have two separate NICU's - a "preemie" nicu and a "med/surg" nicu their hearts still go to the CICU. I work in a cicu now (I worked in a nicu first) and I absolutely love it.

[meanmaryjean, DNP, RN]

I was almost two years in the PICU before I started recovering hearts in the immediate post-op hours. I did it many years ago in a NICU in Chicago, but that was in the 1980s- when a lot of the procedures done today were not available. (I actually participated in the clinical trials for PGE1- before it was an FDA approved drug! Yeah, I'm that old) Back then, there was no treatment for single ventricle conditions except snuggling with mommy and daddy until the end.

Recovering a fresh heart is intense and (not gonna lie) a little scary. A lot is happening and you have to be on top of it all- all the time. AND you have to be ready to go on ECMO if needed. We have two nurses for the first couple of hours at least. (It's a full time job just untangling all the lines, cables and cords!) They typically come back on fentanyl, milrinone, precedex, cisat, epi, dopamine and sometimes lasix gtts. It's not uncommon at all for them to have an open chest. It takes a good long while just to get your charting set up -so the second nurse does that and inputs all your numbers while the primary nurse assesses and does the immediate post-op stabilization (and tried to warm the kid up!)

Our NICU sends the kids to us pre-op the night before surgery, we recover them and send them back to 'learn how to be a baby' a week or so later (after they're off pressors and milrinone and rock solid stable from a surgical point of view). Part of this is because our NICU is two city blocks away, in a separate building- and an ambulance ride is required to transfer.

I love the acuity of cardiac surgery kids, and I love the teaching aspects. We also have an EXCELLENT NP who works with our surgeon who is wonderful at preparing the parents in the NICU for their time in the PICU.

[umcRN, BSN, RN]

agree with all that marycarney said! The difference in my particular unit is that we get all our babies pre op and they stay post op and are transferred to our acute heart unit, they never go to the NICU at all. The rare exception to that is a preemie who is too small for acute care (

[Bortaz, MSN, RN]

This fascinates me, but I think I started my nursing career too late. I'm too old to be trying to learn something as intense and critical as this. I should have become a nurse when I was young and still had most of my 'napses firing.

[umcRN, BSN, RN]

Our NICU sends the kids to us pre-op the night before surgery, we recover them and send them back to 'learn how to be a baby' a week or so later (after they're off pressors and milrinone and rock solid stable from a surgical point of view). Part of this is because our NICU is two city blocks away, in a separate building- and an ambulance ride is required to transfer.

I'm so surprised your surgeons allow this! Our surgeons won't even let the kiddos go to our acute heart unit/step down over the weekend which is literally a 3 minute walk through the building away. Granted over the years as our CICU has gotten bigger the issues our step down "feel comfortable" with gets smaller and our surgeons no longer trust their abilities after the many many bounce backs because kid cried for to long and turned blue.

[meanmaryjean, DNP, RN]

This fascinates me, but I think I started my nursing career too late. I'm too old to be trying to learn something as intense and critical as this. I should have become a nurse when I was young and still had most of my 'napses firing.

I started in PICU just a few weeks after my 56th birthday - it can be done!

[HazelLPN, LPN]

This fascinates me, but I think I started my nursing career too late. I'm too old to be trying to learn something as intense and critical as this. I should have become a nurse when I was young and still had most of my 'napses firing.

I did PICU and NICU late in my career after 30 some years of adult ICU when I was 58... pushing 60. Yes 60 and let me tell you something...60 is NOT old. Keep your mind sharp. Help your grandchildren with their algebra. Do cross word puzzles. Play bridge. Take classes at community college. Learn another language.

I managed to work PICU/NICU (contingent) until I was 75. Now...that's getting kind of old. Then my body started to tell me it was time to do something else. Facing knee replacement surgery, I retired. An old dog CAN learn new tricks if she/he is motivated. If you want to learn post op hearts, honestly, its not that difficult and you can do it.

"Anything we persist in doing becomes easier, it's true, not because the nature of the thing has changed but because our ability grew."

Best to you,

Mrs. H.

[Bortaz, MSN, RN]

You're awesome, Mrs. H.