Help! CCU or Not?

papawjohn · Jan 21, 2006

Hey LoveRN!!

If I understand your question REALLY--you are asking about the learning curve between Tele RN with 6 months experience and CCU RN with real competence. And if the curve is steep and you will have to spend lots of time and energy on the new job, it will conflict with your OTHER priorities like NursePractitioner and GradSchool.

Based on your asking the question that way--I have to say that CCU is different enough and more in depth from TELE Nursing, that trying to do both learning CCU and learning FNP is asking just way too much. (Not to say that TELE Nursing is easy--I have done it and appreciate the special skills and challenges!!!)

But the way Cath Labs and control of the Coronary anatomy and modern platelet-controlling meds have evolved--it seems to me that CCU Nursing in a serious referral Hospital is kind of an extention of the intervention/angiography type thing going on in Cath Labs.

Once upon a time, when I 'floated' between Tele and CCU the difference wasn't that great. My advice would have been different. But in 2006, big difference. If FNP is taking lots of your time and attention--you will have to choose whether to climb the 'learning curve' at school or at work--but probably not both at the same time.

For what it's worth....

Papaw John

PS: If you're NOT yet in grad school, and the CCU would be a part of your background and expertise that you bring to your Nurse Practitioner education--my advice would be different. The knowledge of cardiac anatomy/physiology and heart-health or -disease would become part of the tool chest you bring to Master's level education. But the schedule has to work so that you're doing one at the time, not both.

PJ

NurseEcho · Jan 21, 2006

I have been an RN for a little over a year. Currently working Part-time on my MSN-FNP. I have worked on an open heart unit for three years (2.5 as a tech) and now work on a telemetry unit (past 6 mos). I have been offered a position in the CCU. I am reluctant to go ahead and accept it because I'm afraid it will be too overwhelming to orient AND do school at the same time. I would love to work in this environment as opposed to floor nursing, yet I know it won't be really beneficial to me post-graduation because I am doing FNP not ACNP. I need to make the decision soon! Any suggestions?

I've also been an RN for a little over a year, worked in Diagnostic Cardiology for 10 years before (not as an RN), then 6 months as an RN on a tele/step-down unit.

I moved into CCU 2 months ago. It is way, way harder than I expected. It's also the best nursing experience I've ever had.

I tend to question why you're already placing more priority on your MSN/FNP to the exclusion of getting good solid experience on the floor. Maybe it's a regional thing (I'm in the US South), but it's frowned upon to here enter advanced-practice nursing without at least 2 years of full-time RN experience.

This is just my opinion -- but I think it would behoove you to take the CCU position and put the MSN on hold for a year. You will learn far more than any textbook can offer, and IMO you owe your future advanced-practice patients that extra level of experience. Do you really think that as an FNP, you'll never encounter an acute MI or a life-threatening arryhthmia?

Not to mention that critical care is in *huge* demand; it's always there if you need something to fall back on.

My 0.02

HillNPStudent · Jan 21, 2006

I have worked full-time for over a year as an RN; not just this tele unit but open heart recovery as well; worked 2 years as a tech prior on a heart unit. I think Papaw John understood my question best-is the learning curve TOO much to do with NP school AND full-time RN employment/orientation on a new unit?

I will be working full-time regardless, I just wanted the additional experience of a new environment. I do feel I have a strong cardiac background; I don't particularly feel that one year "on hold" from my MSN program will be of much benefit, I am only part-time in the program in order to gain additional experience on the floor to begin with. Besides, this is an excellent time in life for both myself and my husband for me to return to school. It will take me another 2 years to finish. I know plenty of NPs who went back to school with just a few years' RN experience and did fine.

I am not struggling in school in any way, and besides, although I WILL see plenty of acute MI/cardiac patients in my advanced practice, unless I do ACNP (which I am not, I am FNP) more than likely I will not be dealing with the vents, drips, and procedures done in the CCU. I just want that experience for myself, for my own nursing knowledge. I have learned how to deal with an acute MI, how to recognize life-threatening arrhythmias, and the meds to treat both. You don't have to work in CCU to learn that. Telemetry has taught me a lot...just wanted to expand on that. I don't particularly want to stir up a debate on how long to wait before returning to school for an MSN...there is a whole other thread for that under the NP board.

I've also been an RN for a little over a year, worked in Diagnostic Cardiology for 10 years before (not as an RN), then 6 months as an RN on a tele/step-down unit.
I moved into CCU 2 months ago. It is way, way harder than I expected. It's also the best nursing experience I've ever had.
I tend to question why you're already placing more priority on your MSN/FNP to the exclusion of getting good solid experience on the floor. Maybe it's a regional thing (I'm in the US South), but it's frowned upon to here enter advanced-practice nursing without at least 2 years of full-time RN experience.
This is just my opinion -- but I think it would behoove you to take the CCU position and put the MSN on hold for a year. You will learn far more than any textbook can offer, and IMO you owe your future advanced-practice patients that extra level of experience. Do you really think that as an FNP, you'll never encounter an acute MI or a life-threatening arryhthmia?
Not to mention that critical care is in *huge* demand; it's always there if you need something to fall back on.
My 0.02

NurseEcho · Jan 24, 2006

:heartbeat OK, Lovern, I read your question and papawjohn's response and acknowledge that I may have projected some of my own concerns regarding the when-to-enter-MSN-question into my reply. I agree with PapawJohn that you may have to choose which learning curve to focus on at a time.

I was noting your age -- you say you're 24. In which case I definitely say, woman, you have the luxury of time! Why NOT experiment with some other specialty areas, pursue unconventional interests, add to your experiences base. I'm a bit older than you, and believe me those options tend to narrow with age.

Again, maybe my personal/regional/socioeconomic bias is showing, but this sounds like a wonderful time of life for you to "sow your wild oats" in terms of elective specialties. You sound like a wise and determined woman; make sure you entertain all your options!

HillNPStudent · Jan 24, 2006

Ok, well, I have decided to take the CCU position and make the transfer. For several reasons. 1) For my own nursing knowledge, regardless of whether I will use it in my advanced practice although I'm sure it couldn't hurt; 2) I'm only part-time in the NP program, still have another 2 years left; 3) I know that unless I transfer I will remain restless on my current unit; and 4) the transfer will potentially take up to 30 days to process which means I'll be well-settled into classes by then.

I hope I made the right decision, so far I feel good about it. It was one of those things where if I turned it down, I knew I'd probably always regret it. I really like the manager of this unit, she's been there 30 years. Also, three of my friends from my NP classes work there too, so it will be a nice little support system. Just a little nervous about entering into critical care, and feeling somewhat intimadated by the more experienced nurses. So we'll see..

jennylo816 · Jan 25, 2006

I would love to hear all about your new position in the CCU. I am currently thinking of moving to a CCU also from the ER!