Help! New grad

[massou]

Anyone who has experience in Cardiac Unit? Please help. I am a new RN and I just started working in the Cardiac telemtry unit. I am being told that I am not asking questions that new grads ask. Also, how can I be competent with assessments?

[CABG patch kid, BSN, RN]

First, what kind of assessment do the other nurses do? What did your preceptor show you? In our tele unit, we do a head-to-toe at the beginning of shift, focusing our attention on cardio and respiratory findings. For example, vital signs (are they stable and normal for this pt.?) heart sounds, lung sounds, SOB/dyspnea, chest pain, skin warm, dry and pink, capillary refill, O2 sat, peripheral pulses, dizziness/nausea/vomiting, mentation and rhythm.

It seems like a lot, but will soon come as second nature on a tele floor. It will become easier if you see a few patients that aren't normal to gain some perspective. If there are any codes, make sure you observe a bit and try to find out what happened leading up to it so that you know what to watch for. Take your dysrhythmia class ASAP, especially if your nursing school didn't focus much on rhythms. Know your cardiac meds very well. Familiarize yourself with common tests and procedures that cardiac patients have. Always check your labs at the beginning of the shift, especially potassium, mag, calcium, H&H and platelets (most commonly "off" in heart patients). Remeber that tele usually isn't just heart patients, you may have some (or many) respiratory, renal and/or GI patients, depending on their history/comorbities. Diabetes, hypertension and hyperlipidemia will become commonplace to you.

I have been on my tele floor for 5 months and this is what I've learned. I hope it helps you and I hope you have as much fun at work as I do!!!

[massou]

Thanks for the reply. I really appreciate it. Take care.