How does cardiac tele compare with med-surg?

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Specializes in Med surg, cardiac, case management.

I have an opportunity to leave my night shift med-surg unit and join a cardiac telemetry unit on the night shift. I'm wondering if it will be an improvement though.

The cardiac tele position is at a better hospital than mine. I'd have somewhat fewer patients. It'd be closer to ICU than what I'm doing now. They're mostly post-cardiac surgery patients from the ICU. The place I work at now is pretty bad, pretty broke.

But they have twice as many admissions and discharges as we do, on average. They have lots of post-cardiac cath patients with Q15-30 minute vitals, and transplant patients with tons of meds. And a lot of post-surgery patients with PCAs, which makes me wonder if pain management becomes a major problem.

On my med-surg floor we very rarely have things like PCAs, post-surgery, or post-cardiac cath patients. We have lots of contact isolation and complete patients, but our patients do tend to be stable. We do seem to get plenty of drug-seekers and people with some psych issues. And we get the demanding pain management patients pretty frequently.

I guess I'm trying to determine if this cardiac floor is going to be worse than my med-surg floor. I was really hoping for an ICU or ER position, but so far this cardiac position is the only one I've interviewed for. If they offer it to me, I'm not sure if I should accept or not...

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Specializes in Cardiac.

Hi Joe,

I currently work on a Cardiac Unit that takes care of patients pre and post heart cath. I work at a hospital that is unionized and so each nurse only receives a max of 4 patients. It's a busy floor that has a mix of ICU and Stepdown patients. In order to work with the ICU patients, a nurse has to receive specialized training and work alongside a preceptor for several weeks caring for ICU patients. We also care for patients on IABPs and CVVD. I've been on the floor for about a year and have learned alot. I work night shift and the pace is still steady, if not busy, most nights.

I'm actually thinking about transferring to a Renal Med Surg unit and have an interview on Tues but am hesitant because I'm not sure what my patient load would be and am concerned that it may be a mistake to transfer at this point... I'm wondering if I should have started on less of a specialized unit. On my unit we have patients who are in A-flutter, V-tach, A-fib and have also just come back from a cath, with Acute on Chronic renal failure, and Diabetes, on an Insulin gtt(with several other gtts)...it's alot! I'm also planning on going to NP school and think that working on some type of a Med Surg floor will give me a good overall view of the pathophys of various disease processes...do you agree? How has your experience been in Med Surg? What is the patient load?

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Specializes in Med surg, cardiac, case management.
Hi Joe,

I'm also planning on going to NP school and think that working on some type of a Med Surg floor will give me a good overall view of the pathophys of various disease processes...do you agree? How has your experience been in Med Surg? What is the patient load?

We have 4-5 during the day, 5-6 at night (the cardiac floor would have 4-5 at all times). Maybe 5-6 admissions and discharges per day. We get a lot of nursing home patients, so we see a lot of cellulitis, pneumonia, infected decubs, dehydration, failure to thrive, AMS, and UTI. Med-surg does provide a good variety, though you typically won't see vasoactive drips, LVADs, vents, or epidurals.

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Specializes in Cath Lab/ ICU.

Tele floor vastly better if your interests lie in ICU type care.

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Specializes in LTC, Med-Surg, IMCU/Tele, HH/CM.

It's a step on the way to the ICU if that's what you'd like to do. Or even CCU :)

I work night shift on a unit that was originally intended for cardiac patients only, but now we have turned into more of an ICU overflow with about 75% of our patients being cardiac. I have 3-4 patients a night, sometimes I will get an admission but usually discharges are done on days.

We get post-CABG patients, post-cath sheath pulls, pacemakers,r/o MI/Chest pain, unstable CHF, sepsis patients, renal failure. Sometimes we get patients they don't have room for anywhere else and it's justified because they have "hx of afib".

I don't think that it's "worse" than med-surg. It's just different. Try it, you might like it :)

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Specializes in CICU.

I am on a step-down unit, and we float to ICU. I am still fairly new, so when I do float I get the most stable ICU patients or tele-hold patients. I would say its likely a good step if you want to work ICU eventually.

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Specializes in Family Medicine, Tele/Cardiac, Camp.

Joe, I love your screen name. :)

I agree with pretty much everyone above. Our floor gets mostly medical cardiac stuff: MI's, CHF, TIA's/CVA's, serious arrhythmias, and sometimes pacemaker placements or 1 or 2 days post-cath. BUT...the interns routinely think we're a step-down unit and most of our patients have pretty serious co-morbidities so in many respects we may as well be. We have a lot of back and forth between us and the ICU in terms of patients coming and going between us and them. And when patients on the other med-surg floors start to go bad, they're usually sent to us first.

By our hospital standards, we have a very high turn-over as far as patients coming and going. It's not unusual for us to get 5+ transfers/discharges and 5+ transfers/admissions in the course of an 8 hour shift.

And yes it's much busier, and in many respects "harder", but I think it's an excellent way to transition to ICU. And as you find yourself becoming more experienced in nursing I imagine you'll be interested in challenging yourself more and more. :)

My one piece of advice is to find out about their staffing ratios. It sounds like a very fast-paced high acuity floor. But nothing can kill the happy adrenaline buzz quicker than finding out that instead of 2 or 3 patients with massive pain control issues and Q15 min vital signs, you're getting 5 or 6 patients with massive pain control issues and Q15 min vital signs.

Best of luck with your decision.

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Just wanted to know if you tried the cardiac floor? if yes, then how did you like it compared to med surg? Thanks...

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Specializes in Family Medicine, Tele/Cardiac, Camp.
Just wanted to know if you tried the cardiac floor? if yes, then how did you like it compared to med surg? Thanks...

To whom is this question addressed?

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Oh Sorry....anyone who has worked in med-surg and then on cardiac stepdown (critical care) can answer this question. Many thanks..

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i am on a step-down unit, and we float to icu. i am still fairly new, so when i do float i get the most stable icu patients or tele-hold patients. i would say its likely a good step if you want to work icu eventually.

how do you like the cardiac step down compared to a general med-surg ward?? thanks

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Specializes in CICU.
how do you like the cardiac step down compared to a general med-surg ward?? thanks

i've only worked this unit as a nurse, so i can't compare the two. i do like it though, our ratio is slightly lower and it is faster paced - the nights always go by fast for me. i think it has been a great place to learn about a variety of diseases and treatments. also, i've learn alot with regards to assessments - things can really change quickly with these folks. over all, i am really glad i started here instead of a lower acuity unit.

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