How in the heck did I end up in CVICU from LTC?

[OnlybyHisgraceRN, ASN, RN]

Every since I was little I wanted to work in Obstetrics or peds. I excelled in Mother/Baby and Peds clinical rotations and I grasped the nursing concept of each specialty with ease. Since I tend to have a bubbly personality yet calming nature I thought peds would fit me best.

Since, I became a LPN prior to RN working in Obstetrics or Peds was not really an option. Therefore, my first job as a nurse was in LTC. LTC was obviously not my first choice, however it provided me with a great foundation and I grew to love taking care of geriatric clients. Besides, I could be my bubbly self and the residents ate it up. During down time (which was rare) I found myself entertaining them by singing songs or a little humor. The elderly has always and will continue to have a special place in my heart.

Of course, I hated the fact of working understaffed and having a range of 20-60 residents under my care. Where do you find time to provide good standard of nursing care ? The answer is you don't it was simply impossible for me to give my best in the LTC settings I've worked in. I often left work feeling like I could have done more or I should have picked up that so and so had x,y,z. Working in LTC, there were times where I felt I was doing less "nursing" and more tasks.

Thankfully, by time I was completely fed up with LTC, I had graduated from an ADN program and received my RN license. What a relief I thought, now I can start applying to the specialty of my choice.

Nurse recruiters and instructors advised me to apply to the specialty of my choice. I adhered to their advice and received little feedback. I then started to apply to any job that would promote career advancement and left the rest up to God.

After several interviews (one being in women's health), I received an offer for CVICU. I never thought in a trillion years I would be an ICU nurse of any kind and honestly had no desire to become one. However, at the end of the day I love being a nurse and figured ICU would be a great opportunity and challenge. It was then time for me to step out my comfort zone and begin my preparing for what was ahead of me.

After receiving the offer I immediately started to study common disorders/meds/ interventions used in ICU. I'm the kind of person that if I'm going to do something I want to do it right. Nursing school barely touched the surface of what I'm required to know as an ICU nurse.

I remember the first day on the unit with one of my preceptors. I remember us taking back a heart and seeing the patient hooked up to several lines with 11 drips running. Patient had IABP, A- line, PA catheter, mech. vent, and two Blake tubes. On the outside I appeared as cool as a cucumber, but on the inside I thought: what in the hell did I get myself into? I pondered the thought of slowly walking away and out the door, thinking " no one will notice me gone right"?

As the nurse reported off to the intensavist it sounded as if they were speaking Chinese. I stood there dazed and confused trying to decipher their secret language. Every time I heard or saw something what was foreign to me, I jotted it down and it became my homework to look it up when I got home or ask an ICU nurse for clarification.

As a nurse I know that documentation is the best way for us to CYA, so I eagerly asked my preceptor to view the flow sheet that is required to be completed for each shift. She hands me the sheet and it turned out to be several pages long. My eyes started to cross as I scanned over the document. I figured that there has to be some kind of inservice just for this flowsheet alone. It had a ton of tiny boxes, symbols, graphs, charts, places for EKGS... I took the sheet home and started to familiarize myself with it, the next day I started to document on a patient.

My first day was a bit intimidating, but every day I'm learning. The more I learn the more confident I am. I'm not sure where I quite fit in at work, everyone thinks I'm so nice and passive, little do they know I'm not afraid of their strong personalities. I have been known to turn into "Mama Bear" when it comes to my patients. I also don't tolerate being disrespected. I won't report you but I will make it clear I'm not to be talked to a disrespectful way.

My goal is to work on the floor for as long as I can stand it and pursue a MSN in nursing education. I want to eventually become faculty at a college or university and become a CNS.

I didn't choose CVICU, I believe it chose me and I'm so excited to be where I'm at in my career.

It is so funny how we make plans to do one thing but end up doing something completely opposite. One of my favorite quotes is: You wanna make God laugh, show Him your plans"

So, I ask myself again: How in the heck did I go from LTC to ICU? This is still mind boggling to me.

[canesdukegirl, BSN, RN]

It seems as if now is the right time for you to travel outside of your paradigm. You will learn so much...but be easy on yourself. It takes A LOT of courage and bravery to step onto a new unit, get acclimated to the 'secret language' and to become confident. You have to learn the flow of the unit, the 'unspoken rules' of the unit, the expectations of your NM and you have to learn the preferences of each MD that you work with. All of this new material is ON TOP of learning about your pt population, different drips, calculations, equipment, documentation, flow sheets...it can seem overwhelming.

But you seem like a "type A" personality, so I have no doubt that you will do well. Just keep doing what you are doing now-do your homework, ask questions, and keep your confidence.

[Esme12, ASN, BSN, RN]

I told you you'd end up loving it. Critical care is addictive. There are reason's for why things are the way they turn out to be.

I'm proud of you!!!! :hug:

[nurseprnRN, BSN, RN]

cvicu, my favorite job (until i got this one, and i'm too old to work icu anymore ) enjoy it! there's nothing like it.

[OnlybyHisgraceRN, ASN, RN]

Thank you for the encouragement! ESME you have truly been a big help. Thank you for answering alot my questions via PM. It is addicting. I'm find myself wanting to learn more and more about this specialty.

Canesdukegirl- I'm definitely type A.

I will assume care for my first patient this week with the guidance of my preceptor, I'm a little nervous but looking forward to it.

[whoa-now]

well hmmm.. I am bit confused . Just a couple of days ago I was reading a post in another forum by this same person. Nothing but complaining, using not very nice launguage about EVERYONE you worked with. Maybe that was at your LTC job? this is so odd!!

[Esme12, ASN, BSN, RN]

We all have co-workers that get on our nerves or that we don't like and there are days they get on our nerves to the point of wanting to poke their eyes out. Even with my husband, whom I love very much, I have moments that make me to stab my eyes out if I have to hear even one more syllable uttered from his lips......but that doesn't mean I will not love him tomorrow.

I have worked with many people I don't like.....and I have vented to family/friends about them and that they make my skin crawl. But I don't have to be friends and like everyone I work with and they aren't coming for dinner.......I just need to get exercise my kindergarten skills and play nice in the sandbox.

[ShantheRN, BSN, RN]

I'm hoping this will be my story in the next few months. I'm in peds but I really really want to try critical care. The thought terrifies me, but I think it will be a wonderful experience! I'm coming up on my first year so I'm looking at NICU and CICU openings. Plus I think I'll check out the recommended readings from the CC forum. Keep us posted on your progress! :)