icu vs cvicu, would it be safe to say

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that for a new nurse sicu would be a little harder to adjust to because of the variety of patients as oppose to cvicu where you can kind of expect and predict what will happen. I was just reading a thread on icu vs cvicu and came across a post where someone mentioned that after a while cvicu tends to become like a lung and heart factory and if all goes well you pretty much do the same thing to each patient. I'd really appreciate some feedback on this. I dont mean to offend anyone who thinks i'm implying cvicu nursing is easy WHICH I DEFINITELY DON'T THINK. Hopefully, upon graduating I plan on working either sicu or cvicu.

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you absolutely did not offend me, but let me start by telling you that's not the case. i went straight to cvicu from nursing school, and it's not predictable. every patient is different and can go down the drain fast!!! examples, grafts blow because bp too high, bleeding out of chest tubes, svo2 = to 30%. however, i highly recommend working in cvicu because once you work there, you can work anywhere and I mean anywhere. Think about it there is nothing you would not have dealt with (short of neuro) every patient comes out intubated, with triple lumen central line, swan ganz catheter, chest tubes, arterial line, multiple drips, and very often on a balloon pump. Also, alot of patients have other medical issues that you would deal with in SICU or MICU so you get the best of both worlds. When a patient goes bad, and requires other treatments not related to open heart surgery, who do you think delivers this care? You guessed it the CVICU nurse, catching on yet? CVICU, in my opinion is one of the best ICU experiences you can have, and after you feel comfortable there you can always float on down to SICU and become familiar with other things, with CONFIDENCE! Hope this helps.

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I think that if u r planning on CRNA it doesn't matter what unit, but what the acuity of that unit is. For instance, a CVICU in a rural hospital will typically have a much lower acuity than a CVICU in a large city. Trauma level is another key to look for. If u r into trauma or neuro then a level I or II trauma center is the best place to be. Hearts can go anywhere there's a heart center but trauma is more limited. I have worked mainly in Level I & II trauma centers most of my career in high acuity Neuro ICU so most patients have swans, a-lines, ICP monitors, BIZ, BIO-Z, CVVHD, gtts, vents, etc. So mainly same exposure as other units just for a different dx. I was told that I should have more CV to go to anesthesia school, but I just got into TCU with 15 years Neuro ICU. Moral of the story....work where u are most happy, but go for the higher acuity setting so you'll get lots of exposure.

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Specializes in Neuro ICU.

I agree with neurogeek. I work at a Level I trauma center in the Neuro ICU. I have worked there for two years as an RN. I got in at Mercer and TWU and got interviews to every other place I applied (declined other interviews due to getting in in my home town). I think the acuity is what matters. At all my interviews I was only asked questions on my specialty. I think the schools feel if you know your specialty inside and out then you can be taught anything. Work where you want and do what interests you as long as you get good experience. Good luck!!

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Specializes in Post Anesthesia.

I do not know much about other hospitals but at mine we do not hire new grads to CVSICU but do selectively to ICU. The difference being the CVSICU requires a greater degree of judgement and critical thinking skills that are not applied as independently in the ICU. IN our ICU the resident staff order most of the titrations of drips within narrow paramenters in CVSICU the RN makes those decisions. Change in the patient is expected over days not minutes, and there are more patients- so more staff to back you up if you do get in trouble. I'm not saying the patients in an ICU are easy or the nurses aren't skilled but you have a layer of support in the resident staff that some CVSICUs don't have. Even if the residents cover the CVSICU the attendings expect the nurses to oversee the patient care and alert the attending if a resident is in over his head. Resident staff are largely used to preform proceedures that requier a doc- central line placement, art line placement, x-ray evaluation of line or lung status, chest tube placement and on very rare occasions cracking the chest when a patient tamponades.

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I do not know much about other hospitals but at mine we do not hire new grads to CVSICU but do selectively to ICU. The difference being the CVSICU requires a greater degree of judgement and critical thinking skills that are not applied as independently in the ICU. IN our ICU the resident staff order most of the titrations of drips within narrow paramenters in CVSICU the RN makes those decisions. Change in the patient is expected over days not minutes, and there are more patients- so more staff to back you up if you do get in trouble. I'm not saying the patients in an ICU are easy or the nurses aren't skilled but you have a layer of support in the resident staff that some CVSICUs don't have. Even if the residents cover the CVSICU the attendings expect the nurses to oversee the patient care and alert the attending if a resident is in over his head. Resident staff are largely used to preform proceedures that requier a doc- central line placement, art line placement, x-ray evaluation of line or lung status, chest tube placement and on very rare occasions cracking the chest when a patient tamponades.

I've worked mainly for county & military hospitals, with one exception, and that was still a level II trauma center. Anyway, every facility I worked at had internships to train new grads to any of the ICU's. Critical thinking comes with time, but acute & frequent managment of gtts, vent settings, CVVHD, etc. come from practice. Most ICU's requre that the nurse think independently and with a good solid internship the outcomes are very successful. No patient changes as fast as a neuro patient (now you're awake...blink....now you herniated & died). Some of the finest neuro ICU nurses I've worked with came into our unit as new grads & with many hours of class & bedside training became outstanding! I'm all for new grads starting in high acuity ICU's. No amount of preparation in a lower acuity setting will prepare you, it's a "must be there" sort of education.

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Specializes in Critical Care, Emergency.
I have worked mainly in Level I & II trauma centers most of my career in high acuity Neuro ICU so most patients have swans, a-lines, ICP monitors, BIZ, BIO-Z, CVVHD, gtts, vents, etc.

What??? If you're trying to make me feel inept...it's working!! Needless to say, I don't know anything about neuro. Well, I know a little but not enough to pass myself off as competent. Neurogeek, you are my hero... :pumpiron: Sure hope I have a classmate that's strong in neuro so that I can learn a thing or two before I begin my clinical phase of anesthesia school.

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What??? If you're trying to make me feel inept...it's working!! Needless to say, I don't know anything about neuro. Well, I know a little but not enough to pass myself off as competent. Neurogeek, you are my hero... :pumpiron: Sure hope I have a classmate that's strong in neuro so that I can learn a thing or two before I begin my clinical phase of anesthesia school.

You are too funny! Your own experience is outstanding!!! Believe me, I am going to rely heavily on my classmates with CV experience during school!

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Specializes in Neuro ICU.

In my hospital there is no difference in the expectations of RN's in CVICU, STICU, MSICU, and NICU. We all titrate drips on our own and expect changes in minutes. We have many resident programs but we as competent nurses have to carefully review the orders of the residents because lets face it, they DO NOT know what they are doing!!! Just two days ago I had one write an order to start a nimbex gtt and the very next order said wean propofol as tolerated????? WHAT???? Should I not sedate my paralyzed patient?? Just one example of many. Residents are not there to back up nurses. It is the other way around!! Just my two cents..

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Haha... lol w/ armynurse on this one... :rotfl: Neuro IS NOT my forte'... Kudos for the in-depth, experienced, seasoned neuro RN's out there.... If my loved one has an episode I want your personal cell phone #....

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I have worked mainly in Level I & II trauma centers most of my career in high acuity Neuro ICU so most patients have swans, a-lines, ICP monitors, BIZ, BIO-Z, CVVHD, gtts, vents, etc.

Haha... lol w/ armynurse on this one... :rotfl: Neuro IS NOT my forte'... Kudos for the in-depth, experienced, seasoned neuro RN's out there.... If my loved one had an episode I want your personal cell phone #....

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