Just got the call...moving from Med-Surg to the CCU.

[CCNP-FL]

Hi Friends:

I have often turned here for advice and am thankful for all the great nurses that have been so helpful to me!

I've been an RN for 13-months w/ prior experience as an LPN and CNA spanning about 4-years. My hospital is reorganizing, so I applied to a CCU Preceptorship course which starts in one-month and I just got hired. My background as an RN has been primarily on Med-Surg, though I do have some Tele experience and took the AACN and AHA EKG CME Certification Courses to prepare for the CCU Interview. However, my question is one big: What can and should I do to prepare for the transition?

Other than 3-months in the CVICU as a Grad Nurse during my school's preceptorship program, I have no experience in critical care. Any advice would be appreciated (I am currently in the first semester of Nova Southeastern University's FNP (MSN) Program, so I'm hoping the upcoming advanced physical, patho, and pharm will help).

THANKS!

[Da_Milk_of_Amnesia, MSN]

Best Advice.....

- Eyes open, mouth closed.

- Ask questions if you don't know whats going on.

- Understand the 'why' of what your doing

- Be able to look at the whole picture

- Know how the drugs work, normal doses, etc.

- Be able to predict whats going to happen (as best as you can) a.k.a 'Staying ahead of the curve'

- Have really good assessment skills.

- If something doesn't look right, chances are it's not

- Don't be scared to take the sickest patient on the unit!

- Maybe this is just me, but be honest with family members and orient them to their reality. In my opinion, the worst thing you can do is try to sugar coat things with people. If they don't get it, make them get it. A lot of people have unrealistic expectations of what is going on with their family member and they need to be able to wrap their head around it. Honesty is the best policy, but remember to do it tactfully (or at least try your best to do so).

- Above all else, be confident. The worst thing you can do is lose your cool when a patient decides it's a good idea to start to circle the drain.

[etymed]

In CV/CICU more so than any other unit, you will be watching a patient's hemodynamics like a hawk and titrating vasopressors to fix any issues during your shift. The other big hitter in my unit is knowing the various types of shock and how they influence hemodynamic parameters. Good luck! Sounds like you've got a lot going for you. Remember to breathe, lol.

[Gueenus]

What "da-milk" said. Great advice. Don't forget to read and study. Kathy White is a great resource and so is The ICU Book.

[nursefrances, BSN, RN]

Sorry, no advice just..... Congrats!!!!

[ICURNBSN]

While I agree with much of this reply, the first line seems harsh. Experienced nurses get scared when your mouth is closed, ASK QUESTIONS! Yes, take in everything they have to say because they have so much to teach you, you will be blown away! However, jump in, help out and ask anything and everything! Good luck.

[scifispam]

I made that move myself and I LOVED it!! There's so much to learn and see and do!! I bought critical care made incredibly easy and hemodynamics made incredibly easy and loved both of them!!

[Da_Milk_of_Amnesia, MSN]

I mean it ask like, don't say anything stupid, unprofessional, cocky, etc. You are taking it to literally.

[ICURNBSN]

I mean it ask like, don't say anything stupid, unprofessional, cocky, etc. You are taking it to literally.

Gotcha, thanks :-)

[Ruby Vee, BSN]

Congratulations on your new job! With your Med/Surg experience, you already know how to talk to patients, families and providers. You know how to do an assessment -- and the more detailed assessment skills you'll need for CCU will be covered in your orientation. You know how to give medications and how to look up the ones you're unfamiliar with. You know how to put in an IV, NG and Foley -- and how to assess your patient while you're doing so. You probably have good time-management skills and are well on your way to having good critical thinking skills. You have a lot to learn, but you're aware of that. Good on you!

Expect to have to do some studying at home. I've had to study every time I've switched specialties, or even jobs within the same specialty. The orientees who don't do well in the ICU are usually the ones who insist that they're through with school, they shouldn't have to study. (Or the ones who don't want to ever have to move quickly, but coming from Med/Surg, I doubt that's you.) Check out ICU FAQs. Your ACLS manual is a good starting place for learning rhythms and the emergency drugs. (IF you don't have one, get one!)

Take the time now to do some networking. Introduce yourself to any cardiologists you encounter on Med/Surg. Surely some of your patients have Cards consults! Talk to the Cath Lab staff if you ever have a reason to take a patient there. Make sure you tell everyone how excited you are about your opportunity. Take a look at the CCU charting if you have patients on your unit that have been in CCU.

I've just noticed that this is an old thread. Oh well. Maybe someone else can benefit from the advice.

[Lennonninja, MSN, APRN, NP]

Congrats! I moved from Med/Surg to MICU at 13 months also, and it was great to already have good time management skills, and be able to focus on learning the ICU, not completely learning to be a nurse from the ground up!