Medical vs Surgical Cardiac Floor: which one?

[**All Heart RN**]

(I originally posted this thread in the Cardiac forum but haven't received any responses yet)

Which one do you prefer?

I begin a Cardiac RN Internship in about a month and will be spending about 3 wks on each cardiac floor (15 wks total). At some point in the program, I'll have to decide whether I'd like to work on a Medical or Surgical Cardiac floor before I'm assigned to my permanent unit (I'll be spending the last 4 wks of the Internship on my permanent unit).

Could someone breakdown the differences between the two types of floors as far as pt population and nursing considerations. Ofcourse I have a general idea of what patients (based on diagnosis) would be on each floor but I'd like to hear some specifics from nurses who have worked on Medical and/or Surgical Cardiac floors.

Thanks for your input!

[cardiacmadeline, RN]

I have only worked on a surgical cardiac floor, but I will try to help you as much as I can.

Surgical Cardiac Floor - My unit gets all cardiothoracic surgeries in addition to vascular surgeries. Ages can vary anywhere from late 30's to 90's. The patient stay is anywhere from 3-7 days on average, so our patient turnover isn't as high as the medical floor. We see alot of chest tubes, foleys, IV gtts (amiodarone for example), insulin gtts, epidurals (for our lung surgeries), PCAs and JP drains. You also have the surgical incisions to care for. You also give a lot of pain medication.

Medical Cardiac Floor- I have never worked on this unit, but I can tell you a few things. They get the chest pains, cardiac caths, and CHFers among other cardiac things. The turnover is high, lots of admissions and discharges daily. They don't see alot of the tubes that we get, like chest tubes and drains. They do get IV meds, but probably not as much as we do. With the cardiac caths, they do a lot of frequent vitals and are trained to pull the femoral lines after a heart cath. They also get the chest pains, so they are probably very knowledgeable in how to treat that.

You will learn a lot on both floors, it just depends on whether you are a surgical nurse or medical nurse. I myself have always and always will be a surgical nurse. I hope this helps a little bit, if you have any more questions, just ask!

[**All Heart RN**]

Thanks for your reply...it's really helpful : )

[ukstudent]

I'm a surgical nurse and that is my preference. However, I suggest you go to both places with an open mind. See which one has a better feel to YOU.

I don't want to sell my fellow medical nurses short. The CCU nurses here have patient with multiple drips, vents, swans and balloon pumps. They treat the pt for anything cardiac up to the time a pt may go to surgery.

Surgical or Medical, one is not better than the other, they are just different. It will also depend on what type of hospital it is. Community, regional, teaching etc.

[Tait, MSN, RN]

I work on a floor that used to be primarily medical cardiac and complex surgical GI. Due to rough times and changes in the hospital we are more general med surg at the moment.

Anyway, that aside, I loved when we were more medical cardiac. Lots of CHF, Afib/RVR, chest pains, pre-op open hearts, heart caths. As stated by a previous poster we did get trained to pull sheaths, though we hardly ever had to do it (we have a sheath team), push IV meds like Lopressor, Vasotec and Lasix with Cardizem/Heparin/Nitro drips.

The turn over rate is hectic, but most of the patients are "walkie talkies" in with MI but otherwise independent. This can be a nice change when you deal with heavy GI surgicals like we do, however it makes for very busy days.

While most of the patients are mostly stable, there is always that risk for a patient to go into 3rd degree and suddenly tank or for someone in afib to blow a PE and die. However these risks are pretty much on every floor.

I work nights in a large metropolitan hospital as an FYI.

Best of luck and enjoy!

Tait

[**All Heart RN**]

I'm a surgical nurse and that is my preference. However, I suggest you go to both places with an open mind. See which one has a better feel to YOU.

Surgical or Medical, one is not better than the other, they are just different. It will also depend on what type of hospital it is. Community, regional, teaching etc.

I'm definitely approaching this Internship with an open mind. I love everything that relates to Cardiac and feel that no matter which floor I choose (or is a better fit for me), the learning curve will be steep, and I'll gain a great experience (regardless of whether it's Medical or Sugical).

Thanks for the replies!...this info is helping me to understand the focus of each floor.

[nursej22, MSN, RN]

My floor gets both CV surgical and medical, and I prefer the medical patients for the most part. The surgicals are almost monotonous---pain meds, IS, ambulation and BMs.

I enjoy the chemistry of medicine(CHF, AMI, arrhythmias) plus we get our freq. flyers. And I love the occasional 90 yo who needs a pacer but is in otherwise perfect health.