MICU to CVICU tips?

[mar354, BSN]

I've worked as a MICU nurse since I graduated 3 years ago with a little travel experience peppered in, but want a change, and hope to apply to CRNA school. I just got hired at a great academic CVICU and am so excited! Any advice from ICU RN's who have transitioned to CV, or known those who have? I've taken super critical MICU patients & done a bit of SICU, but the land of ECMO, VADs, (occasionally) cracking chests at the bedside, etc seems wild. What are your unique priorities and what do you wish you'd known? I'm solid on walking people w/ multiple chest tubes, but the immediate postop period's all new. Thanks in advance :) 

[PaSSiNGaS, MSN]

The most important thing I find many RNs lack in the ICU is simple physiology.  Read read read up on physiology.  Anything new can be overwhelming but if you understand the basics it will really help you understand and bring it all together.  Find a good physiology book and read up on cardiovascular and respiratory physiology.  When you can explain how for example normal oxygen consumption and delivery works and how intrathoracic pressures change everything else you do will start to make sense.  Also understand the drugs you use on a daily basis in the ICU so you can make sense of why things are being done.  Levo, Epi, Milrinone, NTG, etc.

 

[ghillbert, MSN, NP]

Also if you'll have fresh postops, make sure you know the consequences of cardiopulmonary bypass and you will understand what you see in your postops a lot more easily. Agree regarding reviewing anatomy and physiology. Knowing which valve is where, what preload/afterload/contractility is, and which receptors your drugs work on will be a huge headstart.