Need advice

Stepdown.

Stepdown.

As a step-down/progressive RN, I agree here. Interventional cardiology is a nice place to be (pre/post cath, PPM/AICD, post-TAVR, etc, though every one is slightly different) but in my opinion, you would benefit more from cardiac step down if your plan is CCU.

On step down, you will have more patients which will teach you time management and broaden your knowledge base in terms of caring for a variety of acute and chronic diseases. In addition you will also have very ill patients, sometimes patients that should probably be in ICU but are not deemed hemodynamically unstable enough given some policy (on high-flow oxygen/bipap and maybe not responding the best but not requiring intubation yet, blood pressure not low enough to require pressors but still low enough to keep you busy and make you nervous, on an insulin drip but not DKA, etc.) That, and you will bounce your patients back and forth to CCU on occasion, you will have codes (any floor can have codes, but step down affords you plenty of coding opportunities), you will still likely see and even recover some cardiac interventional patients, the list goes on. You will also get your fair share of overflow patients as well. Some of your patients will be ambulatory, some of your patients will be total care on multiple drips, tube feed or TPN, with drains and tubes coming out of every which way.

Step down is a great place to start because like I said, you will see a little and a lot of many different things, and you will build a strong foundation as a nurse in general. From there, you can pretty much take your skill-set and knowledge base anywhere. Some brand new nurses start out in ICU and do fine, and others say they wish they had the foundation and basic skills mastered prior to transitioning to ICU. Everyone is different!

I hope you find what you are looking for and best of luck!

I worked on a step-down unit before transferring to the ICU. After being burned out from being tripled everyday I transferred to the cath lab. I learned more about hemodynamics, ACLS protocol, and critical thinking than I ever did in my 2.5 years in the ICU. So it depends on what your goals are. Kick ass pt care? Go to the step-down. Wanna wrap your brain around the fine art of hemodynamics? Go the interventional cardiology route. I'm now back in the ICU with hopes of going to CRNA school one day and doing PRN in the cath lab. I love hearts and cardiology will always be my "thing".

Like I said...figure out what your goals are. What are your weaknesses? What do you want to know more of? Bc everybody will give you a different answer on here. Good luck!!