New Cardiac/Telemetry Nurse

[WildcatFanRN, BSN, RN]

i hope i'm posting this in the right place.

i've just been hired into a position on a cardiac/telemetry unit. during my interview the manager stated it was more tcu instead of med/tele. way back when i was an lpn i worked tele and cvu and loved it. this particular unit requires you to take the same critical care course that the icu/ccu nurses take, this i am actually excited about.

i'm still a new rn and want to do the best i can. what can i do to start preparing? i have been unemployed so long that i'm very rusty skill-wise, but i think once i get back into the swing of things that will be fine.

since i've worked similar units before as an lpn how do i go about not coming across like i know everything? i know i don't, especially from the rn point of view. however, i'm not going to go all panicky over an alarm. i want to make a good impression and learn from my new coworkers. the last attempt at an rn job i wasn't treated as a new rn exactly and didn't progress as fast as they thought i should have. honestly, i thought i was doing fine but was actually missing the "big picture" items. skills i had hands down, charting-excellent, time management-working on it, thinking like an rn-not so much. that last part i didn't realize until after i had requested a transfer, and after a lot of soul searching on my part. i do not want to make this mistake again. how in the world do i keep from making this mistake again? critical thinking looks easy on paper......

[turnforthenurse, MSN, NP]

First off, congratulations on your new job!

To prepare, start looking over cardiac diseases. Remember that cardiac patients tend to have other comorbidities as well. Not sure if your unit does drips, but that would be something else to look over, too. On my unit, we can have patients on Dopamine (max is 5mcg/kg/min), Cardizem (max is 15mg/hr), Lasix, Heparin, Dobutamine (but typically these are the ICU transfers and they are being weaned off), Protonix, octreotide, Amiodorone and NTG (we are only allowed to titrate for chest pain, not blood pressure). Look over your cardiac medications and also your EKG rhythms.

Go with an open mind. Ask questions. No question is a stupid question. You've done this before as an LPN, but the role of an RN is different. It's a learning process.

Good luck and keep us posted!

[WildcatFanRN, BSN, RN]

thanks. it's scary a little since i've been out of work for so long. but i think i will be fine once i get back into the thick of things. the good news is i'll be starting the critical care course within 2 weeks of starting.

i just need to display some of the confidence i lost during this long ordeal.