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New grad in CVICU

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by kyhoward1989 kyhoward1989 (Member)

384 Visitors; 21 Posts

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Hi all!

Hoping for a bit of advice..  I recently accepted an awesome position in the StaRN nurse residency program this June at a larger hospital in Richmond, VA.  I will be working in the CVICU and I am very excited about getting up there and working..  But I'm also very nervous.  I've worked at a level 3 in the ED for years as a tech and more recently I've worked as an LPN in a smaller community ED.  I like to think I've built a solid foundation to build on in nursing just by my experiences as an LPN in the ED, but the CVICU scares the crap out of me..

Any advice?  Books to read?  Things to focus on?  I'm all ears here guys!  I don't want to disappoint my preceptors nor do I want to disappoint myself.

Thanks everyone

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4,771 Visitors; 297 Posts

You've got a good attitude, which should help. Being interested and engaged usually makes for a successful orientation.

Many times, first-time orientees to an ICU are so overwhelmed with information that I suggest not hitting the books too hard in the off-hours so as not to burn themselves out. But that depends a lot on the orientee in question, and you know you better than I do. Some people do best by completely immersing themselves for a while. 

The best references for you might depend on what your strengths and weaknesses are at this point. Paul Marino's "The ICU Book" is frequently recommended for very good reason, but there is a good chance that will be over your head for a year or two still. The book most specific to your new environment might be "Cardiac Surgery Essentials for Critical Care Nursing" by Sonya Hardin. It's a little pricey, but is probably a good reference for the kinds of things you'll be seeing. After that it depends on the gaps you personally have to fill. For basic EKG interpretation, Dubbin's "Rapid Interpretation of EKGs" is pretty good, and for more advanced interpretation, I like "12 Lead ECG: The Art of Interpretation," though online sites like https://litfl.com/ecg-library/ and http://ecg-interpretation.blogspot.com/ are quite good for free resources. For hemodynamic monitoring, I guess I wasn't enamored with "Hemodynamic Monitoring Made Incredibly Visual," but it's probably decent for a beginner if it happens to be suited to your learning style.  For vents, "The Ventilator Book" is great, though again it may be a bit above your head until you've been in critical care a little longer. And frankly, a lot of the better education materials I've used on many subjects have been free online references intended for med students and residents.

Also, take a look at your orientation materials. If there is a list of things you need to know by the end of orientation, great. If not ask your preceptor to maybe dictate a list to you. When you start in an ICU, almost everything you encounter will be new and unfamiliar, and it can be hard to know what to focus on. You should get in the habit of looking up things you encounter that are unfamiliar as you're going, but early on that may be too much to be practical. Instead, make sure you are at least looking up and fully understanding those things you need to know to function independently on your new unit.

Congrats and good luck.

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1,427 Visitors; 19 Posts

Congrats, three years ago I also started in the CVICU as a new grad nurse.

My approach was to try to be a sponge as much as possible. By being fresh out of school, I was already in the habit of absorbing information and had figured out my best learning styles. If you can find a way to apply the techniques you used to be successful in school to your job, that might help you the way it did for me.

My orientation was very organized, we had classes once a week for 8 weeks, were required to make drug flash cards for all the high risk medications we would work with (highly recommend doing this if its not required), and online modules from the AACN.

I also recommend the book "Cardiac Surgery Essentials for Critical Care Nursing" by Sonya Hardin. I think I've read it from front to back 3-4 times by now and always learn something - and its not as hard of a read as many textbooks can be. After I had my CCRN, it was my main resource to study for and pass my CSC. So I found useful both in the beginning and recently.

Good Luck!

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morelaur works as a Nursing student.

672 Visitors; 14 Posts

No advice, just wanted to say good luck to you! That is VERY exciting. I'm sure you will do great! 

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384 Visitors; 21 Posts

Thank you guys so much! I've picked a few books up, waiting to take my boards than i'll start reading through them..  So much to do, so little time!  I can't wait to update this later on and let ya'll know how I'm doing!

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7 Visitors; 1 Post

Good luck on your journey! I have also accepted a StaRN CVICU position within the nurse residency program in the Richmond area. I recommend the "Cardiac Surgery Essentials for Critical Nursing." The material has been very helpful. 

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384 Visitors; 21 Posts

2 hours ago, EducatedG5 said:

Good luck on your journey! I have also accepted a StaRN CVICU position within the nurse residency program in the Richmond area. I recommend the "Cardiac Surgery Essentials for Critical Nursing." The material has been very helpful. 

No kidding, it's a small world!  I'm going to be working at Chippenham, and I'm actually in the middle of moving my entire family down that way.  Shoot me a message if that's where you're working, it'd be nice to link up with some new co-workers.

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