New job as a CCU RN

[Eman A]

Hello! Today I landed a job as a CCU (coronary care unit) nurse in a small hospital (new grad) and I am thrilled! I have dreams of becoming a pediatric nurse practitioner, and wanted to ask if my experience in the CCU will be considered relevant experience.

Also, has anyone else been hired as a new grad in the CCU? Any tips? Also, what should I review before starting my orientation? Any bits of info would be greatly appreciated.

[Ruby Vee, BSN]

Congratulations on your new job.

I would caution you about having such specific aspirations when you've never even worked as a nurse before. It could very well be that once you've worked in CCU, you'll never want to do Peds. Work a while as a nurse, before you settle on an ultimate goal. Be open to loving CCU. Perhaps after a couple of years in CCU, you won't want to leave. Even if your ultimate goals don't change, you'll enjoy the time in CCU more.

Get your hands on an ACLS manual, and study that. You'll take an ACLS class down the road, but it's a good starting place for rhythms, drugs, basic code algorithms. You'll want to pay specific attention to studying material about the cardiovascular system and the drugs used.

Good luck.

[Eman A]

Thank you!

[BeatsPerMinute, BSN, RN]

Congratulations!

A friend of mine wants to be a peds NP too. She started in CCU and after a year transferred to pediatric cardiac ICU (RARELY will you get a new grad in peds, let alone peds ICU) so this is a great route for that goal. You're going to learn a lot in CCU.

I started in CCU as well as a new nurse. Someone posted a question similar to this like last month or something and below was the response I gave. Hope that helps. Post if you have more questions! Also feel free to PM me for questions you have before and during orientation. Good luck!

Repost:

What are your patient populations? More surgical like post CABG/Valve replacements&repairs/Transplants, or more medical like STEMI, heart failure, resp failure, pulmonary htn... Im at a large hospital that divides these patient populations. You might have both. I know more medical than surgical & nursing care can be different. Depends on the hospital but both would likely expose you to vents, pulmonary artery catheters, art lines, CVP & advance therapies such as intraaortic balloon pump, continuous renal replacement therapy, Impella, therapeutic hypothermia... maybe ECMO or LVADs.

It's a steep learning curve... my advice is to be a sponge, write down everything that you can, learn to review and organize your notes (I kept many of mine as reference so I wasn't repeating questions).

First things to learn: Know what to do in an emergency - first actions and who to call (codes like to happen when you least expect them). Telemetry strips: sinus/brady/tachy/heart blocks/ lethal rhythms such as vtach vfib asystole... Learn drips (used for, starting dose, how much to titrate by and frequency of titration, side effects), there are many but most common for my unit are: Norepinephrine, Vasopressin, Dopamine, Fentanyl, Propofol, Cardene, Heparin, Nitroglycerin, Amiodarone, Milrinone, Integrilin... Offer help to everyone on the unit. Be nosey. Take opportunities to see and do as much as possible. During orientation you should never have a "I'm bored" moment. Use the time wisely. Get familiar with orders and protocols and where to find the info if you don't know something.

Also, create an ICU report sheet for yourself. This will help you organize your day, remember what tasks need to be completed, be able to answer questions about your patients, receive and give report, ect. I looked at many on this site and picked things I like from each to come up with the report sheet I use. Mine is front and back and allows me to record up to three patients if I were to ever be tripled. At the top I have space to record name, room #, code status, allergies, covering doctors w/numbers. Below that is space to record the story of the patients admission/hospital stay as I receive the info from the reporting nurse. Under that is space for review of systems: Neuro CV Resp GIGU Skin, then IV access, misc (gtts, family notes, if they need glucose checks, whatever randomness is important to know about the pt), then plan. At the very bottom of the page I allow space to record questions I have. I try to just write a subject word or 2 in that space as the report giving nurse talks if I think of a question during report so I can ask it after the nurse finishes and dont interrupt them. On the back I have time charts from 7:00 - 7:00 and record if I have anything time-sensitive due during that time (labs, meds, glucose checks) and finally on the back under my time chart is my "notes" space - anything that comes up during my day, notes from rounding with docs, new tasks that come up, important notes to remember to pass along to the next nurse...

Always always always ask questions. Never be afraid to ask questions. The saying is there are no stupid questions, and even if you feel they are stupid questions, your orientation time is THE TIME to ask these stupid questions. It's expected anyway.

I like looking at stuff on youtube... ACLS Certification Institute

- YouTube - this guy is pretty good for ACLS, just an example. You can learn a lot about the drips/ therapies / diseases I listed above on Youtube. I find random gems of info everywhere - allnurses, quizlet, slideshare, google images... Hopefully your orientation will give you a resource for learning critical care nursing concepts and sign you up for classes.