New Open Heart Nurse

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Specializes in Med/Surg; CVOR; CVICU.

Hello to all! I have recently accepted a circulating posiiton on our open heart team at my hospital where I've been working as an LPN on our medical floor for the last 4 years. I have been an LPN for 8 years and graduated with my ADN this month. I'm excited, honored, and nervous all at same time. I went through hell and was bullied the first year to two years on the floor...until the bullies left and I have made some awesome friends in the last two years and bonded with my fellow nurses. They have guided and encouraged me throughout my transition from LPN to RN.

My question is, I am a bit worried about resentment I might face due to the fact that I am going straight into open heart. Usually you have to train in the main OR for 2 years, THEN go to open heart...but they are doing in backwards for me, because to put in bluntly, it's the open heart team that saw something in me and has pursued me and eventually made it possible for this to happen. The plan is to train in open heart and then learn the main OR (so I can be well rounded), which I know will take at least 1-2 years. We only have three open heart surgeons, so I think learning open heart will take less time than the vastness I will face in the main OR.

I am humbled and I know better than to say "I was handpicked", even though I'm sure word has already traveled...I will simply say "I applied", when asked how I came to be on the team.

Any words of wisdom as I enter into what I think will be my DREAM JOB? I have developed a thick skin, but we are all human and I will gladly accept all the advice I can get:)

Chocoholic.

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Specializes in Medical.

Hi there, I'm in a similar boat. If that helps?

I recently accepted a position in the cardiac OR starting next month. My hospital's training involves 8 month program w/ 3 months in the general OR w/ other fellows and then moving on to the CV OR training. I come w/ a year's worth of Med/Surg experience. So, I don't have any previous OR experience either. The nurses asked me to check out the AORN website saying it would help out.

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Specializes in Med/Surg; CVOR; CVICU.

Thank you for replying:) I will def check it out! Good luck and focus on the positive! I'll follow my own advice and it helps to know I'm not alone ;)

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Specializes in Peri-Op.

1. Go in with an open mind2. Pay attention to everything that is going on and what people are saying, eventually you will learn the ques that the circulators and scrubs work off of.3. While paying attention, never get tunnel vision and tune out what's going on around you.4. Take the time and effort to learn all the instrument trays the scrubs use as well as the soft goods used. 5. Learn all the equipment and the kits/supplies for them that you will use in the cases...... Cell saver, balloon pumps, istats, defibrillators, off pump suction devices, hemochron, pacing boxes. I don't mean just how to use them but how to trouble shoot and solve problems quickly with them. 6. Learn the drugs your anesthesia uses regularly, you will eventually get new guys coming through that you might have to coach a little bit on how to keep a pressure stable or a heart rate steady....7. Don't expect it to be a quick learning experience because it's not.... With no experienc I would not let you fly solo for 3-6 months minimum as a circulator and 3-6 more months as a scrub.....8. Don't think you can do it alone until you have minimum 10 bad cases under your belt... It's the real deal when you get called in at 3 am with only a scrub tech or two on your team, with you and the surgeon and anesthesiologist. I have had to take report and take over compressions from the cath lab team and roll on to the or doing compressions/defibrillating/trying to keep the patient calm all in the same trip..... 9. Take ekg, acls, pals.... Any classes you can that will give you a quick confidence builder. Even then it will only come with experience.I worked with really good and quick surgeons so we had very little down time in cases. Typical case was 2.5-3 hrs of room time. We would do 3 cabg/valve a day per room and be done by 5pm.

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Specializes in Peri-Op.

Sorry my posts come out all jumbled... Stupid iPad doesn't work well with the forum.

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Specializes in Med/Surg; CVOR; CVICU.

No problem, Argo and THANK YOU so much for the advice. I'm definitely going in there with an open mind, humbled and ready to learn. I don't think they expect me to be on my own until 6 months, and from what I know already of the open heart team, they work very well together. I think most OR's have to, to survive. The teamwork I observed every time I did a rotation there was one of the reasons I loved it so much. I am BIG on teamwork.

I will have to work hard on #3, because I have ADD and tend to get tunnel vision (even with medication) without meaning it. So I will make an extra effort to pay attention to everything around me. That piece of advice seemed meant for me, lol.

I don't think I will learn how to scrub, but I will need to learn the instruments. I'm so ready to get started, but I'm focusing on NCLEX for now, which I'm taking in less than 2 weeks...then I can focus on my new awesome career:)

Thank you again for taking the time to write...it was greatly appreciated,

Chocoholic

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Specializes in OR Hearts 10.

Good luck on your NCLEX and Hearts....

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Hey there! Congrats! Going into the heart room for the first time, my advice is: don't get overwhelemed. You'll be bombarded the first few weeks with positioning, electrocautery, suture, instruments, blood products, bipass, drugs, central lines, art lines, not to mention all the different procedures and implants etc. Just try to pick up on what is the SAME with each case not what is DIFFERENT. Then, once you get the basics down, you'll realize that every case has a foundation that is the same and details that are different. Try to learn the flow of the room and the order in which steps are taken. These things won't change. For example, EVERY case will be: patient comes in, goes to sleep, lines are placed, positioning, prep, procedure, closing, dressing and end. Remember this and then, even when you are given your general OR training, you will be able to take the basic foundation that you've learned and apply it to almost any type of case!

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Specializes in Med/Surg; CVOR; CVICU.

Erin thank you so much! I'm going to have to read this a few times lol. I'm a little familiar with the flow because I've observed a couple of surgeries in open heart... But that's pretty much it! I think the fact that I'm so interested and fascinated by it and the RN role, that it will make it more natural for me to pick up on.

With that said, I know that I'm in for a whole new world I can't be too hard on myself if it doesn't click at first. You have GREAT advice ;)

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Specializes in Med/Surg; CVOR; CVICU.
Good luck on your NCLEX and Hearts....

Thanks...;)

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Specializes in Med/Surg; CVOR; CVICU.
Good luck on your NCLEX and Hearts....

Thanks..?

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Specializes in NICU, ER, OR.
On 5/26/2012 at 1:26 AM, ErinRad said:

Hey there! Congrats! Going into the heart room for the first time, my advice is: don't get overwhelemed. You'll be bombarded the first few weeks with positioning, electrocautery, suture, instruments, blood products, bipass, drugs, central lines, art lines, not to mention all the different procedures and implants etc. Just try to pick up on what is the SAME with each case not what is DIFFERENT. Then, once you get the basics down, you'll realize that every case has a foundation that is the same and details that are different. Try to learn the flow of the room and the order in which steps are taken. These things won't change. For example, EVERY case will be: patient comes in, goes to sleep, lines are placed, positioning, prep, procedure, closing, dressing and end. Remember this and then, even when you are given your general OR training, you will be able to take the basic foundation that you've learned and apply it to almost any type of case!

That’s helpful advice,,to identify what is the SAME, with each case rather than what’s different.... because thinking wayyy back to my very first days in the OR, I absolutely didn’t do that.. it took me a little while to actually KNOW, and have in stone in my head;,that ... OK.. this is your routine, your flow For every single case, every single patient.,you must do these things, first, THEN, you can give your attention to the specifics of whatever case you are doing. It SOUNDS so simple and like it should come naturally, but honest, it doesn’t!! I spent a while , just trying to stay afloat above, what I perceived to be chaos ..with each case,,when I actually could have made it better for myself if I applied what you said!!! I remember vividly those early days, and how this advice would have made a huge difference for the better!!

Great post !!

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