New Stepdown/Tele Job

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I have been an ambulatory nurse for almost 3 years now, most recently working with Peds, but just landed my first inpatient job on an adult Stepdown/Tele unit (yay!). Anyone out there able to give me an idea of what to expect the fist few weeks? I'm a total nerd that has rhythm strips saved from nursing clinicals (no patient info of course!) and have been reviewing arrhythmias. I am planning to go back and review labs (we don't do that in ambulatory) and reviewing cardiac meds (beta blockers, ca channel blockers etc). Anyone have any additional suggestions? ANY suggestions would be super helpful!

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Rhythm strips are important definitely. Will your new unit be cardiac surgical or more medical? How long is your orientation?

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To me it seems to be a combination. The patient population (according to my job description) consists of: "pre and post cardiothoracic surgery; myocardial or suspected myocardial infarction; critical dysrrhythmias; post interventional catheterizations with/without groin lines; unstable patients with tachy/brady dysrrhythmias and angina; CHF requiring IV therapy, electrolyte imbalances; anti-arrhythmic or cardio-active drug overdose or toxicity"

The orientation is 10 weeks, 8 weeks of day shift and 2 weeks night shift.

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Specializes in Quality, Cardiac Stepdown, MICU.

Sounds like you might be pulling lines after caths. Review the entire cardiac cath procedure and groin management. Practice palpating femoral, pedal and post tib pulses on all your family members, so you are good at it on a lot of different shapes/sizes of people. :-)

Look at the drips used for CHF like bumex, dobutrex, etc. I hope you already have ACLS, but if not, review that a lot, those drugs will be helpful, especially atropine. Know your blocks, and if they dont' give you time during your orientation to sit with the monitor tech, make sure you do so whenever you have a spare minute and pick their brain. Post-CT surgery probably means chest tubes, so familiarize yourself with those, it's not something you'll see in ambulatory.

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Thank you so much!!! Unfortunately I'm not acls yet (something ambulatory doesn't deem necessary) but absolutely fantastic information and recommendations. Thanks! :)

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Great info! I'm a new grad that has landed a job in a telemetry floor. I'm very excited!

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