Open heart ICU

Specialties CCU

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How is it looked upon for new graduates to apply for work in an Open heart unit? Did any of you go directly into an open heart ICU after graduation? Do you know of a new grad who did?

I'm a senior and I have a teacher who believes that nobody should even work in the ICU without years of med-surg experience. She said, "Back in my day, open heart nurses were the cream of the crop." I think she may just be bitter that things have changed, but I would like a fair view of how you see this issue in your workplace.

Specializes in Pediatric Critical Care, Cardiac, EMS.
Wow, you'd really hate me because I've done clinicals in a cardiac ICU for a total of 62 hours as part of my senior practicum (yes, I'm still in school) and I've already participated in a code, titrated drips, done head to toes on fresh CABGs, ran the CCRT, called docs for meds, taken wedge pressures and CO/CI, weaned pts off the vent, and I do ALL the charting. I'm in the accelerated program, which is a BSN in 1.5 years and I taught English before that, so I have no tech or medical experience. Do I know it all; not by a long shot. I have a great preceptor who gives me enough rope, but not enough to hang myself. My medsurg rotations were miserable and I found many of the nurses lacking; most were afraid of the doctors and some were just lazy. To the person who started this thread, if you have the ability to grasp information coupled with the desire to put theory into practice, I think you should go into open heart ICU. Unlike Lorilou22rn would have you believe, it doesn't take 8 (EIGHT!) years of floor nursing to be a good ICU nurse. My wife went directly into the ICU after graduating and she's a wonderful nurse (soon to be pharmacist).

Sorry if I ranted, just got done with clinical.

Not to be rude, but it's people like you who scare the crap out of me. (OK, maybe to be a little rude.) 62 hours of senior preceptorship and you think you're an ICU nurse? Dude, you're dangerous. I've got better than 10 years of EMS experience - I've RUN codes and intubated people - plus over 1 year in the Neurosurgical ICU before transferring to the CVICU - and I'm going to suck up every bit of my CVICU orientation/preceptorship I can, and ask a ton of questions - because I know where I am on Benner's continuum and it's somewhere before "competent", solidly in "advanced beginner." Arrogance will kill patients. It will most definitely kill a career.

And in regards to the earlier question - if I didn't have time management and critical thinking skills from my career in EMS, I would have been drowning my first six months in the ICU - as I saw a lot of others drown. We had a great preceptor team, we help each other along a lot, and we have a fabulous orientation process - and there are still several of my class of 28 GN's who are gone now. It's a tough, Darwinian process - and if you don't have or won't develop a fairly thick skin and an open mind to constructive criticism, don't start it, start somewhere else and develop those skills. Just my :twocents:.

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Specializes in CICU.

Well, I wrote that over a year ago. Since then I've been working as a cardiac ICU as a nurse, and, in hindsight, I think you are right about a lot of things. And no, I do not think you're rude. I think you saw in me what I didn't know at the time. I am a little arrogant and very competitive. I'm older than most (as evidenced by my profile name) been in the military, and have seen a lot of life and some death. I did not, however, realize how much I didn't know when I wrote what I wrote. It felt good doing all the things I was doing as a student, and for a student, I feel I did those things well. I felt like I had the power of nursing in my grasp. That changed when my first patient coded while I was being precepted. After that I realized that it is easy to 'maintain' drips, machines, etc. that others have set up and told you how to use, but it takes skill that only time and experience provides to be able to handle unexpected situations.

To make a long story short, I was knocked off my fantasy perch by the cold realization that I didn't know jack about being an ICU nurse. My patient, who was supposed to be going to stepdown crashed, and I felt the fabric of my universe ripping apart as I realized that I didn't know what I was doing. Luckily, it was my first week and was being precepted by someone who knew how to be a nurse. The patient lived and I learned. Everyday I go to work I realize how much I don't know. In fact, I feel that I know less than I knew when I first started. Does that mean that I am regressing? No, it means I am progressing into a better nurse.

I do regret coming across the way I did, but it was who I was at the time. Luckily I work for a great organization that takes the time to train new grads. Even luckier is that I work with fellow nurses who slap me upside the head once in awhile.

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Specializes in Pediatric Critical Care, Cardiac, EMS.

Ya gotta love those colleagues who'll smack you down in a caring way, don't ya?. Believe me, I got my share of it early on, when people looked at me and saw an arrogant Medic newbie nurse - even though I wasn't being arrogant ( I thought/hoped) and was just trying to find my footing! I'm glad you're where you are - knowing what we don't know is humbling and exhilarating all at once, IMHO. I love learning new things, and I'm never bored. Best thing - I've discovered I love being a nurse - and learning how to be a better one each day.

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No, i don't believe everyone needs to spend time on the the med/surg floors before starting in the ICU. Yes, there are some new grad RN's who start in the ICU who can't handle it, but i blame that on the Directors that are hiring them. These new grads need to be given an accurate picture of what the ICU is really like, and what it really takes to work in that environment. Just like in any other job in any field, the ones that are doing the hiring need to screen the applicants to see which are a right fit for the unit.

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Specializes in critical care, PACU.
No matter where you start, you determine how successful you will become. You have to want it and be willing to be aggressive to get the knowledge that you need to be the best nurse for your pt's.

Really amazing post with great advice...especially since I will start in an ICU that has OHs. Thought your post deserved more than a kudos :yeah:

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Specializes in CVICU.

To make a long story short, I was knocked off my fantasy perch by the cold realization that I didn't know jack about being an ICU nurse.

I was lucky enough to have that realization on my first day of floor orientation. I was strictly shadowing and doing nothing else. Was observing the recovery of a fresh open when they vfib arrested. To make a long story short I watched a whirlwind of amazing ICU nurses and CVOR nurses + the surgeon reopen the chest at the bedside and actually save the guy. I'm so glad I had that experience to strike some fear into me and help me realize my role in this game. I go into work every day mentally preparing myself to avoid getting too comfortable.

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Specializes in ICU, Trauma, CCT,Emergency, Flight, OR Nursing.
p.s. open heart nurses are still the "cream of the crop!"

.....as are all nurses in their chosen specialty! :D

I think Flight Nurses REALLY are the Top Cream of the Crop! (Combined ICU , Trauma & nerves of Steel)

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Specializes in Critical Care.

I completely disagree with your teacher. I too started as a new grad in Critical Care. Cardiac ICU, and It can be a monster and overwhelming, but as the other people have stated, with the right motivation and support it is so rewarding.

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Well I started in an open heart unit right out of school.. It's a steep learning curve, for sure. But anyone can do it.

Be open to suggestions, watch people, and you will do fine.

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