Open heart IMC

[KayceeLeeRN, BSN, RN]

Hello- I'm an RN with 4 1/2 years heavy med/surg experience in a large teaching hospital. I'm looking into a position at a smaller community hospital's open heart unit. They advertised the position as an IMC unit, but he nurse recruiter told me this is the open heart unit., but they also have a separate CTICU.

First question- can anybody tell me what the differences might be between the "open heart" IMC and the CTICU?

Second- Do you think 4 1/2 yrs on med/surg is sufficent to go into an open heart unit? I have no tele or ICU experience. But they have a good (3 months or more) orientation.

I'm really interested in expanding my skills and I've always been drawn to critical care.

Thank You!

[Biffbradford]

I suspect you'll get chest tubes galore which you will probably pull when the time is right, JP drains, external pacemakers, and some drips. They'll be basically stable, but you'll send some back to the ICU, and code a few. The EKGs you'll learn and you'll have a grand time!

[nurseprnRN, BSN, RN]

great next step in your career. you sound like someone who will love it and do very well.

[Reno1978, BSN, RN]

Well, if theres an IMC and a CTICU, I'm assuming it's a setup similar to where I work. Patients come from the CVOR to the ICU and are recovered by an ICU nurse. Once the patient is hemodynamically stable and no longer on any of their cardiac gtts, they then get transferred to our Cardiac Unit (IMC), where they remain until they're discharged home. There is a big difference between recovering a patient fresh out of surgery versus the following day when they're up walking around. I'd suspect on the IMC floor that you're going to have patients that will be walking around, with chest tubes...heavy PT. Also, the IMC floor may have patients that are pre op for open heart surgery, so they wait there, get prepped before surgery, etc. On the other hand, in the CTICU, you're going to have patients that return from the OR intubated, with PA catheters, art lines, chest tubes...on multiple cardiac drips and you're going to be managing the patient's recovery as far as getting them extubated and weaned off their vasoactive drips, monitoring for bleeding, and beginning their rehab once that ET tube is out.

Hope this helps!

[KayceeLeeRN, BSN, RN]

great next step in your career. you sound like someone who will love it and do very well.

thank you so much :)

[KayceeLeeRN, BSN, RN]

Well, if theres an IMC and a CTICU, I'm assuming it's a setup similar to where I work. Patients come from the CVOR to the ICU and are recovered by an ICU nurse. Once the patient is hemodynamically stable and no longer on any of their cardiac gtts, they then get transferred to our Cardiac Unit (IMC), where they remain until they're discharged home. There is a big difference between recovering a patient fresh out of surgery versus the following day when they're up walking around. I'd suspect on the IMC floor that you're going to have patients that will be walking around, with chest tubes...heavy PT. Also, the IMC floor may have patients that are pre op for open heart surgery, so they wait there, get prepped before surgery, etc. On the other hand, in the CTICU, you're going to have patients that return from the OR intubated, with PA catheters, art lines, chest tubes...on multiple cardiac drips and you're going to be managing the patient's recovery as far as getting them extubated and weaned off their vasoactive drips, monitoring for bleeding, and beginning their rehab once that ET tube is out.

Hope this helps!

Thank you for all the info! So, it sounds a lot like a regular tele unit to me (just especially for the open hearts). They also have separate tele units though...I guess I'll have to wait to hear more about it from them!

The ICU enviornment sounds so much more interesting to me...I want to learn about all those gtts, lines, caths, and vents! It seems very difficult to get into an ICU with only med/surg experience though. I'm hoping (if I get this position) that it will be great experience and a closer step towards an ICU. Thanks again!

[Reno1978, BSN, RN]

New grads end up in CVICUs all the time. Your experience will definitely help you out. Good luck to you!

Yeah, a lot like a tele unit, but a huge focus on rehab, walking, etc.

[Jenni811, RN]

i got hired as a new grad RN on a cardiac unit, i take care of open hearts all the time!

[Pinkster]

I was a New Grad on a similar floor. (been there for 1 year). I work on the Cardiovascular Progressive Care Unit and I Love it! We are the only unit that takes the open heart patients after CVRR (Cardiovascular recovery room) are hemodynamically stable, usually on Post op day 2. pts normally still have chest tubes, foleys, subclavian lines, pacing wires and sometimes external temporary pacers. typically they are not on cardiac drips when they come down, but occasionally they do go into Afib with rapid ventricular rate and need to be started, so we do run them, we are the only PCU that can run them in our hospital. They also can go bad really quick, so having good assesment skills and a strong grasp on your nursing confidence helps.

We have had a few new grads come to the floor and do well. The acuity of our patients can get very. we are still only a stepdown unit so we can get max 6 patients as we are a tele floor and get cardiac caths, AMIs, and chest pains to fill the unit. So having your time management skills down is more than helpful.

I think this would be a great move for you, you have the basic nursing down, and will get specialized training to make you proficient in a new area. Also the best place to be other than CCU to get into the CVRR is on a floor like that. So at least there you can get comfortable with a stable patient before taking unstable fresh ones. :)

Good Luck

Good Luck.