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Ortho to cardiothoracic ICU

Hello all, 

Some background, I have 2 years experience on a mainly ortho floor with some telemetry for patients with post-op complications.  VERY small ortho dedicated hospital. I loved my job but found myself yearning for more, I always felt like I wasn't taking full advantage of my education in this position. 

Fast forward to now, I have accepted a position in the cardiothoracic ICU at a large level 1 trauma center hospital.  I have finished "corporate" orientation and begin working with my preceptor in 3 days. I am VERY excited but so nervous because I know that it is going to be a steep learning curve and feeling a bit crazy making this huge change.  I have been studying in my own time, reviewing vasoactive drips and trying to prepare myself in any way possible.  I'm just looking for anyone who has been in a similar situation or anyone who has any words of advice about going in to the ICU.

Much thanks!

Nurse Guy Mike specializes in Critical Care.

Hey KCollins, CONGRATS on the transition! I start a CTICU position soon. I'm assuming you've started precepting already, any tips? I just picked up the book: Cardiac Surgery Essentials for Critical Care Nursing, and going to start reading soon. Would love to hear about how it's been for you so far.

On 7/29/2020 at 6:44 PM, Nurse Guy Mike said:

Hey KCollins, CONGRATS on the transition! I start a CTICU position soon. I'm assuming you've started precepting already, any tips? I just picked up the book: Cardiac Surgery Essentials for Critical Care Nursing, and going to start reading soon. Would love to hear about how it's been for you so far.

Mike, 

Yes!  I am actually just finishing my last week of orientation and I start on my own next week. Fastest 8 weeks of my life.  Its been a big change, I really am enjoying the ICU setting over my previous med/surg/ortho background.  There is so much more help and cohesiveness it seems.  One thing I would recommend freshening up on is swan-ganz catheters.  This was something I remembered learning in school and just kind of tucked in the back of my mind.  The first time I had one I had a hard time remembering its purpose.  Definitely familiarize yourself with levo, epi, dopamine, dobutamine, fentanyl, precedex, and propofol.  Those are the most common drips I have seen this far.  And the last thing I would recommend is get used to hemodynamics: cardiac output, cardiac index, and SVR in particular.  I hope this helps! These are just the things I wish I would have looked up  better before starting.  Good luck to you, and congratulations as well!

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