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After reading about using a laser to level hemodynamics, I went and bought a pen style red laser light at office depot and started using it on my unit. All the other nurses thought it was cool and I had a good time playing some practical jokes on them before showing them what I am using it for. It is much easier and quicker than using a yardstick type level. All you have to do is center it on the air- fluid interface, press the laser light button to turn it on, then move the transducer up or down until level. It only takes about 3 sec and shining the laser in your pts eyes is not an issue, plus the pts think it is cool also.

I started working on a cardiac surgical unit a month after graduating from nursing school. After going through a little over a month of general nursing and critical care nursing orientation, I spent about 3 1/2 months orientating on the cardiac surgical unit. Our cardiac surgical ICU and stepdown are on the same unit and the RNs work in both areas, so I oriented to both. I have now been out of orientation and on my own for about a year. It is very important to get with a good preceptor during your orientation period. You need someone who can bring you along according to your pace and learning needs, and is willing to teach you everything they know about the post op management of cardiac surgical pts. Cardiac surgical nursing is a very specialized area of nursing. There is a lot to learn, and you need time to learn it. The longer your orientation time is the better because this will give you more time to experience and learn how to manage all the problems particular to post cardiac surgical pts like post op bleeding, cardiac tamponade, HTN, hypotension, low CO, electrolyte imbalance, resp problems,etc. I would also reccomend that you read as much as you can on the management of these pts. I bought a few books on cardiac surgical nursing from Amazon and BN, and have found it very beneficial to read and reread some of the info in these books. This has really helped me to understand the "big picture", and also understand what is going on with these pts physiologically. For example, it is very important to understand the physiological effects of the cardiopulmonary bypass machine. As far as the hemodynamic monitoring lines you mentioned, you will learn all about this in orientation. I think cardiac surgical nursing is probably one of the most stressful areas in nursing. I have got to the point where I am pretty comfortable, but still get anxious when admitting post op pts. Looking back over my first year, I am very thankful to get some of the experiences I have had behind me. These have made me into a much better nurse. I really think experience is key in nursing. This is the reason I said the longer your orientation the better. The more situations you can experience with your precepting nurse the better off you will be. Always try to get the most challenging pts during your orientation, and if another nurse on your unit is having some problems with their pt, try to get in on the action. One more thing, most of the nurses you work with will hopefully be more than willing to help you after your orientation is over. Cardiac surgical nursing is a team effort. One nurse cannot do it all when problems occur, or when admitting a fresh heart. It really helps take away a lot of stress, and makes your work much more comfortable if the unit you are going to work on has a "team mentality". Try to make sure this is true of the unit before you decide to work there and make sure you have this attitude also.