CardiacRN

Similar scenario here........I work on a 24 bed interventional cardiac unit with a 12 bed CICU net door. As several posters have already said, there is a very high turnover, hence lots of paperwork. We have 6 PCI labs, plus EPS, so we are busy. Assignments: Days 4:1, with a charge nurse; Nights 6:1, charge nurse has full assignment. We generally pull our own lines, and the MDs have been encouraged to use closure devices as much as possible(for all of the many benefits). This RN staffing level is fine, provided you have good ancillary support--secretaries and CNAs. There are always shifts when 6 pts are fine, and then the next night 2 will keep you runnning. There's no real magical number.

In some ideal, some day, I will come off 12h night shifts. I really dislike it, an di am convinced it is taking years off my life. As an earlier poster mentioned, had she known this was what she had to look forward to after nursing school.....well, I don't need to say it do I?! :)

Amiodarine gtts are used on all cardiac units/floors in my institution.

As one of the larger catheterization/angioplasty center son the east coast, we are always trying to reduce the bedrest for the patient. As already posted, generally people stay on bedrest for 6 hours post sheath pull. We are also using Angioseals(collagen plug) in which case bedrest is 3-4 hours.

Depending upon the size of the hematoma, we apply manual pressure 20-30 minutes, then apply a Femstop or sandbag. For the groins that blow and result in large hematomas, sometimes a C-clamp. Depending upon the severity, may get an U/S thr next day.

Yes, you're in murky waters. I do not feel it is the RN's responsibility, I wouldn't do it. If someone is on a balloon in CCU, they are obviously not stable, and the MD needs to be there. Yes, we use Femstops. There's no way I would hold for 30 min.

While the prior replays are "appropriate", it is the tragic reality to nursing. I STRONGLY encourage you to be an ADVOCATE for yourself! Get malpractice insurance. When you feel you have an inapproriate assignment, SAY SOMETHING, DOCUMENT IT, MAKE YOUR CHARGE TAKE NOTE, if you don't get anywhere TALK TO YOUR NRSG SUPER....As noted earlier, we often find ourselves questioning where we stand we safety and the acuity/census level. It is horrible to feel that your license is on the line every time you walk through the door d/t census, acuity, short-staffing, lack of orientation/education, etc. That is my best advice, advocate for yourself, your common sense/intuition is worth a lot, and lead with confidence. As an old instructor always told me...."document as if you had a lawyer on your shoulder....". Best of luck.