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The CSC exam, I feel, was a lot easier than the CCRN. Reason being, if you work in CV/CTICU, you see these types of patients quite frequently. That being said, the CSC solely tests you on your post-op management knowledge. Additionally, there are some things that they ask you about from a medical point of you. So I'd look into things like cardioplegia, anesthetic choices, post-op pain management and VADs (L or Bi). Hope this helps!

you need post-op experience for the CSC.

I 10 fold agree to this. If you have an amazing Code Leader/MD that knows what they're doing, then the code will run so smooth; regardless of the outcome. But if you have a a new resident on rotation or a fried out RN, then you can assume the outcomes and emotions of the code...

I agree with GrnTea. ICU/Critical Care is so much more than MV type patients. It also helps that you have your experience as a LPN, but again there is far much more you would need to encounter before picking up ICU; let alone as per diem. Good luck and hope things work out for you soon.

Here in the Pacific Northwest, we're gifted with an ECG guru! Google Carol Jacobson Rn. She presents at many conferences on ECGs etc.

I tend to err on the side that a ICU patient is never stable till they get transferred...

saline lock should do it w/ a flush @ every shift change. at least that's SOP at my facility.

i too find this is funny! I've had a 2 pt assignment when one pt was on levo & vaso while the other was on dopa & levo! Glad that admin stepped in to oust such a lazy disgrace...

We've been using a lot of IABPs on our post OHS patients lately and yes, they've been meeting some hard times also and have been coding: bad heart pre-op will most likely be a worse heart post-op. Anyways, my unit CNS, manager, and IABP rep that we work with advises to place the IABP in semi-auto and on AP. From there, the IABP will go off the pressure generated from compressions and try and work that way. But if this code is looking to be a long one, the balloon can only remain uninflated for 30 minutes. After that, it has to go... Hope this helps!

At my hospital, we dont even raise the HOB. But we do put them in reverse trendelenberg. The risk is too high and perforating a major vessel is never a good thing...

if she has/had a PICC or TLC etc, transduce a CVP off of that. Also, I noticed that she didn't have a Hx of HTN. Maybe she did? Who knows... I say this for one thing... Pts with htn need higher filling pressure. And if you perfuse kidneys, that likes a higher pressure, with what may be "text book normotensive" you're not meeting the demands of her renal perfusion.

you can say that again! no better way to explain it than this way!

At my facility we do a "4x4" goal... So as soon as the patient has arrived in the ICU room... We have 4 hours to extubate. Restart the clock... Then the 2nd block of 4 hours is trying to get the patient to dangle at the bedside. Restart the clock... The 3rd block of 4 hours is goaled to remove the PA catheter if the patient has been off of vasopressors for at least 2 hours. Restart the clock... Then the last block of 4 hours is dedicated to getting the pt up to a chair for a couple hours and ready for transfer to the floor. Hope this helps!

yea. a 12 lead ekg is great. but if in case you don't have the time to wait around for one and if you're losing bp because of no preload. a quick way to check is with adenosine. done correctly you'll either see the flutter or stop the SVT... Hope this helps!

I have tried that "Hand Clamp" technique and using the fist technique also and I have to say that I like the fist technique much better! But I assess for a fem pulse first, then position myself to the side of the sheath, apply slight pressure above the art. sheath or below for a ven. sheath. then simultaneously pull and press with body weight. Hope this helps!

Same here. I thought orientation would never end. I didn't like how some of my preceptors hovered over my every move and thought. It felt so restrictive and it also threw the critical thinking skills out the window. But it's over and i'm finally feeling like i'm some nurse!

as a rule that we do at my hospital. if what ever you're giving is from the vial and if it's only about 1ml, it's best to dilute it. like ativan especially?! man, that thing is like syrup, so dilute it.

Here's something kinda similar or not. But I totally know where you're coming from re: feeling frustrated with coworkers etc. So at the hospital I'm at, we have 4 pts, no nurses aides and it's a mixed m/s tele floor. My acuity was maxed out and I was taking an admission. While doing all the admission teaching and orienting, one of my pts was up to some mischeif. I had asked for some help while I was stuck in my room doing the admission etc. As soon as i finished i'd come out for a "fellow RN" to say, "I saw your pt on the side of the bed and i didn't know what you wanted me to do but apparently she seems safe and is ok." So i began to feel a bit upset. Cause that isn't a safe situation right? Well at least for me. So i quickly jolted for the room, and low and behold... I'm just glad the patient was ok, but pretty bummed and frustrated to how one can feel like an island... I just don't get how people don't commit to teamwork. "I'll scratch your back if you scratch mine!" Right?