Broken_Heart_RN

I always joke that my experience as a horse woman prepared me for ICU nursing. In CVICU esp where you get people oob 4 x a days starting POD 1 with Swan's, chest tubes, CVLS, pacemaker boxes and they are so weak and dizzy!

Tampa General Hospital in Florida has an amazing CTSICU. ECMO, LVADS ,CRRT, IABP etc on a regular basis. Magnet facility, Clinical ladder that compensates and acknowledges your skills, education etc.

I have worked in several CVICUs as a traveler and as staff. I have also worked in other countries (volunteer) and seen the gamut of the most high tech to least. However, evidenced bases is evidenced based. In pedi CVICU's in less technologically developed countries we give them bubbles to blow or baloons (in leiu of I.S). There are several things in your post that are alarming because the surgeons are not keeping up with EBP and what produces the best results. In an American hospital, there is not reason to not use an insulin gtt (insulin costs like 2 bicks a bottle). Also not using an I.S? I can;t imagine a rationale for that. In my humble opinion, get out now. I had the priveledge of starting my CVICU career at a Magnet facilities associated w a medical school so now I find it hard to stay at a place that does not constantly try to improve.

I agree that if they are asystole or non shockable, a cracked sternum is oreferable t death. However, always shock first. We even have a surgeon who encourages shocking asystole as "you can't hurt anything". Occasionally it stimulates a little something and you have a rhythm ( a gross one but better than nothing).