button2cute

Hello,
No it will not be like med surg at all. You will be dealing with cardiovascular patients with a variety procedures being perform on their heart. I love Cardiac very much.
A step down unit (that I am familar too) is a patient that is stable enough to move out of the cvicu. They can be unstable as well at times. The patients may come in for a procedure and stay for several of days after the procedure. Many of them will come in because they were unstable at home or the physician told them to come in.
You will have them on small ekg boxes which will relay the rhythm to the front desk and they may have some in their rooms. You will do vitals, adminster medications, assess them in the beginning of your shift, making sure your fluids are adequate for the shift and record them, follow the orders of the physicians (I know that is a given), watching for any abnormalities that may occur with the patients, will provide patient and family education, write progress notes (hopefully you will have a computor), maintaining contact with the patients and physicians during the shift, sometimes you will have patients that may have trouble and it is emergency....this where you will learn and bust your butt, and most of all, you will grow to be a great cardiac nurse.
I never compare cardiac with med surg. Because med surg you will recieve any and every thing on the floor. Whereas you will be dealing with cardiac patients and that is it.
Sometimes they would send a patient up to the floor that does not need to be there and you are like why are they here? Well, one is because they have a cardiac history and to fill the specialize beds...and the cardiac unit is specialize. I just to laugh when I have a teenagers with a broken ankle or arm and etc. And med surg floors would close and the rns would go home or if they wanted to stay to work...then be reassign for the evening. I could not stand low census in my hospitals because the cardiac units would be filled all year around.
Emm, you will know your rhythms very well, how to function in a code, learn your patients, recognize s/s of of cardiac problems, and most of all, you will feel like you have accomplish a lot with each shift.
Do not allow them to give you a lot of patients that are requiring alot of care; no more than two unstable patients; do not allow them to dump on you and speak up as well; do not be a runner for anyone....do your work first and then be a team player because there are some nurses who will take advantage of you; do not allow the patients, coworkers or physicians or supervisors or family members disrespect you at all; always ask a questions regardless how small they maybe and keep a note pad; lastly, mark your stethoscope because it will be missing and if you lend it to a physician..get it back.
Oh I forgot, know heparin, coumindian, levonox, like the back of your hand. Know what reverse heparin and coumindan. Remember do not ever run anything with heparin and other anticogulants. Make sure you look at the compatibility of your medications and especially iv meds.
If a patient is on lasix make sure they have a K+ level and oral K+ on board. Make sure you know the different catergory of the cardiac medications. What two cardiac medication catergory should not be together? ace inhibitiors, ca++ channel blockers, beta blockers, and etc. Which two should not be given together?
That all will come in time
Alright that should assist you.
Good Luck and Congrats,
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