What's your favorite thing about working in CVICU?
This is probably applicable to all kinds of nursing, but you never know what you're going to walk into when you get to work. You might be walking into a fresh code where the critical care doctor is still in the process of placing lines, the nurse is mixing vasoactive drips to save his pressure, the RT is trying to make the image of an emergently intubated patient look presentable, and you're looking at the board hoping that you don't have a 2nd patient. It is either feast or famine. You might have a patient that's been there for a few days and you are just keeping an eye on them to ensure they don't go from stable to crashing, or you may be the one stabilizing the crashing patient coming from ER/OR.
What do you find most challenging?
Patients in the ICU, regardless of subspecialty, are at their sickest. The choices you make as a nurse can literally make or break a patient's recovery. Again this is is present in most types of nursing but the reality of it is amplified in critical care nursing because of how sick these patients are. You have to know the mechanism of action of the drugs you are giving, not just what they do in layman's terms. You have to know why calcium channel blockers are detrimental to patients with low EF's, you have to know why beta blockers shouldn't be given when patients are on some inotropes. You can't just know that "lopressor lowers blood pressure and heart rate" and be a safe practitioner. You need to know how it does it and what else the patient has going on that will affect their physiology. A tremendous knowledge set is required to be a safe and competent ICU nurse and as someone who is nearing the 2 year mark, I know I'm not even close to the tip of the iceberg.
What do you dislike about the CVICU?
I hate it when we get overflow from less acute floors just because we have the most beds in our heart hospital. This doesn't happen too often, mainly when there are no beds on the cardiac intervention unit and we have to take a stented [N]STEMI. I don't mind these patients. They're typically easy to take care of and it's not like we're tripled with them. However you get more demanding patients just due to their lesser acuity and it can really irk you. When you have one patient who has been on the vent for 6 days with no promise of being extubated, worsening renal failure new to this admission, can't keep a blood pressure for more than a minute of the levophed being put on hold, then you have a 2nd walky talky patient who really does not need to be in the ICU complaining that you don't have ice cream readily available on your unit (hello, it's an ICU; most patients can't eat), it really can be trying. For the most part, if you can use your call light to complain about your dietary options, you probably shouldn't be in the ICU.