cabgnurse

My perspective is a little different. I am a career-changer. I was a successful banker for 12 years before going to nursing school. So I *WANTED* a change and became an RN. I worked in customer service, front line work, Lending, Info Tech jobs, and lastly, as a Bank Trainer. I dealt with all types of people in that environment, too. People lose their minds over money AND death/dying. (with the same level of craziness, lol) I found people are the exact same in the hospital environment; just a different data set. Since I didn't hate people in banking, I don't in nursing. Because I chose my new career, I love it. (95% of the time.) Has your opinion of people changed at all, do you still have faith in humanity so to speak after dealing with so many types of people? There are isolated crazy family members who will report you to Administration for encouraging the family that mom's not dying. (seriously!) Having said that, yes, faith in humanity intact. Do you still maintain your compassion for others? Yes, intact. I have a lot of dark humor now, but you can't get through the ICU without some. You de-personalize at times to get through a nasty code, or a painful procedure. But when the procedure is done, I'm the nurse holding that patient's hand, hugging them, or wiping their tears. Handing out boxes of kleenex to the family members left behind when Mamaw doesn't make it through the code. Praying with one of the Sisters (nuns) with the family. It's all part of what I do. Do you get depressed at all from the circumstances? Rarely. I was depressed on the floor because I always had 7 patients and I didn't feel like I got to spend enough time with them to "make a difference." Too high of a ratio. Now I work ICU with a max of 2 patients. Still crazy-busy but I feel like I get to be *with* them more. Emotionally, as well as their physical needs. And I have a great director in the ICU that respects my input for small purchases (like cables and other needs) and necessary changes. Why do you keep going back? I chose to be a nurse. It is (now) who I am. Also, I don't get bored. After working in the ICU as a generalist, I specialized to take hearts. (heart surgeries right out of OR) I'm always learning more about that. I'm studying for my CCRN. And then, in addition, I began working with our Infectious Disease doc this year. I round on hospital patients and do our new consults. Works and entirely different part of my brain. So I keep going back because there are so many different things you can do as a nurse, that it's your own fault if you get bored. Be really good at what you do, be positive and professional, and opportunities will open for you to try different things if you wish. I have a standing invitation to become a clinical educator, but I have passed on it 3 times because I'm having too much fun on the clinical side of things. YES, I have terrible days. YES, I have some catty co-workers that I can't stand and just choose to stay away from. YES, I have mean doctors and mean families sometimes. I had all the same things at the bank. It's just people. The good far, far outweighs the bad, though. Good luck. You'll make the right decision.

1:1 fresh hearts until extubated, or until 12 midnight if they're not going to be extubated & are part of the first group (arrival 1300-1400)...And are otherwise stable. :-) CRRT is 1:1, & Hypothermia Protocol (s/p MI) is 1:1. We pair just about everything else.

My facility doesn't give us any incentive to sit for the CCRN, except if we pass, they will reimburse the cost of the exam. (Regardless, I am taking it in the next 2 months for the knowledge and confidence. We only have 2 nurses still at the bedside (& one is PRN b/c he's a flight nurse) with this credential, so I would like to stand out at my facility with obtaining mine.) I've seen old threads, but wanted to ask for 2013... Any of you guys getting paid more for the cert?

oops, that "index" is a link to icufaqs.org

Welcome to CVICU nursing! Sounds like you are well on your way to getting the necessary tools to start. Check out index for some really good info. When I transitioned from the floor to the Unit, what I had on my side was that I wasn't a "new" nurse, but... Unit nursing made me feel brand new all over again! You'll be great at time management already which will be a plus, and you have assessment skills. As you well know, lots of folks with CA end up in the Unit, so your experience in Onc will be very beneficial. I hope you will be able to precept with an experienced Unit nurse to get you in the swing of things. Congrats and good luck!

Our facility doesn't allow us to pull chest tubes or pacer wires. I set up and take the dressings down, but my surgeons do the actual pulling. :)

We don't wedge either. Our surgeons have some "notify me" orders regarding our PA pressures but they're really in love with CI.

Yes. I transfer out two 2nd day patients just in the nick of time to pick up a new cabg. Sorry if I didn't state it very well.

My facility has ICU nurses take two day post op cases, then hearts that were extubated overnight, then precept 7 fresh cases before taking the first one solo. If they aren't giving you learning opportunities, I would ask for them, even if you have to shadow an experienced heart nurse on your day off. I think it shows responsibility that you want to be well prepared. Good luck!

I agree with some of the prior posts. Our policy is also "New to new", but if the patient is dying, time does not permit stringing new tubing. You can't have a CLASBI if you have expired. Hopefully your teammates could step in and help in a scenario such as this.

I would love to hear how my experience compares with my fellow nurses. I take CABGs/Valves fresh from OR. Days (7A-7P) that I do this, I have two CV patients, often that are Two days post-CABG themselves. I have normal nursing duties with the two, assessments, meds, plus d/c-ing all of their lines and drips (swan-ganz and introducer, drips weaned off, art line, and foley. ) Assist surgeon with DC of chest tubes and temp pacer wires bedside. Put them on Step Down bed list, actually take patients to their new rooms, give bedside report. *Somewhere* in there, find time to chart, 15 min vitals after the chest tubes and wires, set up my heart ICU room, hope like heck to get to eat, (which I usually don't) & then be all smiles for when the elevator opens from the basement and the CRNA and team is bringing me today's case. Is this normal????????