loveRNlove

Im on a PCU unit as a new grad and have learned so much. I would recommend it to anyone looking for great experience. Its a steep learning curve but well worth it. Many of our workers end up transferring to ICU after they have PCU experience, so it would probably work out the best for you. We have 4:1 ratio with occasional 3:1 depending on their gtts and acuity. We take post cardiac surgical patients, chest pain patients, pre/post pacemaker patients, pre-heart cath patients, and any CHF/resp failure/ or patients with arrhythmia's needing gtts or closer watching than regular tele floors. We take amio, insulin, dopamine, dobutamine, cardizem, nitro, natrecor, heparin and other anticoagulant gtts. We have temporary pacemaker wires and chest tubes. Basically we take more gtts and higher acuity patients then most tele floors! Goodluck!

I would take it if your job market is anything like most (very slim for new grads). Its a guaranteed job and if you have no other offers, I wouldn't sit around and wait for another one. Get the one-two years of bedside experience over with, then you are more marketable and then you can transfer! I have a coworker who transferred to our cardiac unit with years of L&D experience, so it is of course possible. I still have classmates looking for bedside jobs 1.5 years out of school! Good luck with whatever you chose to do :)

On our floor the doctors want us to hold off on PO amio if we have to start a drip. We will usually give them one dose of PO right before the last bag runs out then d/c the gtt.

I would start with analyzing how far from the patient's baseline are the "changes" you are seeing. If a BP is in the 170's and they are moving, I typically wait a few minutes and recheck. Often times the BP will settle after some rest. Also check on symptoms. If you have a patient that has a lower than usual BP but are asymptomatic I am less frantic than if they are pale, dizzy, or showing other symptoms. For low BP, i check it manually. Usually our floor is concerned if SBP

If they make such remarks just tell them what you have to do instead. "Can you help so and so off the toilet I'm passing meds or changing a dressing or talking to doctors, etc." Its not something you should always have to do, but some CNAs will make those remarks and thus a return remark that shows your reason would help end the conversation. I try to get my patients to the bathroom myself as well, but if you're in the middle of med passes or other important RN duties, the CNA needs to be the one helping with bathroom trips. Don't feel bad for asking, it's their job, and it's your right to delegate certain tasks. It would be one thing if your sitting around doing nothing and ask them to do something.

Thanks for the reply! They were mistakes I have learned from and have not repeated. I gave a newly anti-arrhythmic medication at the same time as a previously ordered one. The patient tolerated the original one fine, so I didn't think twice, i did not slow down to think to separate the two since there was a new one added which could affect the BP. The patient's BP dropped lower than I would have liked and required a call to the doc. The patient was fine and the BP came back up without intervention. I surely will never do that again. That happened on the first few weeks i was on my own. Another mistake was not following up and checking a lab after a medication was infusing. I was not require to check it prior to giving it, but should have checked the lab sooner than I did after initiating it. I think i just need to slow down and be i guess even more cautious than i already am. Mistakes happen, but i don't want any harm to ever come to my patients. I surely have learned from them and will not repeat them.

Hi all. First time posting on here. I've been working as an RN for a little over a year now. I work on a busy cardiac unit with high acuity patients. Somedays I go home thinking I was meant to be an RN. On other days, i find myself questioning if I'm cut out for this. Ive made a couple mistakes over the year, nothing that has truly harmed my patients, but they all have weighed so heavily on my mind. I try to learn from each situation and not repeat them. I'm not sure if I am just rushing and not taking the time to critically think, which makes me miss things, or what it is. Its not a constant occurrence, i can recall 3 mistakes, since Ive been on my own, that I could have prevented. Maybe if I would have slowed down and thought more. Should I look into lower acuity floors? Has anyone else gone through this? I feel so guilty ...