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Discussion

put me on ccu

I picked up a night shift at our local hospital. I was placed on CCU. The agency told the hospital that I was able to do Coronary Care.....WELL, I have been a DON in LTC for the last 7 years, this is my first week doing agency...I have never worked in a hospital let alone CCU. This week I have worked tele..which is fine once you know the requirements. I was scared to death to go to CCU. I have to tell you though, I had a blast. I titrated nipride drip and admitted a lady on a nitro drip. I did more IV pushes tonight than I have done my entire nursing career combined. I really don't have a point, I was just excited that I was able to do this and wanted to share with people who actually understand. I am glad that I have solid assessment skills-that got me through the night. Thanks for listening.

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  • Experts

I had to kind of chuckle :chuckle when I read your post. Kind of nice having only 2 patients for your whole shift, isn't it? I was a nursing supervisor who had to tell a lot of nurses that they were being floated to other units to work. ICU and CCU are the two that scared people the most. Even the stepdown nurses hated being floated there. However, when I was a staff nurse many years ago I always liked going to CCU. The nurses there never gave a "float" (or an agency nurse they did not know) any patients that they thought we could not handle. Most CCU patients were on bedrest and the docs wanted them to rest and not be disturbed too much. The other CCU nurses always kept an eye on the patients I had as well. I always felt like I was in good hands when I was working in CCU.

My mother was a CCU nurse for years. She would come home and just hold us spellbound with these horrible stories of code blues that went on for the whole shift on only one patient. So, the first time I was floated to CCU I was shaking in my shoes! I worked in CCU a lot and never witnessed any of these horrible things she was always telling us. To this day, I don't know if I was just lucky, or if she was jazzing things up just to impress us.

Oh, and when I was a supervisor I used to tell the reluctant nurses who were being asked to float to the units that we weren't expecting them to titrate dopamine drips, take wedge pressures or cardiac output measurements. Basic nursing care and good judgement is the same anywhere. I always checked up on floats numerous times during their shift and advised the unit nurses that the float was nervous about being there and to please keep that in mind and not to expect them to function at the same level as a seasoned unit nurse.

ICU was quite a different story. . .

it just depends on where you work. some ccu's have very sick patients. balloon pumps and the works. others are very mild. sometimes i don't mind getting a float from floor. other times i really don't have the time to keep an eye on their patients. if your not comfortable,.....dont do it. you could really get into alot of trouble if there are more than a couple of bad patients in the unit. it's not fair to the nurse or the patient.

  • Experts

Unless you have had specific training in titrating those drips, I would not take an assignment like that. Remember that if a problem were to occur, it would be your license on the line, not anyone elses.

And one week on a telemetry unit the week before doesn't give you the proper training to know what to do ith an arrythmia, if one were to occur.

Are you ACLS certified?

Just because the hospital was willing to place you there, and the agency as well, since you haven't had any acute facility nursing experience for years, shame on them.

You are just setting yourself up to lose your license, please be very careful with this. Cardiac patients in a CCU can go bad at any time, and they do. And many times it is the very stable one, who has the discharge orders for the am, etc. that codes.

Unless you have had specific training in titrating those drips, I would not take an assignment like that. Remember that if a problem were to occur, it would be your license on the line, not anyone elses.

And one week on a telemetry unit the week before doesn't give you the proper training to know what to do ith an arrythmia, if one were to occur.

Are you ACLS certified?

Just because the hospital was willing to place you there, and the agency as well, since you haven't had any acute facility nursing experience for years, shame on them.

You are just setting yourself up to lose your license, please be very careful with this. Cardiac patients in a CCU can go bad at any time, and they do. And many times it is the very stable one, who has the discharge orders for the am, etc. that codes.

You know, Suzzanne, I was thinking the exact same thing. Only LTC experience recently, and not critical care!Critical care is not a game-----need proper training, or she should have had a preceptor with her the whole time!

  • Experts

When you are assigned to a unit, you are the nurse responsible for that patient. If you can't read EKGs or are not familiar with the different drugs, you are "delegating" that responsibility to someone else, but you are still ultimately responsible. And it would be that nurse's license on the line if anything happened.

I can understand enjoying the shift, but I think that was a result of not knowing the position they put you in. You don't know how much you don't know- and it seems incredibly unsafe to me.

I guess I have been very fortunate. The company I have worked with lately actually have nurses in the office that I can call on for support. Granted, I am working as a traveler for them, but they have not assigned me anywhere that I have not had sufficient training to work. They have not even asked me to try to "stretch" my nursing experience. I have had experience in several aspects of nursing and each time I am interested in a different floor, like pediatrics, telemetry, ICU, and so on, they give a new proficiency test to make sure I know what I say I know.

I think that's completely unsafe and unprofessional. I have worked with floats and agency nurses in that position before and the common denominator is that they don't realize how much they don't know.

I think that's completely unsafe and unprofessional. I have worked with floats and agency nurses in that position before and the common denominator is that they don't realize how much they don't know.

Yup. I've also had quite a few 'pretend' ICU nurses via agency. They want the specialty pay so they exagerate their experience in ICU. Which is why I made it a practice to watch them closely during their orientation...they tend to give themselves away by the questions they ask. ;)

To the OP: I'm glad you enjoyed it! Please consider a good critical care internship program if you would like to continue working ICU. That way YOU get the correct education and support, AND the patients are receiving safe and effective critical care.

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