"If I Knew Then What I know Now" -Med/surg-to-CCU


i did it! i got a transfer to our hospitals ccu from a med/surg floor. i start in a few weeks;. i am really nervous. i have been an rn for 3 years, so not new to the hospital....i should not feel this anxious, but i am. there is so much to learn.

question: if you heard that a new nurse would be transferring to your department ( ccu nurses), what would you expect of him/her? how would you perceive her? (if that makes any sense). what should i already know or try to know pertaining cardiac stuff?

i'm desperately looking for that "if i knew then what i know now" advice from former med surg to ccu nurse.



51 Posts

I say study and pass the CCRN. The only resource I think you need is the Pass CCRN book (throw the book away and use the cd of computer questions its just like the test).

Also check out these podcasts/blogs: emcrit.org, emrap.tv, ercast, icurounds, resus.me

Study up on ACLS algorithms.

My favorite book is Clinical Anesthesiology by Morgan/Mikhail/Murray (its anesthesia but lots of the meds and physiology apply to icu work).

Also get an EKG book and learn rhythms.

Specializes in rehab.

Thanks Haji,

CCRN? wow! i though you have to have at least 2 years of critical care before you can even look at that...

Got the EKG thing and ACLS algos going...it just seems like so much, but I gotta start somewhere!!:anpom:

Thanks Again!!


255 Posts

Specializes in ICU, CV-Thoracic Sx, Internal Medicine. Has 11 years experience.

Yes, you have to have a minimum of 2 years of critical care experience to sit for the test. You can always prepare in advance though, so you're ready to test right at the 2 year mark.

Having rhythms down is big. I strongly recommend a book called Rapid Interpretation of EKG's by Dr. Dale Dubin. It's an easy read with a full explanation of 12 lead interpretation.

Also, read up on STEMI, NSTEMI, a-fib, pacers (external, internal), AICD's, CHF, pulmonary hypertension, aortic aneurysm, aortic dissection, hypertensive urgency and hypertensive emergency.

Start with the rhythms and work on the other topics listed, in no particular order.

Best of luck and congrats!


261 Posts

Specializes in CVICU.

You only need 1 year of full time experience to pass ccrn. It has to be WITHIN the past two years though. I'd say study up on stemi and the differences between the different wall mi's.

Specializes in NICU. Has 17 years experience.

I think it is very appropriate to feel anxious. If you weren't anxious I'd be worried.

My advice:

Know what you don't know.

Specializes in ICU. Has 20 years experience.

Med Surg means a lot of quickie problem focused assessments. No judgement here but you need to assess every square inch of your patient. Report is in depth. Memorize the anatomy of the heart and lungs. Learn everything there is to know about the bedside and central monitor, it's recall function, and always measure intervals and run a strip at the start of your shift. Know everything about a proplonged QT interval. Know the we be ****** rhythms. Really know how to use the biphasic, synch mode and paced mode and how to defib. Read up on every new gtt. How to mix and titrate and your institution's protocols. Go to every single seminar and educational opportunity. You have to be committed to this and it's mainly self taught.


3 Posts

I just left the Med/Surg floor and landed in the CCU for about 6 months now. Thoroughness is imperative. Most of these patients have ACUTE systemic illnesses making your assessment as well as your establishment of priorities HUGE. Knowing current lab values, rhythm monitoring, pre- and post- procedural care are high on the list. Above all, ASK QUESTIONS. Ask questions, be attentive, research the internet, and read the physicians' progress notes. Observe how other nurses deal with mainstream problems and make mental notes of how to more effectively deal with patient care when crises come about. Because oh lawd do they come, and you want to be the most proficient nurse you can be when that time arises.


51 Posts

when i was brand new in icu i asked some more experienced (20-30+ years) nurses about the ccrn test and they told me i had no business studying for it. the test isn't that hard and studying for it will force you to learn some good stuff.

i say start learning now. you can't sit for the test for a while, but the knowledge you gain will help you. its very empowering to learn.


7 Posts

First off, chill out! they'll teach you everything you need to know! or check out nursetoons.com :p

Secondly, get Fast Facts for Critical Care, by Kathy White (iphone or binder)--look it up if you don't know it! Anyway, there's soo much to learn, no one can keep it all straight till they've been doing it at least 6 months.

thirdly, http://www.icufaqs.org/ will become your best friend---it's like an online preceptor :p

have fun! enjoy those adrenaline rushes! and lastly---please don't faint in the ICU!

Specializes in rehab.

Wow Guys!! Thanks! so overwhelmed right now !I start in a week. Wish me luck!!


2 Posts

I started in a CVICU in January. I came from tele/med/surg in a community hospital. I would say the hardest thing in the beginning was that it sounded like everyone spoke a foreign language with all the abbreviations and terms I wasn't familiar with. Don't get overwhelmed, ask questions! Ask your colleagues to define terms and abbreviations for you. Make a binder with info that you get during orientation so you can reference it down the road, because you won't remember it all! It will get easier with time and you will fond your reference nurses to go to. I LOVE my job and have learned a ridiculous amount since I've started. Have fun and good luck!