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Discussion

Single-stay unit

I am a senior student, and I applied for a post-grad residency in a cardiac single-stay unit. From what I know/understand about it, it sounds very interesting, but I'd love to hear more about what a typical day is like for an SSU nurse, if anyone wouldn't mind sharing!

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Do you mean short-stay, like an obs unit? I've worked at such a unit at two different hospitals, but it's the same concept.

They are usually quite busy, with constant admissions and discharges. The typical cardiac pt is a chest pain rule-out MI, NPO overnight with cardiac enzymes for a stress test in the AM.

If you have to draw your own labs, which is common on these units, you need to be very organized so all your troponins get done on time.

Some of these units also have non-cardiac obs pts in them, as long as they meet 23-hour criteria. These can be nausea/vomiting with no acute GI process or an asthma exacerbation that's stable now after treatments. Both such units Iv'e worked at had a book with policies on just what diagnoses could be admitted, and what would necessitate a transfer. For example, if the pt developed rapid afib and needed a cardizem drip -- goodbye!

One of the units really cared about fall risks and totals -- they were not eligible, the pt had to be a walkie talkie and toilet themselves. The other didn't really care, which was stupid. I can't watch an actively detoxing ETOH person and also have a total care that needs a full bed bath, plus 3 others.

Ratios are usually 5:1 around here. If you have to do a full admission profile on each, it can be arduous, but sometimes they let you get away with less specific charting, like the ED uses.

Bottom line: Something different every day, sometimes it's something different every hour! Daytime is much busier than night because there are more discharges. You can clean out the entire unit and fill it back up again in 12 hours.

You're going to meet a lot of people and impact a lot of people's lives in a very short time. A lot of these pts are not "frequent fliers" and it's the first time they've had to go to the hospital, so they need lots of reassurance. You won't typically see a lot of interesting stuff -- unless something very unexpected happens. That's why you need sharp eyes, so you can see if something's going downhill and get help quickly. This is not the floor to learn about cardiac drips/meds, because you probably won't be giving much or any of those. It is the floor to learn rapid assessment, IV and phlebotomy skills, and time management.

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