What to expect on a CVSU floor?

sher1206 · Aug 31, 2008

I am in the same boat as Sweet & Sassy, in that I just found out my clinical rotations will be on a cardiac unit. Although I am in my second semester and last semester I was on a med-surg floor.

I don't know if my wing also houses the step-down unit or not.

I am curious as to what I can expect and if my prior experience/knowledge base with med-surg will serve me in cardiac care.

I have to be honest and say that cardiac scares me a little.

Also any good websites to teach myself by would be much appreciated.

Spatialized · Sep 1, 2008

I can't generalize for other places, but I'll give you a quick rundown on what we have on our unit:

pre/post-open heart (valves, CABGs), post-op are usually day 1-2 depending on how they're doing, off pressors, sometimes still with chest tubes, and/or pacing wires.

post-angio & coronary intervention (PCI), with and without introducer sheaths

rule-out MIs, especially with unstable rhythms and/or wacky labs

arrhythmias requiring antiarrhythmic drips (amiodarone, diltiazem

EPS and ablations, like #2, some with sheaths still in place

CHFers needing drips (milrinone, dopamine/dobutamine, nesiritide)

acute CVAs, especially those with rhythm disturbances and unstable hemodynamics

plus we do get med-surg patients with really high acuity, but that no longer need the ICU.

Your prior med-surg experience is the basic building block to build on. It's not that much different, except the patients are wearing telemetry. Yes, it can see overwhelming when you start thinking about cardiac stuff, and I've had numerous float nurses freak out saying, "I don't know what to do, I'm not a cardiac nurse!" but the reality is that it's still about the ABCs. If the patient does something funky on the monitor, you go check on them, and go from there. On a step-down unit the folks can range from pretty sick (rough open heart cases with multiple comorbidities) to fairly benign (post-angio) but all need increased level of care/monitoring. It's a challenge, intellectually and otherwise, but it's a good challenge. My advice is this: ask questions, lots of them. Let it be known that you're on the unit and would love the opportunity to observe/help with anything. If you're lucky, you can see some cool stuff.

Sites for info:

https://allnurses.com/forums/f9/excellent-resources-cardiac-nursing-172090.html

https://allnurses.com/forums/f15/helpful-information-ccu-other-critical-care-units-140706.html

www.icufaqs.org

Good luck, learn lots and have fun.

Tom

sher1206 · Sep 1, 2008

Thanks Spatialized. That was most helpful. Now I can start investigating what some of those terms mean, since a lot of this if Greek to me. It will be nice to walk on the floor with atleast a precursory understanding of what is going on instead of feeling like a complete fish out of water!

Thanks again.