What to Expect?

[AKAnurse4]

What can you expect as a New Grad on an Progressive Care Unit/Step Down Unit? Any experiences you would like to share would be appreciated!

[ObtundedRN, BSN, RN]

Lots of learning. But part of that will be determined by the acuity of your unit. Not all progressive units are the same. The Prog unit at my hospital is about equal to the ICU of many other hospitals. So its acually called progressive critical care, and then we also have other true step down units.

You will probably see many trach'ed patients, some on vents and some on trach collars. Also may see many chest tubes, tetra/para-plegics, and people coming from any of your ICUs that are still critical and can't be sent to the floor, but stable enough that they don't need titrated vasoactive or sedation drips. And remember, just because they aren't in the ICU, doesnt' mean they won't go bad on you very quickly.

Does your hospital use AACN's "ECCO" program? It's the "Essentials of Critical Care Orientation." Lots of great information in that program. My advice is that you get some books on critical care nursing and learn as much of that more advanced nursing info. And you'll definitely need to know EKG interpretation.

IMO, the best book for EKG interpretation is "Rapid Interpretation of EKG's" by Dr. Dale Dubin (even if he did serve 3.5 yrs in prision for child Mediaography...) Here is a link on Amazon.

http://www.amazon.com/Rapid-Interpretation-EKGs-Sixth-Dubin/dp/0912912065#_

[AKAnurse4]

Wheeeewwww thx so much!!! That just gave me an headache

[ObtundedRN, BSN, RN]

Lol, don't worry about it. It is a great place, especially as a new grad. Lots of stuff to learn, and usually prepares nurses to transfer into being a great ICU nurse. Consider joining AACN. They provide free CEU's through journal articles and monthly local chapter meetings. And check to see if you're hospital offers that ECCO program. It can be a royal pain because it is 70 hours of CEU's, but like I said, it has tons of great information!

[AKAnurse4]

Lol thank you im very excited! But the he hospital already has a ICU And a CCU will i still see those patients? Do you know any good critical care books I can purchase? Like fast facts?

[ObtundedRN, BSN, RN]

Fast Facts for Critical Care by Kathy White is good. http://www.fastfactsforcriticalcare.com/

[ObtundedRN, BSN, RN]

I also have Quick Reference for Critical Care http://www.amazon.com/Quick-Reference-Critical-Nancy-Diepenbrock/dp/0781747171

And I'm not sure exactly why type of patients you may see in your unit. Like I said, the progressive unit in my hospital is a higher acuity then most hospitals. Smaller hospital's progressive unit will still see plenty of chest tubes, and I'm sure still see plenty of patients with a trach. Although I'm not sure if they will have trached patients on vents. You probably won't see any new quad/para-plegics since they would've been tranferred to a level 1 truama hospital. But that doesn't mean you won't see any that are there for something else. I'm sure you'll see some patients that are recovering from sepsis, pnuemonia that required a stay in the ICU, strokes, MIs, Dialysis patients, etc.

[AKAnurse4]

Ok thanx so much for your help!