What do you like about CVICU/CCU?

jspacegirl · May 2, 2008

So, no one here likes their job, eh?

Just kidding :-) Seriously, any awesome stories, or something along the lines of "I wouldn't want to work any other place than the CVICU/CCU because.....," would be very much appreciated and inspiring.

I'm getting more and more excited about this job as each day goes by, and I am happy that I got chosen for the position. Now that I've had time to really let it sink in and contemplate everything, I think that it will be a much better fit for me than the MSICU would ever be. But I still want to know why you all like it so much!

Thanks in advance! :redbeathe

allnurses Guide · May 3, 2008

Hi there, I haven't worked CVICU for many years but I did find it an excellent expereince for learning, my love was always a general or neuro ICU and when I first started in critical care we rotated around all of the units.

I think the bit I liked the most about CVICU was the fact the care was fairly predictable (obviously not always) but the patients came back post op, you knew when to start weaning, what to do with the chest tubes and it was good to see these patients recovering well.

Those that didn't kept you on your toes as when they deteriorate it requred chest opening on the unit (this was many years ago so not sure if this still happens)

allnurses Guide · May 4, 2008

I love the challenge that cardiac ICU involves - there are so many moving parts that you have to coordinate. Once you get good at it, being able to look at the hemodynamics and know immediately what you need to increase/decrease/start/stop etc is fun. It's fast-paced. You generally don't have people hanging around for weeks like you can get in general/neuro/medical ICUs. Sometimes, but not often. You're mostly "fixing" people, which I find more fun than looking after say, trauma patients, who are broken and damaged.

diosadelsol, ADN, BSN, MSN, RN, APRN, CRNA · May 4, 2008

I really enjoy the CCU. I also find it a very good environment for learning and while you do a lot of the same things for many patients, they are each unpredictable. I like having to be on my toes at all times. The sick-sick ones may keep you busy, but like Ghillbert said, once you learn what you're doing and what needs to be done its is an exciting field. I think the heart is fascinating. I'm an adrenaline junky as well, so the codes were a plus for me in the CCU.

RNforLongTime · May 12, 2008

I love the challenge that cardiac ICU involves - there are so many moving parts that you have to coordinate. Once you get good at it, being able to look at the hemodynamics and know immediately what you need to increase/decrease/start/stop etc is fun. It's fast-paced. You generally don't have people hanging around for weeks like you can get in general/neuro/medical ICUs. Sometimes, but not often. You're mostly "fixing" people, which I find more fun than looking after say, trauma patients, who are broken and damaged.

Ditto! I worked in a combined CVICU/CCU/SICU/Trauma-Neuro ICU for over three years......I miss my trauma patients for sure but I am really starting to excel with the cardiac stuff.....

SkateBetty · May 15, 2008

Autonomy - you have to think on your feet, move quickly, and make important decisions on the fly, and you better know your stuff because it's no game. Fixing a patient on the fly with medicines is challenging and fun, and you have the power to take action, which every nurse craves. Some days/nights are like a marathon, and you better have your track shoes on, because your actions will be keeping a patients alive, no joke.

Average length of stay - They move to step-down as soon as they are extubated and stable (usually a couple days). I did trauma step-down before, as well as burn, and those patients stick around for weeks to months. Call-lights are a drag. So are food trays, active bellies, feet going over the side-rails, road-trips, and the "wuh-wuh, wuh-wuh" you hear from the moving mouths of awake patients that are taking more control of their care. I have never worked in MICU, but since they are medical and not surgical I'd think they stick around longer? Not sure.

Those are the big ones for me.

Summitk2 · May 15, 2008

In addition to what other people said about the pros/cons, I think this decision may also come down to anatomy & physiology.

Most cardiac nurses I've met LOVE the heart (as do I). I imagine neuro nurses LOVE the brain (I have a hard time understanding the brain). If the MSICU you're talking about is in the same hospital as the CVICU, you probably won't see many cardiac problems. Maybe you enjoy endocrine/metabolism, renal/GU, GI? MSICU is just for you. There's some incredibly complex A&P, patho, and pharm going on. It's no less of a challenge than CV--any ICU is a challenge. Do Kupfer cells or pancreatic enzymes float your boat? For me, I could talk for hours about different cardiomyopathies or swan catheters. When you say heart-lung transplant, I say "gimme."

Maybe you're too young in your career to know? Try one out--the one you have a better feeling about. You'll know with a little time. I found my fascination of the heart during my senior clinical in a CTSICU, but it may take some trial and error to find your fit. Best of luck.

cyndiinphilly · Nov 17, 2008

I started in our cardiac unit right out of nursing school as well. I must say the heart was my least favorite subject in school and I was not the best at it. I was chosen for this unit because I am a "mature" new grad and my ND felt with my experience in other fields and life in general I could bring that to the table. Although I was totally overwhelmed and humbled by my lack of knowledge in the beginning, I am lucky in that I had the very best preceptor on earth and I work with a great supportive TEAM or nurses and yes, docs. I ask questions constantly, eavesdrop on everyone's patient care conversations and I learn incredible amounts every day. Now, only 7 months in, I'm amazed at how much I've learned and how much I can anticipate. Good luck on your unit and congrats on finishing nursing school. Now,the real learning begins!

joeyzstj, LPN · Nov 18, 2008

J.....I have worked in ICU, CCU and CVICU where I currently work. CVICU, as someone else mentioned is an area where I believe you have to most autonomy due to the patient population. Most CVICUs I have been to allow you a lot more freedom to do whatever you need to do for a patient, wheather its starting drips/pressors, giving blood, making changes based on swan readings and equipment, ect. There are many times in which you will just have to understand a multitude of drugs and hemodynamics that go along with them based on your swan readins and BP and adjust them accordingly. I work in a CVICU that does not do transplants, so for you its going to be even more exciting. Pretty much every day that I work I see something differnt or take care of a different patient. We run VADS, IABP's, CRRT, Vents, ect, ect.........basically all the normal stuff, but aside from that we also take traumas and every other type of ICU patient you can think of with the exception of bolts. We do everything that they do, however they dont take VADs and IABP's and most of their patients rarely have Swans. In my opinion, it is a lot easier to learn a bolt then it is to learn 15 drips and their hemodynamic effects, VADS, IABP's (and their proper timing, waveforms,ect) and the extreme fluctuation in Post-op Valve patients. You will learn to manage severe bleeding and a multitude of other problems. You will soon find that CT surgeons are going to expect AND demand that you funtion at a higher level than most of the other units, and youre going to have to if you want to excel at what you do. I truly believe that once you are proficient in CV or have worked there, that you can work anywhere. Good luck.

jbp0529 · Nov 20, 2008

J.....I have worked in ICU, CCU and CVICU where I currently work. CVICU, as someone else mentioned is an area where I believe you have to most autonomy due to the patient population. Most CVICUs I have been to allow you a lot more freedom to do whatever you need to do for a patient, wheather its starting drips/pressors, giving blood, making changes based on swan readings and equipment, ect. There are many times in which you will just have to understand a multitude of drugs and hemodynamics that go along with them based on your swan readins and BP and adjust them accordingly. I work in a CVICU that does not do transplants, so for you its going to be even more exciting. Pretty much every day that I work I see something differnt or take care of a different patient. We run VADS, IABP's, CRRT, Vents, ect, ect.........basically all the normal stuff, but aside from that we also take traumas and every other type of ICU patient you can think of with the exception of bolts. We do everything that they do, however they dont take VADs and IABP's and most of their patients rarely have Swans. In my opinion, it is a lot easier to learn a bolt then it is to learn 15 drips and their hemodynamic effects, VADS, IABP's (and their proper timing, waveforms,ect) and the extreme fluctuation in Post-op Valve patients. You will learn to manage severe bleeding and a multitude of other problems. You will soon find that CT surgeons are going to expect AND demand that you funtion at a higher level than most of the other units, and youre going to have to if you want to excel at what you do. I truly believe that once you are proficient in CV or have worked there, that you can work anywhere. Good luck.

Very true, and well-said. Autonomy is HUGE. I also work CVICU. Our surgeons (for the most part) want you to act first, then call them. Otherwise, you could be on the phone, or waiting for a call-back...all the while your patient is crashing harder and harder. Understanding and being comfortable with hemodynamic and vasoactive gtts is essential. You have to be able to walk into that unstable pt's room, with the IABP, Swan, vent, 4 chest tubes, 6 different drips and be able to quickly and accurately assess the situation and take action. There's very little room for error, usually. It sounds scary, and it is. Fortunately, however, not every cardiac surgery pt is like this. Most do fairly well and have predictable plans of care. But, like everything else in life I suppose, things can change in an instant.

On a less dramatic/scary note,...once you get comfortable with the stress and energy level, and start to know your stuff...your surgeons become more and more comfortable with you, usually let you do more stuff and cut a few apron strings, and you experience an ICU nursing tempo that is like no other (IMHO). One of the best feelings for me is having that really unstable pt get better bc of my actions; makes me feel like I made a difference. And also...having that no-nonsense, no-room-for-errors surgeon tell you that you did a good job.

Tessaprn · Dec 13, 2008

I do work in the area. I like my job. When I first started in this area I suffered much anxiety, intimidation, and embarrassment for my lack of knowledge. In CVICU it came from a few doctors and a cowoker or 2. Strong personilites are the norm in the area. With CCU I had great coworkers who helped me learn and enjoy the work. Now I am only pulled to CVICU when needed and I always request the chronic side, no fresh hearts for me. I also have discovered that to survive in OR or ER the nurse not be easily intimidated. You have to be able to take some crap from coworkers and give better than received.