What are the pros and cons of working in CCU?

elemschoolnurse · Jan 19, 2007

I have no answeres, but I am a new grad also, to be exact I found out I passed state boards yesterday. I was an LPN for 11 yrs and did the whole Med/Surg thing already. I have always wanted critical care, but no one is willing to train anyone in those areas anymore, they strictly want experience. At least in my neck of the woods that is what I have run into. I interviewed yesterday for an ICU position and at first had good feelings about it, but when another area of the hospital called me today that made me feel like my chances are probably not good for the ICU position. I feel frustrated! I don't want to give up my present job as a school nurse for a dept. I know I won't be happy in.

AfloydRN, BSN, RN · Jan 20, 2007

CCU can be a very intense, stressful environment. You will need to be a quick thinker, fast learner. You will have to make good decisions w/ out someone else telling you what to do. We have alot of autonomy in our CCU and the doc's expect us to think- not call them all the time. You have to be able to juggle several critical patients and be able to prioritize their care. It's tough, but very rewarding. You will learn alot. You will have great days and you will cry alot.

Katydidit34 · Jan 22, 2007

CCU can be a very intense, stressful environment. You will need to be a quick thinker, fast learner. You will have to make good decisions w/ out someone else telling you what to do. We have alot of autonomy in our CCU and the doc's expect us to think- not call them all the time. You have to be able to juggle several critical patients and be able to prioritize their care. It's tough, but very rewarding. You will learn alot. You will have great days and you will cry alot.

Thank you so much for your reply. As a student I think you have a fantasy of what it is like to work in variou areas but the reality is something much, much different. I want a good assessment from those in this area to help me understand wheather or not this would be a good fit for me. I so appreciate your reply!!

DoniaRN · Jan 29, 2007

i just accepted a peds, tcu ,icu position and they are training me for it. i have one year of medsurg, and orientatin to L&D. i may have chosen L&D but no positions ever came available. i just was pulled there everyonce in while and the less i went, the less comfortable i felt about working there. i guess it just depends on were you work and the opportunities that arise.

QuestForWa · Jan 29, 2007

Katy,

I just graduated in May 2006 and started in CVICU at a large hospital w/ open hearts, thoracotomys, AAA's, etc... I had a 6 month orientation from June till the start of January which I felt I learned A LOT from. However, I never tech'ed or held any other RN position, so I was at a disadvantage compared to those who already knew the way around and within the system. It ultimately led to me not being able to continue in CVICU for the time being. I can't yet say exactly what it was that prevented me from pulling it all together on the consistent basis that they needed to see from me. A combination of feeling overwhelmed(daily), "I can't possibly get all this done/ transfer them that soon", and clouded judgement/crit. thinking when it hit the fan i guess. I tried with all of my power to reel it in and prove it to them for the last month that I could do it, but in the end they just weren't satisfied with my progress. So now, regretfully, i'm on my way to some other unit to regroup and address my deficiences.

The point is that although my brains and heart were never in question, I just couldn't get with the flow of the unit. It was extremely busy, with multiple different Docs/services involved, QUICK pt. transfer expectations, little HCT help (simply by numbers, not quality), Family issues, etc. On top of that stuff you HAVE TO stay mindful of all the ICU stuff that you learn and be able to apply/recall it while under pressure. Take heed what the others have said above as the "ICU stuff" is enough to make your head spin on a good day. Some preceptors are better than others; I had 2 great ones and 7 in total (when interviewing i was told there'd be 2, MAYBE 3). And yes, as a student you have an idea, not fantasy, of what your job will entail. And for the most part you'll be drastically off from the reality of it, so you'll need to adapt quick. You need to be strong/confident, but also shed any cockiness/closemindedness you may have. And btw, this came to me as a big blow since I've never had something I couldn't conquer/handle. So just be ready for the fact that you might find yourself in my position should you not be ready for this type of position. On the other hand, you may take off and fly without any problem.

I don't regret taking this position because I now have to leave it. Great experience. So even if you take the ICU position and decide to/have to leave, you will still learn a lot that will help you as an RN.

Sorry, hope I didn't soapbox too much...PM me with any other questions.

jennt9 · Feb 2, 2007

Well i think it's great that you're considered cardiology as a possible area to specialize in:) I graduated May 2005 and started working on a cardiology floor. I spent 10 months there and learned a lot. Many of the nurses had worked in critical care and other areas so i found them to be a great resource. I accepted a full time position in the CCU of a larger hospital in a different city. I feel that working on the ward or "floor" gives nurses an understanding of how chaotic it can be there. Often you are in charge of six or seven patients so this gives you the opportunity to develop your time management skills which are key in CCU.

Our CCU is very exciting and fast paced at times. But with this also comes responsibility. I wasn't at the top of my graduating class and I wasn't the top student in my clinical groups in school. I worked really hard- perhaps the hardest I had ever worked in my life during my last 9 months in the CCU. I had to prove to these nurses- some who had worked many years in this unit that I was as compentent as them in providing care. I remember one of the first days off my oreintation i received a patient from a neighboring community hospital in complete heart block and was symptomatic. The charge nurse that day (all the nurses take turns) had been a nurse on the unit for over 25 years and has a true balance between medicine and caring. Well, what she said to me that day I will never forget "You will see one, you will do one (assist) and teach one".

So picture me, fresh out of orientation, going down the hall to get the line cart praying that i give the doc the right cordis, the right sized pacer wire, etc.....The insertion went well, placement verified by CXR and in no time my guy was eating a tuna sandwich sitting up in bed.

The nurse in charge that day had the "see one, do one, teach one" expectation of me and it scared the beans out of me. Later on that afternoon she let me know that I had done a fine job. That day I finally understood all that was expected of me from my collegues, my manager and most importantly my patients. In an area such as CCU there are so many things to learn and skills to develop.

If there is one piece of advice I can offer you it is ASK QUESTIONS! do not ever feel like you cannot ask questions. Now mind you some are better than others at answering them and then there are the nurses that seem to get annoyed but your "newbie" years are the years to ask questions. I look at it this way- the more you ask the more you learn. Well, I feel as though I have rambled on way too long but if you have any questions, feel free to post more- perhaps specific questions:)

cheers

Dinith88 · Feb 4, 2007

well...just shooting from the hip,

pros: you'll work with the most advanced technology/monitors/machines in healthcare (many only seen in ICU's), you'll be highly trained, you'll be more autonomous (as far as ordering x-rays,labs, etc) than most other nurses, you're EXPECTED to be relatively autonomous and proficient, you'll be challenged daily by caring for the sickest of the sick, you'll be (in the vast majority of places) expected to step in as 'code blue-captain'(or something to that effect) and/or 'rapid-response team captain'(or something to that effect)...the buck stops in ICU (meaning they either get better or die...which i suppose could be pro or con, depending on how you look at it)

cons: on a daily basis you're dealing with families in crisis (this is a HUGE part of icu that often gets over-looked), you'll be pulled in a gazillion directions at the same time (yes..this happens even though you'll have only 1-2 patients)...to stress this point, try and imagine taking care of a critically sick patient...with 5 doctors on the case...each one comes to you at different times and needs your attention...ancillary staff (lab, respiratory, etc.) comes to you and needs attention...freaked-out(sad/scared/angry) families come to you and needs attention (and of course the patient deserves a little attention as well)...

AND you have a second patient with all of this... day in...day out. you'll age at an accelerated rate...and be prone to ulcers and such.

BUT... some people love it and wouldn't do anything else... So if you like and/or thrive in this type of environment, you'll be fine.

Brad_RN_Student_PA · Feb 22, 2007

well...just shooting from the hip,
pros: you'll work with the most advanced technology/monitors/machines in healthcare (many only seen in ICU's), you'll be highly trained, you'll be more autonomous (as far as ordering x-rays,labs, etc) than most other nurses, you're EXPECTED to be relatively autonomous and proficient, you'll be challenged daily by caring for the sickest of the sick, you'll be (in the vast majority of places) expected to step in as 'code blue-captain'(or something to that effect) and/or 'rapid-response team captain'(or something to that effect)...the buck stops in ICU (meaning they either get better or die...which i suppose could be pro or con, depending on how you look at it)
cons: on a daily basis you're dealing with families in crisis (this is a HUGE part of icu that often gets over-looked), you'll be pulled in a gazillion directions at the same time (yes..this happens even though you'll have only 1-2 patients)...to stress this point, try and imagine taking care of a critically sick patient...with 5 doctors on the case...each one comes to you at different times and needs your attention...ancillary staff (lab, respiratory, etc.) comes to you and needs attention...freaked-out(sad/scared/angry) families come to you and needs attention (and of course the patient deserves a little attention as well)...
AND you have a second patient with all of this... day in...day out. you'll age at an accelerated rate...and be prone to ulcers and such.
BUT... some people love it and wouldn't do anything else... So if you like and/or thrive in this type of environment, you'll be fine.

WELL SAID!! (especially since you were only shooting from the hip!!!) Very good points, and very helpful!

LadyNASDAQ · Feb 22, 2007

I have been working critical care 25 out of 28 yrs. of Nursing. Trust me, the best road is the toughest.... first and second year Med-Surg, Tele and then ICU/CCU. Do it this way and no one could ever touch your knowledge base.

ZootRN · Feb 26, 2007

I have been working critical care 25 out of 28 yrs. of Nursing. Trust me, the best road is the toughest.... first and second year Med-Surg, Tele and then ICU/CCU. Do it this way and no one could ever touch your knowledge base.

By the time people are done with Med Surg and tele, they may want to move out of profession.

Summitk2 · Mar 5, 2007

By the time people are done with Med Surg and tele, they may want to move out of profession.

I totally agree. I'd say first and 2nd year ICU/CCU, third year grad school! :nuke: