Friday, April 23, 2010

Open Heart Orientation

One of the things I love about the unit I work on is that it is sort of a “catch all” ICU. We have everything from medical patients to surgical, neurology to cardiac. Anything that comes through the O.R. or E.D. and is in critical condition is ours. Granted we are not a trauma hospital so we don’t see too much of that, but considering our patient population (I work at a veteran’s hospital) we see some pretty rugged and sick patients. Many who suffer from multi-organ dysfunction related to alcohol and drug abuse.
We are a teaching hospital, which is great because it is a place that is very conducive to learning. It can also be a challenge because you are dealing with people who are doing just that….learning.

Where I work we have on average 2-6 (I think) open-heart surgery patients a week. We have a phenomenal set of cardiothoracic surgeons that I feel incredibly honored to work with. In order for us as nurses to take care of these patients we have to go through a process. Gain at least (usually) one year of experience, take a class on open-heart surgery, pass a written test and then precept with another nurse for a total of three post-op. open-heart patients. Translation: It’s a big deal.

Luckily I squeezed my way into the class that was running last year. I wasn’t even done orienting to the ICU but I knew that our nurse educator comes around only once a year, so I slyly asked my manager to put me in it with the argument that I had already seen an IABP (intra-aortic balloon pump) inserted at the bedside.

Long story short I was able to go to the class and amazingly I was asked last week to come in for my first open-heart orientation! I’ve only been working on my own for about six months and there were definitely people on the list above me who had priority to orient first. Still, where there is a will there is a way and I can officially take care of a patient from the O.R., directly after open-heart surgery!

The first day I was called in to take my first ‘heart’ patient the surgery went so well, they finished about an hour sooner than they expected. I was so proud of myself because despite being a night shift person, I crawled myself out of bed early enough to grab some coffee, navigate the crazy dayshift parking and still have ten minutes left before my shift was supposed to start. As I’m strolling down the hall, excitedly telling everyone I was now orienting to hearts (as we call them), my charge nurse comes around the corner…

“Andi, the heart is already here, honey! I left you a message!” (She’s so cute, she always calls everyone ‘babycakes’ and ‘honey’)

“Shoot!” I thought as I threw my lunch box behind the nurse’s station and ran towards the room. I had missed the most important part! When these patients come out of the OR it is truly a mess of lines and frantic people trying to get this patient stabilized after the trauma of surgery. I affectionately call it the spaghetti factory because usually there is a minimum of six IV lines and a plethora of monitoring cables that even the most type A, organization freak will have a hard time sorting through. (hint: I am definitely one of those type A nurses, it’s a common trait amongst us ICU people)

Luckily my old preceptor gave me a good tip for the next two days.
“When they tell you to come at 11:30 for the heart. Come at 11:00.”
Haha,thanks Julie!
I came at 10:45 the next day and the patient didn't come out until 1pm, of course. I love cardiac patients and I can’t wait to take care of them more often now. I have a few more posts coming up about the other two patients I took care of. I definitely learned a lot and I have a few good stories to share too.
In other news, I’ve decided to start doing a recipe section on this blog. I love cooking and sharing recipes and for the most part I try to make healthy meals so I can take them to work. Next post: Pesto orzo with baby asparagus!

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