Is Working in a CVICU for You?
Are you intensely organized and adept at managing several high-pressure tasks at once? CVICU nursing might be the specialty for you. CVICU stands for the cardiovascular intensive care unit of a hospital, and it’s where some of the sickest patients are treated for cardiac, vascular, thoracic, and surgical problems. A CVICU nurse helps care for these patients by managing invasive lines, monitoring advanced vital signs, titrating medications, and so much more.
The work environment for these types of cardiac nurses can be intense because patients can quickly go “down the tube” in the CVICU (meaning, they can become very unstable). These nurses are known for their attention to detail, organization skills, critical thinking, and depth of knowledge. And when things go wrong, they have to keep their cool while making split-second decisions that can be the difference between life and death for their patients.
Could you be a CVICU nurse? Let’s dig into what a CVICU is, and what it’s like to be a nurse there.
What Is a CVICU?
A CVICU — also sometimes called a CTICU (cardiothoracic ICU) — is where highly skilled healthcare professionals work to stabilize, monitor, and provide life-saving interventions to critically ill patients with cardiovascular disease, a leading cause of death in the United States. These patients might be recovering from cardiac and vascular surgeries, heart attacks, and infections. They might also have chronic illnesses such as heart failure, valve disease, and other heart conditions.
CVICUs have specialized equipment, and staff have expertise in using advanced technology to monitor patients. Arterial lines, ventilators, extracorporeal membrane oxygenation (ECMO), and intra-aortic balloon pumps (IABP) are all common equipment. These machines help staff monitor patients and keep them alive.
Many patients need surgical interventions, like coronary artery bypass grafts (CABGs). They might go to the cath lab for diagnostic procedures, or to get ablations, angiograms, or stenting done. CVICU nurses play a pivotal role in administering medications, managing post-operative pain, monitoring vital signs, and responding promptly to any complications.
Cardiovascular ICUs require specialized staff and equipment, and not every hospital has one. Smaller rural hospitals generally do not have one, so patients might be transported to a larger facility if they need more specialized cardiovascular care. Sometimes other ICUs fill up, and the CVICU will take patients from other units, like the surgical-trauma ICU (STICU), neuro ICU (NICU), or medical ICU (MICU).
CVICUs are staffed with intensivists, cardiologists, cardiovascular surgeons, respiratory therapists, CNAs, and nurses. Let’s get more clear on what it’s like to be a CVICU nurse, the daily workflows, the skills required, and the challenges and rewards of this intense specialty.
The Life of a CVICU Nurse
Every day is different as a CVICU RN. You might be caring for a patient on ECMO who is pharmacologically paralyzed, while transferring another patient after CABG surgery. After that, you might get a code-blue transfer from another unit. Patient statuses often change throughout your shift — you can start the day with a relatively stable patient and be administering CPR by lunchtime.
There’s an emotional component to taking care of patients in some of the most frightening moments of their lives. Some heart failure patients might need to be admitted every few months, and you have an opportunity to build long-term relationships with them. On the other hand, there are days when you’ll only know a patient for a few hours before their death. Nursing can be an emotional rollercoaster; breathtaking in its tragedies and uplifting in its triumphs.
Example of a Day Shift in the CVICU:
Start of shift: You arrive, see the assignment board, and take report from the offgoing nurse. You review your patient charts, gather your essential supplies, and write down the key tasks you need to remember. Many CVICUs require bedside report, so you might do your first shift assessment with the offgoing RN.
Mid-morning: You chart your first assessments and gather any morning medications your patients need. You might need to chart assessments every hour, every other hour, or even every 15 minutes. Physicians and advanced practice providers come by for morning rounds, and you listen in and give feedback on the care plan.
You’ll give morning medications, draw labs, and assess and document any lines or devices your patient has. Many patients will get their medications and food through feeding tubes, like nasogastric (NG) or percutaneous endoscopic gastrostomy (PEG) tubes. You’ll also likely give medications through IVs and central lines. Vitals are often monitored continuously through arterial lines, pulmonary artery catheters, pulse oximetry devices, and rectal temperature monitors.
Mid-day: You have another nurse monitor your patients while you take a lunch break. Sometimes shifts feel too busy to take a break, but many states require one every few hours.
Afternoon: You continue with patient assessment and collaborating with the care team. If a patient’s ventilator is alarming, you might call the respiratory therapist into the room to change the settings or assess the seal. Many critical care patients need catheters to collect their urine, and you’ll monitor their output throughout the day.
Pain management is a key component of care, as many patients are recovering from surgery or cardiovascular events like heart attacks. You’ll likely do continuous pain assessments throughout your shifts, and some patients can tell you their pain level while others can’t. If family is visiting, you might need to answer their questions and explain certain assessments and devices.
Late afternoon: You catch up on charting and gather supplies for the next shift. Teamwork is a big part of nursing, so you might help your peer with an admission or gather labs on a patient. You might orient a new nurse on how to read an external pacemaker, or how to set up and use a train-of-four monitor.
End of shift: You finish off your shift by giving a detailed report to the incoming RN. Using bedside report, you go through all the medications they’re on, any lines and tubes they have, and their most recent lab results. You’ll share any concerning events that happened during your shift, such as a drop in blood pressure or oxygen saturation. If your patient has any surgical wounds, you might assess and re-dress those together.
Every shift is different, and many are more eventful than this one, but this outline gives you a general idea of the workflows of a CVICU RN.
CVICU Nurse Salary
The average CVICU/CTICU nurse salary is on par with the average ICU nurse salary of $84,700 per year. Your CTICU nurse salary would depend on your location, your experience, and any extra certifications you have.
The Top Skills of a CVICU Nurse
Every nursing role requires critical thinking, compassion, and a deep knowledge of human physiology. But there are certain traits that might make you particularly well-suited to be a cardiovascular ICU RN.
Here are some of the specific skills that CVICU nurses use daily:
- Attention to detail: nurses meticulously track vital signs, equipment, and patient status to detect complications as early as possible. They’re known to be highly organized and precise.
- In-depth documentation: Many patients require documentation every 15 minutes. It’s up to you to be sure your charting is up to date and follows your facility protocols.
- Stamina and resilience: The unit environment can be intense and physically demanding. Nurses need physical stamina and emotional resilience to handle long shifts and challenging cases.
- Thinking on your feet: What’s your plan if a patient’s chest tube falls out? Or if their telemetry monitor flatlines? Nurses must assess complex patient situations, analyze data, and make timely decisions that impact patient outcomes.
- Communication skills: Effective communication with patients, families, and the healthcare team is essential. Patient statuses can change in an instant, and nurses must keep the team and family updated. Assertive communication helps keep patients safe.
What Does It Take to Be a CVICU Nurse?
Here are the educational and certification requirements for this career:
- Nursing Education: You’ll need an Associates or Bachelors in Nursing degree. A BSN is increasingly preferred for this specialty.
- Licensure: After completing nursing school, you’ll need to pass the NCLEX to get your RN license.
- Experience: Cardiovascular ICU nursing typically requires prior experience in a general intensive care unit (ICU) or cardiac care unit (CCU). You might start out as a new grad on a telemetry or progressive care unit before moving to critical care.
- Certifications: Basic Life Support and Advanced Cardiac Life Support are both required in critical care. Many nurses pursue additional certifications. The Critical Care Registered Nurse (CCRN) and the Cardiac Medicine Certification (CMC) are relevant certifications.
- Advanced Education: Some nurses pursue advanced degrees, such as a Master of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP), to expand their career opportunities or move into leadership roles.
Cardiothoracic ICU nursing is a specialized and demanding field that requires a unique blend of qualities, educational preparation, and certification. If you’re passionate about cardiac care, possess the necessary attributes, and are committed to continuous learning, a career in cardiothoracic critical care nursing could be a fulfilling and impactful choice.
FAQs About CVICU Nursing
Is CVICU considered critical care?
Yes, it stands for cardiovascular critical care unit. Critical care and intensive care are interchangeable terms.
Is CVICU the hardest ICU?
Every nursing specialty is challenging in its own way. CVICU nursing might be described as hard because it requires a very specialized knowledge set and demands a high level of critical thinking. Other critical care units also require these skills, but there is a stereotype that cardiothoracic critical care nurses are especially intense and passionate about their work.
Ultimately, whether cardiothoracic is the most difficult of all ICU jobs is a matter of personal perspective, and what matters most is finding a nursing specialty that aligns with your skillset.
What’s the difference between CVICU and neuro ICU?
CVICU and neuro ICU are both critical care units, but they care for different patient populations. In the cardiovascular ICU, patients have critical heart and vascular conditions and need specialized cardiac monitoring devices. In the NICU, patients have critical neurological conditions that require brain monitoring tools.
Of course, many patients are complex and may have both neuro and cardiac problems. Keep in mind that there’s often overflow between the two, so you could see a neuro patient in the cardiac ICU and vice-versa.
What’s the difference between CTICU and CVICU?
Confusingly, these terms are interchangeable. CTICU stands for cardiothoracic intensive care unit, but it’s less commonly used.
Is ICU nursing harder than ER nursing?
ICU and ER nursing are known for their distinct skill sets, and neither is necessarily “harder” than the other. ICU nurses are known for being highly organized, and they generally maintain a certain workflow most shifts. On the other hand, ER nurses are known for their flexibility and on-the-fly assessment skills, and there’s less natural rhythm to an ER shift.
Find Intensive Care Roles With IntelyCare
Cardiovascular ICU nurses are at the forefront of cardiac care. They tend to patients recovering from complex heart surgeries, manage acute cardiac crises, and guide patients toward the path of recovery. This specialty isn’t for the faint of heart.
If you’re looking for your next nursing role, IntelyCare can match you with great jobs in the CVICU, MICU, STICU, neuro ICU, and more. Learn how we can help you in your nursing career across many specialties.