Cardiac Nursing For Beginners

This is everything you need to know when you are a new cardiac nurse. This cardiac nursing for beginners will answer all your questions.

When I say I have experience in cardiac, I’m not exaggerating. I’ve spent years at the bedside in acute-care cardiac. I’ve also taken care of cardiac ICU and cardiac step-down patients (and lots more). I want you to learn from some of my mistakes and share the most important things you need to know as a new nurse.

There is a lot that you need to know when you are a cardiac nurse. It can feel overwhelming at first but don’t worry. You’ll get it. The more you work on the floor and study at home, the easier this will all be for you. Here are some of my most valuable tips for new cardiac nurses.

Understand Where The Heart Issues Are Originating

If you can separate in your mind the difference between electrical issues and structural issues with the heart, you’ll be able to provide better care to the patient.

This is important because the patient could have an issue with one or both of those things.

Electrical Issues In The Heart

The first kind of issue they might have is an electrical one. This includes EKG tracing. There are electrical impulses that go throughout the heart to make it contract. It starts up in the SA node and goes all the way through to the Purkinje fibers which cause the ventricles to contract.

Structural Heart Issues

Your patient could also have an issue with the heart valves and heart muscles or the coronary arteries. You need to be able to separate all of this out in your mind.

They could also have an issue with blood going into the heart through either the superior or inferior vena cava.

You need to differentiate where the problem is originating so you can respond appropriately.

Examples of Both Issues Happening At Once

Maybe the patient had a mild cardiac event where they had a myocardial infarction (MI) and then that caused electrical issues as well.

Or you may find patients who have valve issues that irritate the muscles so much we get some electrical issues as well.

Respect How Much Power You Have As A Bedside Cardiac Nurse

When you are taking care of that cardiac patient, the physician will say, “these are the blood pressure and heart-rate parameters,” which means “I need the blood pressure to be between this number and this number.”

You as the nurse, who is at the patient’s bedside all day, must monitor and be responsible for them. Ask yourself the following questions:

Is this medication appropriate?
Do I need to call and ask if the medication is ok?

You are making decisions based on the assessment of their vital signs. You are constantly reevaluating whether your interventions are appropriate. Just because they are ordered doesn’t mean you have to do them.

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Learn Your Basics First

Cardiac is very complex. When you start getting into 12-lead EKGs and different kinds of murmurs, it gets really confusing. If you are a brand new nurse, don’t get tripped up in those complex details.

Learn your foundational baseline information first.

Before you learn different kinds of blocks, you need to know this basic knowledge first:

Normal sinus rhythm
Sinus tachycardia
Sinus bradycardia
Atrial fibrillation

You should also be familiar with the different heart sounds too. First note the difference between normal and abnormal heart sounds. You don’t need to be able to know all the different murmurs at first, you just have to be able to identify if something is abnormal.

I want to reassure you. It is not our jobs to diagnose. It is our job as nurses to observe and assess and then communicate to the health care provider when something is abnormal and needs attention.

I become a nurse in 2010 and earned my critical care certification in 2015. I didn’t even learn about 12-lead EKGs and what they mean until 5 years into my career as a nurse. I had 2 years of cardiac step-down and 3 years of neuro ICU before I became accustomed to the really complex world of the heart.

Thinking a new nurse will master all of this right away is not an appropriate learning curve. We need to understand the foundations first.

Most Important Things To Pay Attention To

As a cardiac nurse, it is our job to assess and communicate changes to the physician. To do this, you need to closely monitor these things on your patient:

Labs
Vitals
Understanding electrical and structural heart issues
Heart sounds