Are you thinking about a career in cardiovascular intensive care unit nursing? That’s excellent news since coronary heart disease is the most common kind of cardiovascular disease in adults, and around 695,000 people die from heart disease each year. By becoming a cardiovascular intensive care unit (CVICU) nurse, you can be confident that you will work for a good cause.
What is Cardiovascular Intensive Care Unit (CVICU) Meaning?
In medical terms, The acronym or medical abbreviation for the cardiovascular intensive care unit is CVICU. This unit may be used for post-operative care or to treat patients with severe heart or vascular disorders, and it specializes in treating patients with cardiothoracic conditions and related illnesses.
A CVICU nurse works in a fast-paced and demanding environment, providing specialized care to patients with heart conditions, those recovering from cardiovascular surgery, and trauma patients. A CVICU nurse can also help educate and encourage patients to live healthy lifestyles that support cardiovascular health.
Working as a CVICU nurse requires compassion, the ability to multi-task, and strong critical thinking skills. It’s an ideal career for registered nurses (RNs) looking for a challenging yet rewarding role in nursing. Keep reading to discover the benefits of becoming a CVICU nurse and what makes this profession unique.
Who Works in a CVICU?
Interdisciplinary teams of healthcare professionals collaborate to provide specialized and personalized care in cardiovascular intensive care units. These teams are led by intensivists, medical professionals specially trained in critical care. Intensivists work with physicians from many specialties, including anesthesiologists, cardiothoracic surgeons, cardiologists, and palliative medicine. Other professionals working in CVICUs include the following:
- Resident physicians
- Physician assistants
- Nurse practitioners (NPs)
- Respiratory therapists
- Dietitians
- Pharmacists
- Physical and occupational therapists
- Speech and language therapists
- Nurses
What Is a CVICU Nurse and What Do They Do?
Working as a CVICU nurse involves caring for cardiovascular intensive care unit patients. From monitoring and treating patients with complex cardiovascular conditions to administering medications and managing specialized medical equipment, the work of a CVICU nurse is invaluable to a patient’s treatment and recovery. CVICU nurses have responsibilities similar to those of any other registered nurse. These responsibilities may include assessing patients, administering medications, monitoring vital signs, and providing patient education and support. Furthermore, CVICU nurses often need to perform more specific skills, such as preparing surgical sites for vascular surgeries, providing post-operative care, and monitoring a patient’s cardiac status. Therefore, these nurses are well-equipped to handle patients with various cardiovascular diseases.
Nurses working in the cardiovascular intensive care unit commonly provide post-cardiac surgery care and treat the following conditions:
- Congestive Heart Failure (CHF)
- Cardiac Arrhythmias
- Valvular Heart Disease
- Cardiogenic Shock
The following is a more detailed description of the typical responsibilities of a CVICU nurse:
- Monitoring patients: A cardiovascular intensive care unit nurse carefully monitors each patient’s vital signs and heart rhythms. In addition, a CVICU nurse evaluates a patient’s health and reports changes in the patient’s condition.
- Administering medications: CVICU nurses are often responsible for administering medications. These medications can include intravenous medications to help manage pain, control blood pressure, and prevent infections.
- Assisting with procedures: A CVICU nurse may assist and support doctors and other medical professionals by helping to insert pulmonary artery catheters, arterial lines, and central lines. They may also assist in managing different kinds of cardiac monitoring equipment.
- Providing post-operative care: CVICU nurses may be responsible for caring for patients during and after specific cardiac surgery procedures, such as coronary artery bypass grafting or valve replacement. They may be in charge of closely monitoring the patient’s recovery, helping to manage a patient’s pain, and ensuring proper wound care.
- Educating patients and families: A CVICU nurse can help educate patients and their families about patients’ conditions. Upon discharge, a cardiovascular intensive care unit nurse also gives patients instructions for taking medications and suitable steps for at-home after-care.
- Collaborating with the healthcare team: CVICU nurses collaborate closely with doctors, surgeons, respiratory therapists, and other medical specialists to create and implement a thorough treatment plan for every patient admitted to the cardiovascular intensive care unit.
What Technical Skills Does a CVICU Nurse Need?
Cardiovascular intensive care unit nurses are technical wizards. That’s because the complex nature of CVICU machinery requires nurses to understand the machines’ functionality and operation on a deep level. Technical issues and emergencies are inevitable in CVICU nursing. Add that to constantly making critical decisions under pressure, and you can see why CVICU nurses need an impeccable ability to troubleshoot and respond to technical issues.
Common Therapies and Devices in the CVICU
The following are some standard therapies and devices that nurses in CVICUs must be familiar with:
- Temporary pacemakers: These devices increase heart rate and may be inserted for conduction disorders such as heart blocks, rate disorders including symptomatic bradycardia, or prophylaxis for postsurgical augmentation of cardiac output.
- Intra-aortic balloon pump (IABP): An IABP is a device inserted through a sheath in the femoral artery that augments cardiac output, decreases afterload, and improves myocardial oxygenation.
- Impella: An impella is a temporary mechanical support device inserted through a tear-away sheath in the femoral artery. The distal end of the device is located in the left ventricle, pulling blood from the left ventricle and ejecting it across the aortic valve into the systemic circulation.
- Centrimag: Centrimag is a short-term centrifugal support device for patients with acute heart failure. It decreases ventricular workload by bypassing the affected area of the heart, improving hemodynamic conditions to optimize myocardial recovery.
- Extra-Corporeal Membrane Oxygenation (ECMO): ECMO is a treatment platform for patients with severe heart and/or lung dysfunction. It is used to support patients whose organ systems should recover, such as those suffering from pneumonia, ARDS, Takotsubo cardiomyopathy, or acute rejection following a heart or lung transplant. It can also be used as a bridge therapy for those with end-stage heart or lung disease to either durable mechanical support or transplant. There are two types of ECMO support: Veno-Arterial (VA) ECMO supports a patient’s hemodynamics and oxygenation by bypassing both the cardiac and pulmonary circulation, whereas Veno-Venous (VV) ECMO only supports a patient’s oxygenation.
- Left ventricular assist devices (LVADs): LVADs provide durable mechanical support to the left ventricle. Unlike many other devices, LVADs allow patients to be discharged from the hospital.
- Total artificial heart: A total artificial heart is a durable mechanical support device approved as a bridge to transplant for patients with biventricular failure, left ventricular thrombus, or malignant arrhythmias that preclude LVAD implantation.
Overall, nurses must have expert clinical and technical skills to provide patients with adequate care in the cardiovascular intensive care unit. The following are some standard requirements to work in the CVICU:
- Proficiency in cardiac monitoring and interpretation of ECGs
- Ability to monitor oxygen saturation levels
- Accuracy when performing stress test assessments
- Management and troubleshooting skills to operate various types of medical equipment, such as ventilators and hemodynamic monitors
- Proficiency in IV insertion and IV management skills
- Knowledge and skills to perform chest tube insertions
- Experience and skills in wound care management, including appropriate dressing changes, infection prevention, etc.
Apart from requiring technical skills, or “hard skills” in nursing, a CVICU nurse will need a range of “soft” skills or personality characteristics to fulfill this role. Let’s move on to that next.
What Does It Take to be a CVICU Nurse?
Being a CVICU nurse requires running highly technical machinery, performing specialized medical tasks, and making informed decisions. To work in the CVICU, nurses should possess a range of personality traits such as a strong sense of empathy and compassion, resilience, and the ability to handle high-stress situations.
Working with critically ill patients and their families is another aspect of being a CVICU nurse. Therefore, maintaining composure under pressure is another prerequisite for working in this specialty. Thus, the commitment of a CVICU nurse extends beyond the specialized work done in a cardiovascular intensive care unit. Because CVICU nurses must support patients and family members while rushing around to help keep patients alive, nurses in this unit must strive to be both compassionate and meticulous in their line of work. These nurses must also be emotionally prepared to provide end-of-life care.
Although any RN can technically become a CVICU nurse, many nurses in this unit share the following characteristics and personality traits:
- Assertive and intelligent
- Meticulous and detail-oriented
- Analytical
- Calm under pressure
- Compassionate but thick-skinned
- Quick to respond in emergencies
- Resilient with a great sense of humor
What Is CVICU Nursing?
CVICU nursing is a specialty in which a registered nurse works in the cardiovascular intensive care unit. Nurses working in other hospital units may be eligible to transition to a cardiovascular intensive care unit when an opportunity arises.
So, what does a typical day shift in the CVICU look like? Depending on a hospital’s policies, patient acuity, and staffing levels, each day will look slightly different for a CVICU nurse. However, here is a general idea of what a day shift as a nurse in the cardiovascular intensive care unit might entail:
Start of Shift: Handover and Patient Assessments
A day shift in the CVICU may begin with a handover from the night shift nurses. A handover generally involves receiving a report on each patient’s condition and any changes or updates about a patient’s treatment plan. Typically, after the handover, a CVICU nurse will conduct a thorough assessment of each patient, which involves checking the patient’s level of consciousness, monitoring vital signs, evaluating the cardiovascular status, and ensuring all intravenous lines and devices function correctly.
Mid Shift: Medication Administration and Monitoring
A CVICU nurse will continue to closely monitor vital signs, cardiac rhythms, and oxygen saturation and keep an eye on CVICU machinery and equipment throughout the shift. Simultaneously, they will administer scheduled medications to patients according to specific prescription orders. Anticoagulants and painkillers are among the medications CVICU nurses may give their patients. A CVICU nurse may also administer medications via central lines or other access points to administer precise dosages.
Documentation and Collaboration with Healthcare Team Members
Accurate and timely charting and documentation is a critical aspect of a CVICU nurse’s job to ensure continuity of care. Throughout a nurse’s shift, thorough patient documentation may cover the medications given, emergency procedures or interventions, and a patient’s response to different treatments. Working cooperatively with other medical specialists in the cardiovascular intensive care unit, such as psychologists, respiratory therapists, and physical therapists, is also essential to a CVICU nurse’s job.
Multiple studies have shown that interprofessional healthcare collaboration is vital to providing safe and high-quality patient care in intensive care units like the CVICU. This collaboration involves discussing patient care plans, sharing updates on a patient’s condition, and using complementary therapies to improve patient outcomes.
Shift Handover and Clocking Out
Towards the end of the day shift, a CVICU nurse will give a comprehensive handover to the incoming night shift nurses. A complete shift handoff includes updates on each patient’s condition, critical events or issues, and any changes in a patient’s treatment plan. A CVICU nurse may also communicate any pending tasks or follow-up treatments required to the next nurse on shift.
Patient-to-Nurse Staffing Ratios in the CVICU
RN-to-patient staffing ratios vary by state. However, intensive care units have among the lowest patient-to-nurse ratios across the board. For example, Oregon and California have passed legislation requiring nurses in intensive care units to care for no more than two patients at a time. Additionally, in Massachusetts, nurses in intensive care units, including CVICUs, may only care for one or two patients at a time, depending on the patient’s stability. Although most states don’t stipulate mandatory staffing ratios, the acuity level of patients in CVICUs demands that patient-to-nurse ratios remain low.
What Is the Average CVICU Nurse Salary?
Nurses in the cardiovascular intensive care unit need to be adept at critical thinking, have lightning-fast reflexes (the capacity to act accurately under stress), and be able to explain complicated medical conditions and procedures to patients and their families. Because of their unique ability to operate in high-stress situations, CVICU nurses and other critical care nurses are in great demand nationwide.
Fortunately, cardiovascular intensive care unit nurses are well compensated for their efforts. Our research indicates that the average yearly salary for a nurse in this unit ranges from $97,500 to $118,000. Experienced CVICU nurses may even be able to earn up to $143,000 annually. Compared to the average registered nurse wage of $94,480, a CVICU nurse salary can provide a much more lucrative pay scale for nurses.
Furthermore, nurses can earn an even more competitive hourly rate while working per diem CVICU jobs. Nursa’s per diem healthcare staffing app connects hospitals and clinicians directly. Every day, facilities seek to fill shifts with reliable nurses and nursing assistants. After verifying your registered nurse license, you can look through the PRN shifts available in your area and apply for high-paying positions in your state or nationwide.
How Can I Become a CVICU Nurse?
Becoming a cardiovascular intensive care unit nurse isn’t too tricky, but it certainly requires time, specialized training, experience, and, yes, a good amount of studying. Becoming a registered nurse is the first step toward becoming a CVICU nurse, so if you already have that license, you can skip a few steps. The following is a basic breakdown of the steps involved in becoming a CVICU nurse:
1. Earn Your Degree from an Accredited Nursing Program
A nurse wishing to start a career in the CVICU might want to consider earning a BSN. A BSN is a four-year Bachelor of Science in Nursing from an accredited university. While RNs can also have associate degrees, having BSNs can sometimes entitle them to more opportunities, supervisory positions, and—perhaps the tie-breaker—higher compensation. Additionally, some hospitals require a registered nurse to have a bachelor’s degree to work in specific units. The good news? You can opt for an accelerated BSN program if you already have your associate’s in nursing or a bachelor’s degree in another field.
2. Pass the NCLEX
Nurses must pass the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to practice in the United States. Don’t worry. We’ve got plenty of information on how to pass this exam quickly and confidently with our NCLEX study tips.
3. Gain Experience in the Field
Many registered nurses work in other areas and eventually focus on CVICU nursing. A nurse can obtain valuable experience by working in a medical-surgical unit, emergency room (ER), post-anesthesia care unit (PACU), step-down unit (SDU), or general intensive care unit (ICU). In these settings, nurses will gain experience providing care for patients with acute care needs. Job requirements vary. Whereas it is common for CVICU positions to require at least one year of acute care nursing experience, some hospitals are willing to hire and train new grad RNs for these specialized units.
Moreover, a nurse may be able to advance in their CVICU career by obtaining additional certifications and training.
CVICU Nurse Certifications
For nurses working in the CVICU or hoping to enter the specialty, some certifications are optional, and others are required.
Let’s start with life support certifications.
Most roles require nurses to have a Basic Life Support (BLS) certification. This training course prepares participants to recognize numerous life-threatening emergencies, deliver high-quality chest compressions, give appropriate ventilations, and provide early use of an AED. Furthermore, nurses who manage cardiopulmonary arrest or other cardiovascular emergencies should also obtain the Advanced Cardiovascular Life Support (ACLS) certification. This certification builds on the BLS skills and emphasizes the importance of continuous, high-quality CPR. The American Heart Association offers both of these courses.
Another certification often required for a CVICU position is the NIH Stroke Scale. Developed by the American Stroke Association, in conjunction with the American Academy of Neurology (AAN) and the National Institute of Neurological Disorders and Stroke (NINDS), nurses can take this online training program to learn or review how to use the NIH Stroke Scale for acute stroke assessment. This program is certified for continuing education (CE) credits.
CCRN® (Adult)
Moving on from the typically required certifications, the preferred optional certification for CVICU nurses is the CCRN® (Adult) offered by the American Association of Critical-Care Nurses (AACCN). This certification is for nurses providing direct care to acutely/critically ill adult patients in numerous locations, including intensive care units, cardiac care units, trauma units, or critical care transport/flight.
To be eligible for this certification, a nurse must have a valid, unencumbered US RN or advanced practice registered nurse (APRN) license and meet one of the following clinical practice hour requirements:
- Two-year option: A candidate must have practiced as an RN or APRN for 1,750 hours, providing direct care to critically ill adult patients during the previous two years, accruing 875 of those hours in the year before applying for the certification.
- Five-year option: A candidate must have practiced as an RN or APRN during the previous five years with at least 2,000 hours providing direct care to critically ill adult patients, accruing 144 of those hours in the year before applying for the certification
Aside from the CCRN (Adult), the American Association of Critical-Care Nurses offers the CCRN (Pediatric) and the CCRN (Neonatal). Although most CVICU patients are adults, these specialized units may also see children and infants. Furthermore, a CVICU at a children’s hospital will exclusively receive pediatric patients. Therefore, nurses must decide which certification would be most relevant and valuable for their career path. Eligibility requirements for these certifications are the same as those for the CCRN (Adult), except that the hours of practice must be with the target population.
CMC®
Also offered by the American Association of Critical-Care Nurses, the CMC® is a subspecialty certification for nurses providing direct care to critically ill adult cardiac patients. Typically, nurses who pursue this certification work in cardiac care units, medical ICUs, telemetry, progressive care, heart failure clinics, home care, interventional cardiology, cardiac cath labs, and/or electrophysiology units.
Since CMC is a subspecialty certification, nurses must already have clinical nursing specialty certifications, to which the CMC credential will be attached.
Additionally, candidates must complete one of the following clinical practice hour requirement options:
- Two-year option: A candidate must have practiced as an RN or APRN for 1,750 hours, providing direct care to critically ill adult patients during the previous two years, accruing 875 of those hours in the year before applying for the certification. Of the 1,750 hours, 875 must come from caring for acutely/critically ill adult cardiac patients.
- Five-year option: A candidate must have practiced as an RN or APRN during the previous five years with at least 2,000 hours providing direct care to critically ill adult patients, accruing 144 hours the year before application. Of the 2,000 hours, 1,000 must come from caring for acutely/critically ill adult cardiac patients.
CVRN Level II
In addition to the certifications offered by the AACCN, the American Board of Cardiovascular Medical Accreditation (ABCM) provides certification opportunities to all healthcare providers working in cardiology, including nurses. It offers the following certifications:
- Basic Cardiac Monitoring ECG Board Certification
- 12-Lead ECG Board Certification
- Advanced ECG Board Certification
- Cardiovascular Nursing Level I Board Certification
- Cardiovascular Nursing Level II Board Certification
- Cardiovascular Nurse Practitioner and Physician Assistant Board Certification
The Level II Cardiovascular Nursing Exam was designed for acute care cardiovascular nurses. It covers specialized knowledge and skills concerning assessing, managing, treating, and evaluating patients with acute and critical cardiac episodes, including managing patients on mechanical ventilators, knowledge of hemodynamic monitoring, and intra-aortic balloon pump management. Nurses who obtain this certification must be skilled at recording, reading, and responding to anomalies seen in the 12-lead ECG and administer IV medications as physicians or nurse practitioners prescribe.
Besides holding a current RN license, candidates must meet the following requirements:
- Have a minimum of two years experience as an acute care cardiac RN (LPNs with experience may apply); nurses with less experience may appeal the decision and provide proof of adequate study in cardiovascular nursing practice.
- Read the ABCM Certification Handbook and sign off that they have read and agree to its terms and stipulations, particularly regarding the Exam Confidentiality Statement (ECS) and the Exam Candidate Agreement (ECA).
- Define work experience in acute care practice areas on the application form (experience does not need to be current or sequential).
- Have the physical ability (mobility, sight, and hearing) to provide cardiac patients bedside care.
Tips for New Nurses and Those Transferring to the CVICU
Starting in the CVICU can be intimidating for any nurse. While the CVICU is considered a challenging, fast-paced, high-stress environment, it can also be a rewarding place to work. With this in mind, here are a few pointers for getting started and feeling at ease in the cardiovascular intensive care unit:
- Know there will be a learning curve: Starting in a new specialty area, especially in a CVICU, comes with a learning curve. Feeling nervous on your first, second, or third day is normal—and maybe even weeks or months into being a CVICU nurse. Therefore, the best tip for learning while in a new nursing specialty is not to be afraid to ask questions—as many as you want. For this purpose, you can keep a notebook or phone readily available to take down any important notes or details during your shift.
- Develop skills in ECG interpretation: If there is one critical skill CVICU nurses should master, it’s ECG interpretation. In light of this, if you are considering transferring to the CVICU, practice and hone your ECG interpretation skills. Feeling confident in these skills can give you the boost you need to feel more confident when stepping onto the CVICU floor.
- Be extra vigilant in patient monitoring: A patient’s vital signs alert a CVICU nurse of any life-threatening status changes in a patient’s condition. As a result, a nurse in this unit will need to monitor all intravenous lines, machine equipment, and settings closely and frequently. If you notice something is off, don’t hesitate to communicate immediately with a nurse colleague or physician in the same unit.
- Ask for support: Research indicates that working in the CVICU, especially in end-of-life situations, can be difficult for nurses, regardless of experience level. As a result, a qualitative study suggests that support networks may be helpful when dealing with end-of-life care. As a new CVICU nurse, you can seek help from colleagues, mentors, and other experienced nurses. You can also participate in debriefings, attend seminars, or download CVICU-related applications to your phone. In either case, seeking assistance can help you manage stress and provide quality patient care while working in the cardiovascular intensive care unit.
CVICU Nursing: Heart and Perseverance Meet to Save Lives
While leaving the cardiovascular intensive care unit may be the first step toward a patient’s long recovery, a CVICU nurse may tell you nothing beats seeing a patient take that first step. After all, these nurses often play a vital role in getting patients out of life-or-death situations. So, although working in the cardiovascular intensive care unit can be challenging, the satisfaction from positively impacting a patient’s life is unmatched. The CVICU nursing specialty also provides competitive wages recognizing and rewarding nurses’ efforts and commitment to their work.
If you are considering pursuing a career in CVICU nursing, now is the time. You can take the first step today toward changing patients’ lives in a rewarding career as a CVICU nurse. If you are already a registered nurse, you can gain valuable experience by picking up per diem hospital shifts through Nursa today.
Sources:
- New York State Department of Health: Heart Disease and Stroke Prevention
- ScienceDirect: Interprofessional collaboration in the intensive care unit: Power sharing is key (but are we up to it?
- ScienceDirect: The cardiovascular intensive care unit nurse’s experience with end-of-life care: A qualitative descriptive study
