Day 1 on cvu Be able to clock in and out using productive time codes for “training” (TRN)

Walk through clocking in as non productive time, ia pay, training pay, & on call worked pay

Locate your locker and combination to unlock the locker Locate bathrooms, break rooms, RCMS, med rooms, supply room, nourishment room,

respiratory equipment, and huddle room Locate code carts, surgery c cart, and procedure cart

Have a knowledge of what is in the carts in what drawers Discuss uses for each cart and scenarios/patients for the carts

Nursing goals for day 1 Follow your preceptor:

Listen to report and use a report sheet Complete a head-to-toe assessment with preceptor

Watch and discuss how to best to chart, begin to navigate through charting and “show all” in each category

Discuss what IV medications should be hung mainline vs. piggyback Verbalize and demonstrate vital sign times, normal limits, changes of normal

limits, and how to locate those orders. Find a blood sugar, take one, locate how to find insulin scales, and review how to

draw up insulin Put in orders Review how to check labs and how to get labs to lab

Lab can be called at x3470 Review how to get a hold of a doctor

Intern/resident, senior resident, fellow, attending Locate their phone numbers/pagers

Module goal for day 1

Begin module 1 with preceptor

Day 2 on cvu Complete any task left from day 1 Login to api

Review how to schedule and print your schedule Review finding the on-call schedule

Locate CVU binder and go over with preceptor how to pick an on-call day Go over difference between EASI lead placement and standard lead placement

Trouble shoot the monitorso Spo2, bp programming, EKG, & respiratory adjustments

Look at report sheets provided and discuss best options for reporting Reporting structure:

Name, age, primary team, secondary teams, code status, allergies, diagnosis, systems, lines, gtts

Discuss and determine best report structure for you with preceptor

Nursing goals for day 2 Complete a head to toe assessment with preceptor on stepdown assignment and chart

on at least one stepdown patient Include assessment, vitals, meds, POC, & pt education

Walk through a discharge with preceptor Review tube system Fill out requisition slip and review what needs to be charged to patient Review ordering floor stock Locate blood bank forms Locate code status from Locate AMA forms

Review how to fill out all

Module for day 2

Continue with module 1 information

Day 3 on cvu

Complete any task left from previous days Program your ascom phone on the pick station at nursing stations Review safety net

o How to fill outo When to fill out a safety net

Review color labels for the doors Discuss prep of a room for a direct admit vs an ER admit

Who should you call for a direct admit Who should you call for an ER admit

Review special considerations for a cath lab patient Who do you call for a cath service patient on days and on nights Who discharges your cath service patient and when do you get the orders

On nights call the operator via “0” and have the fellow on cath service paged On days call the cath lab liason

Review how to put in cath pre-orders Who is your first call in the pecking order of doctors

When do you use the Ascom phones, when should you use the pager

Nursing goals for day 3 Complete a head to toe assessment with preceptor on stepdown assignment and chart

on at least one stepdown patient Include assessment, vitals, meds, POC, & pt education

Walk through an admission with the lead nurse in the computer system Look through procedure cart Look through the consult book and review frequently used phone numbers Review patient demographics in huddle room

Locate and use resource cards from huddle room Complete an admission in the computer using your lead nurse for assistance @

1470(AB)/1472(CD) (on nights and when there is one lead, use 1470) Complete a discharge

o Call lead, clerk, and RCMS with discharge promptlyo Strip room or delegate to NA

Module for day 3

Continue with module 1 information Begin working through module 2 with your preceptor

Day 4 on cvu

Complete any task left from previous days Locate telemetry in RCMS Review code status

Find the code changing paperwork Utilize Micromedix

Print a patient friendly micromedix and chart it for your patient

Nursing goals for day 4 Take on at least 2 of the patients on your own

Manage their care in its entirety Complete a discharge or an admission on your own Review how to find what tube for blood for specific labs

Locate and review how to do a type and screen

Module for day 4

Continue with module 2 information

Day 5 on cvu Complete any task left from previous days

Locate blood gas lab Review blood gases Find Central in basement Find pharmacy for inpatient and outpatient Review how to get blood products from lab

Nursing goals for day 5 Take on at least 2 of the patients on your own

Manage their care in its entirety Report off with preceptor standing by

Take or review how to manage a cath lab patient If you have not had a cath patient at this point, talk to your lead nurse with your

preceptor and request that for the assignment

Module for day 5

Continue with module 2 information

Day 6 on cvu Complete any task left from previous days

Locate all code carts on the unit (4 code blue carts and 1 code surgery c cart) Review what the carts have in them How do you call a code blue, code surgery C?

Where is the istat? 3 B med room and may be used if trained for codes and icu

patients Review what is in the drawers of the surgery c cart Review the procedure cart

Review when each item is to be used in the procedure cart How do you assist in a procedure? How do you do a time out?

When are time outs used?

Nursing goals for day 6 Take on at least 3 of the patients on your own

Manage their care in its entirety Receive report Report off with preceptor standing by

Take or review how to manage a surgery C patient If you have not had a surgery C patient at this point, talk to your lead nurse with

your preceptor and request that for the assignment

Module for day 6

Continue with module 2 information Begin with module 3 information

Week 3 on cvu Complete any task left from previous days Care for stepdown assignment

At this point, weeks will become our orientation focus.

Complete reviewing module 3 Start working on module 4 Care for patient with an arrhythmia

o What medications was the patient on and why?o What were the defining parts of the rhythm that confirmed the arrhythmia?o What interventions did you use?

If you have not had a patient with an arrhythmia, ask your lead nurse for a patient with an arrhythmia.

Care for a patient with a stemi/nstemio What interventions were used?o What changes were noted in the ECG?

Compare the ECGs in the charto What medications were used?o Did you have to titrate a drip?

What were the parameters for titration? If you have not had a patient with stemi/nstemi, ask your lead nurse for a

patient with a stemi/nstemi.

Week 4 on cvu Complete any task left from previous days Care for entire stepdown assignment Complete work on module 4

Start working on module 5 and 6 Care for patient with a chest tube

o What warning signs are there for complications with chest tubes?o How much suction should be used with a chest tube?o What supplies do you need to have bedside for a patient with a chest tube?o What is available for pain for a patient with a chest tube?

If you have not had a patient with chest tube, ask your lead nurse for a patient with a chest tube.

Care for a patient after a pacemaker placemento What interventions should be used when the patient arrives on the unit?o What changes were noted on the monitor?o What medications were/are used?

What signs for complications should be used If you have not had a patient with pacemaker, ask your lead nurse for a

patient with a pacemaker.

Week 5 on cvu Complete any task left from previous days Complete work on module 5 & 6 Start working on module 7 and 8 Care for patient post open heart

o What warning signs are there for complications can occur?o Where would you expect to not find a pulse?o What medications would you expect for these patients and why?o What is available for pain?

If you have not had a post open heart patient, ask your lead nurse for a post open heart patient.

Care for a patient after a GI tubes o What interventions should be used with these patients?o What changes should you assess for as complications with these patients?

If you have not had a patient with GI tube, ask your lead nurse for a patient with a GI tube.

Week 6 on cvu Complete any task left from previous days Complete work on module 7 & 8 Start working on module 9 and 10

Care for patient with a Lumbar draino What warning signs are there for complications can occur?o What medications would you expect for these patients and why?o What tasks must be completed?

If you have not had a patient with a lumbar drain, ask your lead nurse for a patient with a lumbar drain.

Care for a patient with a trache or trache to vent o What interventions should be used with these patients?o What changes should you assess for as complications with these patients?

If you have not had a patient with a trache, ask your lead nurse for a patient with a trache.

Week 7 on cvu Complete any task left from previous days Complete work on module 9 & 10 Start working on module 11

Care for patient with neuro complicationso What warning signs are there for complications?o What is a part of a neuro assessmento What medications would you expect for these patients and why?

If you have not had a patient with neuro complicaitons, ask your lead nurse for a patient with neuro complications.

Care for a patient with a wound o What interventions should be used with these patients?o What changes should you assess for as complications with these patients?

If you have not had a patient with a wound, ask your lead nurse for a patient with a wound.

Week 8 on cvu Complete any task left from previous days Complete work on module 11 Care for patient with sepsis and a renal patient

o What warning signs are there for complications can occur?o What medications would you expect for these patients and why?o What is available for pain?

If you have not had a septic or renal patient, ask your lead nurse for a septic or renal patient.

Care for a patient at end of lifeo What interventions should be used with these patients?o What changes should you assess for as complications with these patients?

If you have not had an end of life patient, ask your lead nurse for an end of life patient.

Extras for CVU orientees Cath lab day __________________________________

RCMS ________________________________________

Lead Nurse time ________________________________