Competency in invasive line monitoring (Swan Ganz, a-lines), pacemaker management (epicardial, transvenous), chest tube care, cardiac medication administration (inotropes, vasopressors, sedation/paralytics), ventilator/trach management, and cardiac rhythm interpretation required. Support team includes a charge nurse (rarely with patient assignment), 24/7 HUC, dedicated CVICU Intensivist, CT Surgeon on call, hospitalist, general Intensivist, and ICU-designated RT.