Skills required: o Cardiac and hemodynamic monitoring, cardiac strip and rhythm interpretation, arterial lines, titration of drips, ventilator care (we have Respiratory Therapist 24/7), vascular lines, chest tubes or drains, post procedure site care – trans radial bands, femoral venous or arterial sheaths, CRRT, immediate post open heart experience, advanced cardiac support-Impella/IABP, Advanced hemodynamics including Swan, temporary pacemaker, post pulmonary artery thrombectomy (EKOS, Prenumbra, Inari). ● Patient Ratios: o RN: ICU Level of care is 1:2; Special high acuity of RN 1:1 care (immediate post open heart, Impella/IABP support, CRRT, or organ procurement); Overflow patients waiting on stepdown Intermediate the RN to patient ratio is 1:3 or 1:4 depending on interventions.