Empowering Care in the CICU: The Role of the Nurse Specialist
In the Cardiac Intensive Care Unit (CICU), every decision counts—and so does every member of the team. Nurses in the CICU at Beth Israel Deaconess Medical Center care for patients with complex cardiac conditions with the vital support of a Nurse Specialist. This role bridges clinical expertise and leadership, collaborating with nurses, physicians, and cross-functional teams who are engaged in care decisions.
Fostering Growth and Resilience
The CICU Nurse Specialist brings deep clinical experience and wisdom to each shift in the 15-bed ICU—someone to consult in real time about clinically complex patients or debrief after rapid responses and code scenarios. That presence not only saves time but also builds confidence and fosters learning.
Beyond the day-to-day clinical support, the Nurse Specialist is key in mentoring CICU nurses. From leading onboarding cardiac education to teaching telemetry interpretation classes, they help ensure that nurses have the knowledge and skills to care for high-acuity patients. They also create space for reflection and learning, allowing staff to process challenging cases and build resilience in a demanding environment.
A unique strength of this unit is its continuity—nurses often receive updates from outpatient follow-up visits, allowing them to see how their patients are doing long after discharge. It’s uplifting and a powerful reminder of the team’s impact on patients’ lives. That continuity of care is at the core of what makes this BIDMC unit special — and it’s also central to the work of the CICU Nurse Specialist.
Collaboration That Transforms Care
“The CICU Nurse Specialist is an integral part of our advanced cardiology programs,” says Andrea Milano, MSN, RN, CCRN, CMC, Assistant Nursing Director of the Cardiac Care Unit, and a former Nurse Specialist in the CICU. “We care for patients with some of the most advanced heart conditions — those on extracorporeal membrane oxygenation (ECMO), with durable left ventricular assist device (LVADs), or waiting for a heart transplant.”
It wasn’t always the case that CICU nurses cared for patients with ECMO. As a Nurse Specialist, Andrea worked with a multidisciplinary team to update order sets and policies, restructure bedside rounds, and provide initial and ongoing education to the CCU staff to care for this new patient population.
“One of the most rewarding parts of this position,” Andrea adds, “is taking on new initiatives that expand our staff’s skillset and raise the level of care we can provide. I’m fortunate to work with such a talented and supportive team — you’re always encouraged to learn and lead. As a Nurse Specialist in the CICU, I felt supported, challenged, and inspired.”
