Nurses who work in the cardiac catheterization lab

Ready to learn more about nurses who work beyond the bedside?  Nurses who work in the Cardiac Catheterization Lab (CCL) play an important role in cardiac care.  Amy Sellers, RN blogs at Nursing Influence and graciously agreed to give us a peek at what a nurse is responsible for doing in the CCL.

Amy has worked in the Cath Lab for about 6 months now.  She previously worked in cardiovascular intensive care unit for almost 5 years before deciding that she needed a new challenge.  She is paid hourly and works three 12 hour shifts per week (all daytime Mon-Fri) with lots of opportunities for overtime and call shifts.

A cath lab is an area of the hospital that uses fluoroscopy and contrast dye to check for narrowing/blockages in arteries or veins in the body. Using special equipment, they are able to perform angioplasty (open the arteries with a balloon), place stents, insert IVC filters (a filter that is inserted into a large vein which prevents blood clots that form in the leg from getting to the lungs) as well as inserting pacemakers/ICDs.  ICDs are Implantable Cardiac Defibrillators.  They detect if a patient’s heart goes into a lethal rhythm and provides a shock to the heart if necessary to get it beating correctly again.

What do you do all day?

I care for patients, of course!  We have 5 cath labs and we have at least one nurse assigned in each lab (a 2nd nurse may be assigned to that room under the role of “scrub”, meaning they prepare the sterile field and assist the physician during the procedures). When I’m assigned to the nurse role, I am responsible for all things related to patient care & medications during all of the day’s procedures. After the physician arrives, I am responsible for administering conscious sedation, performing all of the charting during the case, monitoring patient status during the procedure, as well as giving any emergency medications that may be needed during the case.

Amy says she loves the direct impact that she’s able to have on a patient’s life. For example, patients come in to the cath lab from the ER actively having a heart attack. Within minutes, her team is able to locate the blocked artery in the heart and open it up, restoring blood flow and improving the patient’s clinical symptoms.

“In addition the impact we have medically, I feel like I make a difference each day by helping to calm the nerves of our patients undergoing this procedure. Most patients are pretty nervous as we wheel them into the lab and I really take pride in being able to talk to the patients and help them through education or just small talk.”

Do you feel you receive adequate support for your responsibilities?

I feel like I get a great deal of support from everyone in the team, from the physicians, to the radiology techs, to the scrub techs. It’s the combination of everyone’s skill and experience that makes the cath lab run so smoothly and helps to back up the growing skills of a newbie to the cath lab (like me).

What is something a nurse who does not work in your particular field might find surprising about your job?

I love the positive relationships that the staff in the cath lab have with the cardiologists. Working in the CVICU prior to the cath lab, I felt like I had a good relationship with most of the physicians. They would listen to the observations and suggestions I made about my patient, leaving me feel like I was making a difference for my patients. The relationship between staff and physicians in the cath lab is much closer; it truly is a team. Physicians ask for, and accept, suggestions from staff as far as the best equipment to use for a particular case or which vessel is more crucial to fix before another. Physicians and staff get to know each other to the point that it feels like a second family – they ask each other about their children’s school plays, volunteer activities they’re involved in, etc.

Amy says she finds that she does accomplish her responsibilities in the time frame she is given:  “Working in a procedural area makes this easier as cases are scheduled within a set time frame. When emergencies happen, we have a 3-person call team available at all times during non-work hours.  Working in the cath lab is 100%, without a doubt, a job that requires a great deal of teamwork. Without one of the essential staff members, a case could not be done.”

Was there any extra training besides on-the-job learning that you were required to complete for this job?

As a cath lab nurse, there is no specific training, but experience in the cardiovascular field is highly recommended as advanced EKG recognition and knowledge of hemodynamics are a big part of the nurse’s role. A nurse that is new to the cath lab will more than likely need about 2 months of orientation to be able to function safely and proficiently on his/her own.

One of the biggest complaints given by hospital unit-based nurses is that they rarely have time to eat or go to the bathroom. Do you find that to be the case with your job as well?

I always have a few seconds between cases to use the bathroom…. but the problem of using the bathroom can happen during a case that runs unexpectedly long. As the only nurse in the room, we are unable to leave. So, at that point, I’m thankful for the bladder control I developed during my days in the ICU.

Thank you, Amy, for sharing what it’s like to work in the Cath Lab!

“Gina” is an intensive care nurse who blogs at code blog – tales of a nurse.


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