I've been in cath lab for almost two years now. I work in a high volume lab that runs a three person team in several rooms. Our hospital does most of the standard style cath cases such as EP study/Ablation/PVI/Left atrial appendage isolation/LHC with PCI/RHC/PPM/Loop Recorder/AICD/BiV/ASD Closures/PFO/Carotid Stents/IVC filters/Peripheral PTA/Atherectomy and Thrombectomy. All the cool toys Impella/IABP/CSI/Crosser/Laser/Turbohawk/Rotobladder/Angiojet/IVUS/FFR/OCT. As of now we do not do TAVR or any coiling procedures. With that being said, I have 5+ years ICU and Step down experience.
You better have your big boy pants on when you step into the cath lab. Many of our patients are stable, but many of them are deathly ill. Patients go bad quickly, much more so than on a nursing unit. Just learning the types of procedures and what the hell is going on can take a year. Mix in a whole host of new pharmaceuticals to play with and you can lose your mind. There is no pharmacy tech mixing drugs and putting them in a pyxis for you. You mix your own pressors and gtts. Its mind blowing just trying to learn the supplies associated with doing interventional cardiology. Like CCL RN stated, it really gets bad when its 3 am and you are doing the job of 5 people, mixing drugs, titrating drips, setting up equipment, monitoring vitals, assessing your patients vitals and rhythm, running a code, shocking/pacing your patient, pushing meds, getting thrown up on, dropping sterile supplies, and trying to document all this chaos unfolding.
I am sure there are cases of new grads thriving in a pre-op/recovery area for CVI, but it is not healthy for the RN to try to make this leap into the lab without some SOLID background in emergency/critical care/even paramedic training. You need to be 100% independent. I learned so many things in the ICU and even on step down. LVN's with 20 yrs experience have even taught me things I use in my practice today. Bottom line... Its not safe for your career or your patient. You need to know things like what you need to do if you perf a right ventricle during a PPM insertion without the MD asking, he's busy putting in the pericardial drain you dropped to him. What you do with a CHF patient that's BP/HR has tanked with an LVEDP of 35. Its almost like being the MD's ultimate resource. Some of the older nurses I work with know more than some of the Cardiologist doing the cases. My cath lab nurses out there know what Im talking about here.
I hope this reaches new nurses or nurses who want to get into the lab. Its the most rewarding job I've ever had, and I wouldn't trade any of the blood, sweat, or tears I have shed while working there. It has made me a stronger nurse with a huge skillset. Please know that every goal is attainable if you put in the work.