I am an ECMO specialist but my day job is being an ICU nurse, and I can tell you it is not even close. Let's be honest, when we have a balloon pump or VAD, mostly we just write down numbers, we had to learn a few assessments/checks to do and a few precautions to follow, and it is extremely rare for anything to go wrong, and if it does we just do what minimal, simple interventions we know how to do, panic, and call perfusion. Not necessarily in that order
But you're still doing typical ICU nursing, it's another machine in your patient's room and it is critical, but it doesn't significantly change the general job duties. Being an ECMO specialist is an entirely different ball of wax. ECMO specialists require a few weeks of full-time additional training to become certified, it is not like getting VAD or ballon pump certified. When the ECMO managing physician isn't present, the specialist is the leader of the team caring for that patient, and you are responsible for anything that happens. You have to make complex decisions regarding management of anticoagulation, clotting, bleeding, and hemodynamics/oxygenation (the physiology and management is very different than any other ICU patient). You have three circuit pressures you are monitoring, three separate blood gasses to interpret to determine how to adjust your sweep gas and pump flow, but must also take into account pt. BP, native CO, gtts, patient lung function, vent settings, volume status, cardiopulmonary anatomy (e.g. in our congenital heart babies or neonates with shunts), type of support (VA, VV, VAV), where they are cannulated, patient assessment, circuit assessment, etc. etc. And even just the routine necessary things you do often require accessing the circuit, which is extremely high risk, as in if you turn one stop cock the wrong way you could cause a massive catastrophe. And if there is some kind of circuit catastrophe, until the ECMO doc, perfusionist, and other ECMO specialists get there to help, you alone are responsible for fixing it, while the rest of the ICU team that is coding the patient is screaming at you "how much longer?" Don't get me wrong, there are times on very stable patients where it's mainly just watching blood pump in a circle and jotting down numbers. That's why they say being an ECMO specialist is 90% boredom and 10% sheer terror.
To answer the OP's question, ECMO is scary and hard and it is not for everyone. It requires a certain level of passion, you have to be a little obsessive to soak in all the knowledge needed, and you have to be the type of person who is willing to be the only person in the room who knows anything about this crazy machine that is usually the only thing keeping the patient alive. I disagree with your statement that only perfusionists should staff ECMO pumps. With proper classroom, lab and clinical training experienced ICU nurses/RTs are qualified and capable to do the job, and do at most ECMO centers. It is not like you'll (usually) be doing full CBP with circ arrest. But that doesn't mean it's simple enough for a "ten minute crash course." That is completely insane. Our initial training is 80 hours, plus 4 hour comps every 3 months. Also, if they aren't offering you a nice pay differential, they are robbing you. When we sit a pump we get paid the same rate perfusionists get paid to run bypass in the OR. ECMO requires you dedicate much of your personal life to learning this, being on-call, and shouldering huge responsibility and high stress levels, and being exposed to some of the most emotionally demanding situations possible, above and beyond the demands of being an ICU nurse. The job absolutely deserves additional compensation.
Sorry for the long post and I know this is two years old. But when I saw one person say that only perfusionists should run ECMO and then another say it's just like a VAD, I couldn't help myself.