[gwenith]

Asking a group of prejudiced people here - of course it would be better aren't nurses better than anyone else at what we do???

[Salpicovalentim]

So gwenith,

which do you think are the reasons for nurses not be involved the way you agree it should be?

[nialloh]

In our hospital we send our pts to the cath lab for the insertion. Most pre-procedure teaching is done by the nurse, and teaching for the follow up by the Drs office is done by us as well. We watch the insertion site for bleeding, and give iv andibiotics (2 more doses). We keep them for another day or two, unless they have other problems. We don't insert AIDC's.

As for out-patient care, other then looking at the wound, I really dont know what a nurse would do. Other then the 1-2 month check over the phone, the pacemakers take care of themselves. Just don't have an MRI

[st4304]

Our cath lab inserts all pacemakers and AICDs. The implants (if outpatient) are in our outpatient cath recovery unit for about 4 hours and then they go home. AICDs stay overnight. The cath lab also does all pre- and post-teaching before the patient goes home. Our pacemaker clinic follows the patient transtelephonicly and/or in their office and that clinic is run by RNs. I work in the cath lab. If a patient on the floor needs changes to his/her pacemaker settings, we have all been trained to do it so we rarely have to call in the rep. A rep is usually present during implants and exchanges, but all the RNs in our cath lab are trained to analyze and test parameters during insertions and our docs are comfortable with us doing so if the reps can't make it for some reason. In fact, I think the only reason reps are asked to come is because they usually bring food and gifts!

As for patients admitted to the floor, if their admission is not related to problems with their pacemaker, they are not treated any differently than other patients, and I believe they are not even placed on telemetry unless the doc orders it.

It is very interesting to hear how different hospital do things! Thanks.

Your pal,

Sherri

[catlabrn]

I'm a cath/EP nurse. I'm learning to do more follow-up on pacemakers & ICD's. In our hospital, many pacer/ICD patients will go home the same day. They follow up in the cardiologist's office where their pacemaker nurses will interrogate and reprogram the device as necessary (usually turning the voltage down and so forth). The patient's follow-up is generally taken care of by the pacer RN's, in addition to the doctor, of course.

If the patient is admitted, we will do the follow-up until they are discharged. We also do pacer checks for any other inpatient if the physician requests it. We can always call a rep if we need it.

[HARN]

When a pacer is going to be placed, the patient get teaching on this from an RN that does nothing but this. THis is b/c I am assumng the dr don't have time to explain all details plus the floor nurses don't alwasy know which type of pacer is being placed & can't answer all qustions. They are able to answer all & any questions as well as have them sign their consent. Then the pt is sent to the cath lab for pacer placement. Pt is sent to tely floor & on bed rest until the next morning when a chest x-ray is done to see if leads are all in place. Then if oked by Dr pt goes home, with pacer interigation scheduled.
I hope that I was able to answer your question