Cardiac Stress Testing - page 2

by ICN2U 31,334 Views | 15 Comments

In my hospital setting, nurses do not attend cardiac stress tests performed in nuc-med. The cardiac stress meds are administered by the tech with the cardiologist in attendence. This is not what I am used to. In my previous 10... Read More


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    I'm just starting to use Lexiscan, but I'm having a hard time with my documentation process. I have an exercise data sheet with the 1 min increments, but Lexiscan is so fast, I feel so out of time with everything. Anyone else experience this when they started using Lexiscan? Anybody wanna share their documentation sheets? My rep wasnt' available to walk thru one with me, so I'm just out of time.

    Thanks
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    I understand the issue about the documentation of Lexiscan with the one minute increments on your sheet. Our sheet only has the lines for the minutes and we write the times in ourselves.

    We document Supine HR, BP and Pain Level (0-10) [Joint Commission NPSG] on our sheet; then the nurse injects the Lexiscan, the NucMed tech injects the isotope, and the treadmill tech will run an EKG so that there is a HR for documentation during the test. Rarely can the tech get a blood pressure done during that time. The test is put into the recovery stage and there is a BP and another EKG performed giving a HR post procedure. [We document the pain level again for Joint Commission.] This is all we document on tests without any type of complications. Perhaps you can draw a dash through the times you do not use.

    Does this make sense?
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    I been starting with a baseline EKG, then starting my exercise testing and when all injections are in, I'm switching to Recovery phase and monitoring for 4 minutes. Don't know if this is too much or what. I think I'm going to redo my sheet with any times so I can make that part work. Seems like Lexiscan reps would have something for us to work with.
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    My cardio tech and I were doing double charting of VS and Sats. She is tracking EKG, b/p and sats while I administer drugs and has handwritten oxygen sats on the EKG. On my paper, I do my baseline VS, and Discharge numbers, but inbetween, make a comment to refer to the EKG for VS, Oxygen Sats and isotope times.
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    So I just started at a hospital where we "help out" with giving the lexiscan and the Cardiologist is across the llllooonnnggggg hall in his office & at times has been doing a heart cath when these patients are being stressed. I have reviewed some of the literature not only state but also oh that big governing body who pays some of the bills medicare & medicaid & if the Cardiologist....... again CARDIOLOGIST has to be in the IMMEDIATE AREA. The 2012 white paper states that RN's DO NOT FALL UNDER PROVIDERS who can SUPERVISE stress tests!!! Especially with a chemical! No hospital policy can trump that! We are NOT able to immediately provide a cardiac intervention if patient becomes unstable. Read the literature its sooo ridiculous but the bottom line is if you give lexiscan & there's not a MD you are opening yourself up not only for negligence but insurance fraud. Clearly states the MD has to be there
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    Hello everyone. I know this topic started a few years back, but here's my input. I am a nuclear medicine technologist and I received my BSN in January. In Texas, where I studied and worked as a nuclear medicine technologist, we (NMT) infused all pharmacological stress agents with a Cardiologist monitoring the EKG at small cardiology clinics. Same with the hospitals. I now live in San Diego, and in CA, only RN's can infused the chemical agents. As a NMT in CA, I was one of the first people to be trained to use Lexiscan. If Lexiscan came out before the use of Adenosine, people would comment on how great Lexiscan is compared to adenosine.

    Anyhow, as I mentioned before, I am a New Grad RN. Just started my first job as a part time med nurse at a SNF. They have also been training me to do Charge as well. The facility just offered me a full time position there last week. A couple days back, they offered me a different position as a business development specialist at a sister facility they are getting ready to launch. Now, I have a great opportunity to get an RN position at a large cardiology clinic doing stress testing. I think with my Nuc Med background, the cardiology clinic will be a better fit for me. At least it will give me experience to get onto a tele floor at a hospital.


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