Cardiac Cath Lab... What's it like??

CCL RN, RN · Sep 24, 2012

There's plenty of posts on here where we talk about a typical day for a cath lab nurse...but I will just say this: it is not an appropriate place for a new nurse.

You will be running the balloon pump, titrating drips, managing a crashing pt, getting sterile supplies, circulating, planning, anticipating ... ALL at 2am.

If you find a hospital that allows new nurses (note, I did not say new grads.) then it's an unsafe lab that is setting you up for failure.

Most nurses have several years of either ER exp or ICU exp prior to coming to the lab.

I worked with a girl with only tele exp (10 yrs) and she failed miserably. You really gotta be exceptionally comfortable in your own nursing skin, be able to intellectually interact with Drs, and be able to multi task like nothing else.

And wear a ton of lead all day.

And give your life away to call.

The cath lab is great! But not appropriate for newer nurses...

eatmysoxRN, ASN, RN · Sep 24, 2012

It was awesome when I got to spend a day there during my externship. The nurses were so knowledgeable it was amazing. I imagine it would require extensive knowledge of not only the heart but all other systems as well. Most postings for CCL jobs I've seen require 3-5 years of experience. Dream high and maybe try to get a job in a CVICU.

queenjulie, RN · Sep 25, 2012

I've got to disagree with CCL RN, at least for my hospital's cath lab. They hired a new grad from the class before mine directly after graduation, and a year later, she is now doing caths herself and has been extremely successful. That said, she was an excellent student and very skilled from the beginning, so a less-advanced new grad may have much less luck, but it can definitely be done! I love watching cardiac caths, but I couldn't do them myself--too much standing in one place for hours and hours at a time.

CCL RN, RN · Sep 26, 2012

You don't do "caths by yourself" and you don't "stand in one place for hours"

I actually work in the lab, do you?

I don't stand-at all. I work. Nonstop. Sometimes through the night. 12 hours would be a dream but its more like 14-16hr shifts...if I'm lucky!

I'm constantly moving. Fast. And wearing a ton of lead.

Most LHCs take an hour or so. I think you're mistaken on your time estimates...

Many labs differ ...but a true lab is NO place for a new grad, let alone a nurse without several years of critical care exp. if this is the case, then the are endangering pts lives.

Sounds like your lab is substandard.

I'm sorry, but it's true.

A new grad wouldn't last one minute in my lab. Not.one.single.minute.

We just turned down a nurse with 11yrs CVICU exp, 20 yrs total exp.

Please tell me how you will know how to run the pacer in a TAVR case, or run the IABP/Impella case.?How will a new nurse handle a crashing STEMI at 2am, IABP, anticoagulation, circulating the case, running the vent, anticipating te supplies, which pressors to mix and hang...all alone at 2am?

Tell me, queenjulie, what your cath lab experiences have been? Because I've been there. And it's NO place for the new or weak nurse...

oh, and I'm sure as heck not 'standing around for hours!'

I wish!!!

tgodwin45 · Sep 26, 2012

Hi I am a CNS in tertiary ccl as well as.private practice. I went into cath lab at the end of my new graduate year and after 2.5 I was successfully with obtaining CNS status. Working across differing labs ur role may well be different in different labs in terms of the level of specialisation you require and level of support. Primary my.clinical role in ccl is to prepair pts for angio and the equipment such as manifolds for injecting contrast or.auto.injectors. maintaining and using emergancey equipment such as defibs balloon.pumps etc. You experience.a lot.of.emergancies however most pts are stable. Working.in.the ccl you develop an excellent understand of cardiac disease and.cardiac anatomy. You will also learn a lot about heamodynamics and advanced life support. Ccl is also evolving all.the time so stuff.you do.one.year will.be.different the next! If.u love cardiology and are.dedicated to it and.want. a dynamic job give ccl ago.but be prepaired to study ur orifice off for a.year or two when.you get there! Hope that gives you.some.insight! Written by phone. Cheers tim

queenjulie, RN · Sep 26, 2012

You don't do "caths by yourself" and you don't "stand in one place for hours"

Good Lord, that was obviously an exaggeration. I meant that she is actually doing the insertions, not just getting supplies, circulating, etc.

tgodwin45 · Sep 27, 2012

Angiograms are performed by RN's in some centres. Was reading great article on a lab in the UK that RN's do caths (as in gain access and canulates the coronaries) and have fewer complications than advanced trainee interv. Cardiologists. Haven't heard of RN's doing in Australia. There's lots of courses you can do that allow you to do certain procedures for example I am currently being accredited to insert angioseal closure devices. Like I.said.depending.on where you work your role maybe very different. Some labs as an RN you might be on monitors or.scrubbing or scouting or u might have a rad that does.the.monitors and the imaging. Some labs only do diagnostic caths some do pacing electrophysiology, valves, pfo's the lot! I'm sure the roles differ in countries as well! Ur lab may do.manly radial.access or femoral or both and I've read of centres in Europe that do c.caths sitting.in a.chair via the radial approach! In the UK they have angiogram trucks which are mobile labs! Theres lots.out there and its a.great speciallty of its own! Written by phone Cheers tim cns ccl

NettersRN · Jan 9, 2013

Hi CCL RN,

I noticed that you mentioned about TAVR in your post... my hospital is currently developing a TAVR program. Our hybrid room is almost completed, and our proctored cases begin sometime the end of next month.

I was wondering if you could give me some insight into the TAVR program with your hospital... more so with the nursing aspect of things. We have already done a few valvuloplasties, so I relatively familiar with that. What I do not know is the OR side of things or what exactly is expected of cath lab nurses vs. OR nurses in the TAVR procedure.

All chance you're willing to share your experiences- the good, bad, and ugly?! Thanks!

buckeyefan1970 · Feb 9, 2013

I have to agree with CCL RN. Especially if you are a new grad, you need to build up your skill set for a few years (yes, I said years). Having that base knowledge will make that transition to the cath lab much easier! For that matter it will make a transition to any unit much easier. That being said there are diagnostic cath labs and interventional cath labs. You MUST have a strong critical care backgound (second nature) before going into the interventional labs. When things go bad in an interventional lab it goes bad very quickly! Some cath labs only let nurses circulate cases where you are responsible for the entire patient plus, medicines, vents, Balloon pumps, Impella and on top of that you are also running to get equipment. I work in a large urban interventional cath lab where I am often the only nurse at night. I had 15 years of experience before I applied and I still learn new things all of the time.

P.S. I had to laugh at the "stand in one spot for hours at a time comment." That's a pipe dream.

afterseason, ASN, RN · Mar 3, 2013

I've been spending time in a cath lab currently in my clinical rotation. It is AMAZING! The nurses are brilliant. I happen to be at a lab that has nurses who LOVE to teach, and they are constantly narrating their every move for me. It's definitely piqued my interest, and I feel much more comfortable there than I think most people with my experience level would, but I wouldn't even consider applying somewhere like that as a new grad. Not because I think I would fail, be overwhelmed, etc, but I think you just owe it to your patients to have a solid foundation before taking on their care in such a critical setting.

Much respect to all the men and women working in the setting, though. Like I said, all the ones I've met have been truly brilliant.

Jenni811, RN · Mar 3, 2013

Hmmm you guys have me second guessing that application I filled out for our Cath Lab. We are a very large cardiac hospital and have both diagnostic and interventional. I've had 2 years in intermediate care/tele (cross trained). Maybe ICU will be more up my ally. I want out of the bedside so bad though.