I've been in the cath lab for almost 2 years now, and before that my only experience was ob and NICU. Talk about a HUGE change and feeling so lost and out of place! I am a fast learner and I ask a ridiculous amount of quesstions, but it was a difficult place to learn. I still learn something new every single day.
In my lab, RN's and all techs do EVERYTHING. Basically, regardless of your background (RN, resp. therapist, rad tech, or scrub tech, whateverr), we all learn to circulate, scrub as a first assistant, and monitor patients. We all administer conscious sedation and any other meds the MD orders. We take turns rotating through all of the positions. It was very difficult for me to learn to scrub at first, but now I love it. My lab is the busiest lab in the state, although we are not the largest lab. We do approximately 7 acute MI's PER WEEK, and several thousand angioplasties per year!! We do approximately 35-50 cases per day in cath, 2-5 in EP (pacers, ablations, etc), and 5-6 in peripheral. We do pacers, ICD's, loop implants and removals in the cath area as well as EP, but we don't do peripherals in the same labs. We take call 7 days every 8 weeks or so, depending on the schedule, and we rotate holiday call. There are very few nights that we don't get called in for an acute, and even fewer days that we don't stay late to finish a case. We are in lead most of the day, and it is HEAVY.
Some days it feels like you are running a marathon with your lead on when you are circulating a PCI of any kind, not just an acute.....running around the lab getting meds, starting o2, starting IV drips, anticoagulating, reassuring the pt, fetching equipment for the md, making sure the scrub person doesn't need any other equipment, watching the pt's vital signs, anticipating needs, etc, all while trying to minimize exposure to x-ray. It is different with every patient, even though the set up generally remains the same.
Scrubbing is fun, too. You still wear the lead, and you are responsibile for maintaining a sterile field at all times, setting up the scrub table and draping the patient in a sterile fashion, and helping the physician with the equipment. For example, when doing angioplasty, I prep balloons and stents and load them over the wire and advance them to the lesion. The MD positions the balloon or stent and then tells me to inflate the balloon or deploy the stent where he has placed it. So, basically, I put stents in patients, while the MD just says where to put it and what pressure to blow the balloon up to and for how long. It's a wonderful feeling.
We do computerized monitoring, and that is like a little break for us. We don't wear lead behind the glass, and we get to sit down for a few minutes. But if the circulator needs help, the monitor person gets up and helps. It's the easiest part of the job physically, but very technical. When doing right heart caths, if your numbers are wrong, you could have a pt. sent for valve surgery when they really don't need it or have pts. who do need surgery not go because your data was inaccurate. You really have to know what you're doing and make sure that you get good data.
I LOVE my job. I love the work that I do, and I LOVE the fact then when I go home every single day, I know that something I have done makes a difference in a patient's life. In exchange for this, I go home nearly every day bone tired, wore out and with a backache from the lead. But it's worth it to me. I can't imagine working anywhere else now that I've gone into the cath lab.