cardiac rehab NP

[milian7]

i think one specialty i may love to eventually get involved in is cardiac rehab.. i love wellness and teaching people all about such life habits. i have been looking at job postings, but do not see any ads for nurse practitioners in this setting? are NPs used in cardiac rehab facilities?? any experience with people here, and if so, what did you typically do??

thanks!!

[mom2cka]

I work in inpatient rehab (not cardiac) and was told by our physiatrists that CMS reimburses differently for mid-levels; can't do admits, pre-screens, etc. So for our particular unit, it's not cost-effective to have a midlevel as others might be. Please correct me if I'm wrong, but that's what I've gotten from 2 different docs and a few blips here & there from CMS info. I don't know if cardiac rehab is similar, though.

[carachel2]

Medicare *requires* an on-site physician (billing is done "incident to physician services)in order for reimbursement for monitored cardiac rehab services so that is why you don't see any NP positions. I think I saw one state that somehow worked around that (either Minnesota or Michigan??) but with the feds so involved in cardiac rehab I don't know how they do that. Hopefully someone will chime in!

Medicare had a very hazy definition of "on-site" physician services for years but then RAKED through a bunch of programs who did not have Dr's within X amount of feet while monitored services were provided. They did detailed chart reviews and required these programs to give back hundreds of thousands of dollars. Some of those programs had to shut down.

I did cardiac rehab as an RN for almost 10 years but have been out for a few years so hopefully things have changed?

[misha12]

Carachel - can you tell me a bit about the rn's role in cardiac rehab / schedule / any way to move up in the field?

[carachel2]

Carachel - can you tell me a bit about the rn's role in cardiac rehab / schedule / any way to move up in the field?

Sure! I'll give you a bit here and then you can PM me if you want. I had a BS in Exercise Phys and had worked in cardiac rehab before returning to nursing school. I worked in cardiac critical care for 2 years after graduation because it was a requirement for our cardiac rehab department and I am glad I did ! You will see more crazy rhythms, angina, heart failure, syncope, etc. than you ever saw in CCU and *none* of them have existing IV access and oxygen, LOL!

Most cardiac rehab departments require an RN to have some critical care experience. If you are looking to break into the field I would contact your department and ask to observe (I know this isn't what you want to here, but I would say you want to do this on your own time somehow...cardiac rehab departments don't have huge budgets). If you like it and you have the appropriate tele experience then you could ask if they need PRN help. Almost all of our openings that came up in cardiac rehab were filled by our PRN nurses who were just waiting for an open spot.

In the meantime, it would be good to join the PCNA and the AACVPR and look into attending conferences. The more you can show you want to work in the field, the more eager and sought after you will be. Make sure you are already ACLS certified as well.

I loved working cardiac rehab. The days were semi-predictable, we only worked 4 days per week and NO weekends or holidays. Hourly pay may be a smidge lower in cardiac rehab and you will more than likely lose all of your shift diff and holiday pay. But if that is ok with you, then I would otherwise highly recommend cardiac rehab.

[Tmcmill]

NPs are not used in Cardiac rehab as of now. However, we are waiting on the bill to allow APNs to cover cardiac rehab in free standing sites.