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Discussion

Cath Lab NP's

Hi,

I am currently working in the cardiac cath lab and interventional radiology suite where (permcaths, PICC's, mediports, and various vascular angiograms are performed). I will be applying to NP school this fall. I would like to know if there any NP's who are currently working in any clinical area such as the cath lab/IR because I have never seen any NP's used in this capacity only PA's. I really find this area interesting and would like to return to this type of clinical environment. Just wondering what opportunities are open for NP's in this clinical capacity.

SheNic

Featured Replies

Hi,

I am currently working in the cardiac cath lab and interventional radiology suite where (permcaths, PICC's, mediports, and various vascular angiograms are performed). I will be applying to NP school this fall. I would like to know if there any NP's who are currently working in any clinical area such as the cath lab/IR because I have never seen any NP's used in this capacity only PA's. I really find this area interesting and would like to return to this type of clinical environment. Just wondering what opportunities are open for NP's in this clinical capacity.

SheNic

Intriguing question…. I would be interested in hearing about other parts of the country.

The closest I have seen with NPs working on a cardiac floor they were doing H&Ps pre-intervention as well as doing the actual stress testing. If a PA was involved in the actual procedure it was the doctors PA.

  • Experts
Hi,

I am currently working in the cardiac cath lab and interventional radiology suite where (permcaths, PICC's, mediports, and various vascular angiograms are performed). I will be applying to NP school this fall. I would like to know if there any NP's who are currently working in any clinical area such as the cath lab/IR because I have never seen any NP's used in this capacity only PA's. I really find this area interesting and would like to return to this type of clinical environment. Just wondering what opportunities are open for NP's in this clinical capacity.

SheNic

We have two NPs (and one PA) on our PICC service.

Here is a description on what PAs do in IR:

http://www.aapa.org/gandp/radiology.html

Here is a nice article on NPs in IR:

http://findarticles.com/p/articles/mi_m0ICF/is_5_33/ai_n17215426

One issue is that with more patients needing to be admitted after IR procedures, more IR departments are hiring NPs and PAs to manage the inpatients (ie round). This can be very frustrating if the physicians are not interested in dealing with the inpatients.

As far as NPs or PAs in cardiac cath, it does happen but it is rare. There are three studies that I know about that look at this:

Krasuski RA, Wang A, Ross C, et al. Trained and supervised physician assistants can safely perform diagnostic cardiac catheterization with coronary angiography. Catheter Cardiovasc Interv 2003;59:157-160.

Boulton BD, Bashir Y, Ormerod OJ, et al. Cardiac catheterization performed by clinical nurse specialist. Heart 1997;78:194-197.

DeMots H, Coombs B, Murphy E, Palac R. Coronary arteriography performed by a physician assistant. Am J Cardiol 1987;60:784-787.

Two of these look at PAs and one with CNS. The 2003 study compared the PAs with fellows and found that the outcomes were comparable (PAs were slightly faster). This is only diagnostic caths. I have a hard time believing any hospital would credential an NPP for therapeutic caths. I would also guess that this is confined to academic/VA institutions and is very rare.

There seem to be more PAs than NPs in IR, however, there are definitely IR jobs for NPs posted out there. I've heard that there are problems with some state nurse practice acts in regard to Xray use and whether port placement is considered surgery (there are also states that will not let PAs use flouroscopy).

David Carpenter, PA-C

I am an NP employed by a large hospital system for one of their Cardiac Cath/EP labs. I do H&Ps, discharges, groin management and some follow up of cardiac issues/arrhythmia management. Essentially I do the same thing for the hospital as I did when I was employed by an interventionalist, but now I am hourly instead of salaried.....life is beautiful!

I am a NP in radiology. I work primarily out patinet side but I do cover in patient as well. Great gig usually but I wworked radiology before befoming a RNFA/NP so small learning curve. I do some procedures, a lot of patient management. Good field to get into in my opinion but definitly not for everyone.

As David mentioned there are some problems with x-rays, I cant physically use flouro, but I can direct the rad tech to use it. Others get around this by spot films for piccs/ports. One plus about this is that it makes sure there is another person in the room for saftey reasons.

Jeremy

I work in the cardiac cath lab at Mount Sinai Hospital in New York Ciy. There are 8 diagnostic NP's who perform diagnostic procedures with an attending physician and one who performs diagnostic and PCI's with an attending physician. We also rotate consenting, and performing all pre and post cath/PCI care as well as the cardiology clinic. So absolutely, there is career for you in the cathlab as an NP. I am sure other hospitals will be hiring more nP's in the cathlab by the time you graduate. Good luck!

Hello Phineas

I've seen the cath lab in Mount Sinai and it looks state of the art, excellent!!

I have a question for you. Is there an issue being pregnant, and working in the cath lab as an R.N?? I am interested in working in the cath lab in Mount Sinai but I will like to have children in the near future. Would there be an issue, and how would you judge the radiation exposure??

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