Considering switching to Cath Lab (a non-RN position)

[BeatsPerMinute, BSN, RN]

I have an interview coming up soon for a cardiac interventional (cath) lab position that I am really excited about. This particular position is a little different from what I have heard about most cardiac cath labs hiring RNs and am hoping to get a little clarity on a couple of things..

I have been a nurse for 5 years and work in a large teaching hospital (cardiac ICU and post procedure recovery for Cath/EP/IR labs). While working in the post procedural/recovery area I have been able to shadow in the labs and had so much fun being there. The technology in the labs is fascinating to me. The team is phenomenal. I talk to the cardiac invasive specialists (CIS) techs regularly and have been told by several that I should come switch over to work in the labs. I don't love bedside nursing and really think working in the labs could be a better fit for me.

After thinking about it for a few months (and continually picking the techs brains) I applied for a cardiovascular invasive specialist 2 position. I passed the initial screening, met with an educator for an informational interview, and now a formal interview has been scheduled. I learned that if I were offered the position that my job title would change from RN to CIS. They do not hire "Cath Lab RNs" and instead hire RNs to become CIS (through direct training, formal classes, and eventually testing for RCIS certification). It was explained to me that they need RNs in the labs and want RNs and CIS to educate one another so that we may blend/share roles (to promote teamwork / avoid potential role conflict, such as "you are the CIS so you need to do this" or "but you are the RN and RNs do that, not CIS" sort of stuff..). It sounds like a great set up. I love to learn (and teach!) and so this all appeals to me, too.

CIS base pay is better than RNs in my facility, so my pay would increase to match CIS with the title change (another plus!). There are call requirements, but the pay is great (and still beats the constant day-night-day rotating that I did for 3 years on ICU, lol).

I feel like this may be obvious & silly to ask... but I am wondering that if I were to get the job, would I still be able to keep my RN license active since my job title would to change to CIS? If my RN license went inactive, is it difficult to reactivate it? I am a little naive on how this works and mostly ask to so that I fully understand what the job change would mean for me career wise.

Any advice / other things I should take into consideration before deciding whether or not I should take the position if offered would be greatly appreciated!

(In case its relevant, I have my BSN, CCRN, and work in VA state).

Thank you!

[traumaRUs, MSN, APRN]

Hmmm...this sounds weird to me. So they hire RNs and then rename them something else?

I don't get the "teamwork idea" either. CIS and RNs should work together but their titles should reflect their licensure. If "teamwork" and "everyone called the CIS" then heck, lets call the doctors, perfusionist, housekeeping all "CIS" and then voila everyone is the same. IMHO this is not "teamwork" at all but rather a weird way to cut RNs out of the workplace.

[BeatsPerMinute, BSN, RN]

That is what they used to do, unfortunately it hasn’t worked out well.

From what I understand - they used to hire RNs, and turn over was high. RNs grew upset once they learned that their pay was less than CIS. And again, there were “issues” over who does what - I imagine if they were short CIS or RN, either side would feel burdened and overworked, and felt lack of help from the other, because of “that is out of my scope” or “that’s not my job,” like responses, leading to breakdown in teamwork, burnout and high turnover.

It seems like retention is an issue everywhere, with the trend of hospitals trying to cut costs (hire fewer staff) and nurses leave bedside to travel, go back to school, etc...

I haven’t seen RNs in cath lab in the 5 years I’ve worked at my hospital, no current postings for hiring Cath Lab - RN exists in my hospital either, so they cut them awhile ago. Unfortunately that has forced CIS to take on the traditional RN responsibilities, and that now contributes to CIS work stress and then over. Travelers are expensive, constant retraining isn’t making current staff very happy.

So, they are trying this instead: hiring nurses to be CIS. CIS will train the RN to take on CIS roles and RNs will educate CIS so they’re more comfortable. We will all be paid the same. We will all work under the same set of rules. So far the staff have seemed happier with this set up. Again, Ive always like technology so I would be excited to learn CIS.

I’m an introvert, bedside leaves me feeling worn out daily with constant interaction with many many different people all day long.. I don’t hate it, it just wears me out.. ICU was a good fit (same patients and MDs worked better for me) but high turn over, bad schedule, constant rehiring of new grads, (and babysitting overconfident new grads ...not paying attention to their vasopressor bags running dry... freaking out at every alarm...) politics, cost cutting (our supplies and resources were literally cut in half in all ICUs in my hospital and their sister hospitals), and other things pushed me away (it’s long story...). In summary, lots of unnecessary stress was added in a naturally stressful environment. Anyway, I wanna try something different.

As for the lab set up- they SHOULD just hire more staff - RNs and CIS. But again, hospitals are more business oriented these days and proper staffing is an issue everywhere. What do?

Again, I’m just concerned about maintaining an active RN license if I were to take the job. I am optimistic that I’ll enjoy the work, but you never know, maybe I won’t wanna do it forever and wanna return to nursing in the future. I’m a baby nurse with only 5 years under my belt. So I wanna know if keeping an active RN license possible if I do take this job. If that’s not possible, then fine. Or if I would have to take a nurse refresher course, retake NCLEX , etc, then that’s also fine. I just wanna know. Maybe I won’t ever return to nursing and stay CIS. Maybe it’ll turn out to be a better fit than nursing. Won’t know till I try it ?

[traumaRUs, MSN, APRN]

If you aren't working as an RN then obtaining enough hours to relicense in your state would be impossible as you would then not be working as an RN.

Personally, this sounds like a liability nightmare - you all will do the same thing even though you are a licensed RN?

In my area, RNs are RNs and unlicensed assistive staff are just that, not RNs. Healthcare is a team environment - there are RNs, LPNs, CNAs, APRNs, MDs, etc - we should all be respected and we should all work together. Just changing my title to CIS doesn't mean I'm not still an RN with a wider scope of knowledge.

The hospital is just trying to cut corners