Hello! Any Cardiac Cath Lab nurses out there? Questions about how your lab runs...

Esme12, ASN, BSN, RN · May 9, 2011

Any interventional cardiac cath lab nurses out there? If so, do you take call? How often do you have to take call? Do you have to stay at the hospital? How many on your team? Do you "double chart" i.e. does your circulator chart in your hospitals charting system while the recorder charts in the "Mac Lab" or whatever else you use.
I work in a small, urban, diagnostic/interventional lab. I was just curious how other labs have their call schedule. We take call twice a week and have 30 minutes to be at the hospital. We only have three people on our team but I have heard of 4. I think with computer charting 4 call members would be nice. It is too hard to be a circulating RN and double chart in stupid EPIC (the computer charting system we use) We also use Mac Lab to record cases.

It was just 20 years ago and when the hospital I worked for went from a 2 man (1 RN 1 tech) to a 3 man (2 techs 1 RN) call to my urban Cath lab. I was recorder, circulator and nurse. Then when they went to a 3 man I was just circulator and nurse. We too had a 30 min response time. We didn't have computer charting and hand wrote all charting. We were the only cath lab for almost 80 miles. ANYTHING that stuck an artery for including "cut films" (which required film and developing) carotids, aortagrams,artieograms were all done in the cath lab.

ALL balloon work, including peripheral, and "LASER" :uhoh3: was done in the (only) cath lab. Balloon angioplasty was in it's infancy and we disected ALOT of coronary's and did CPR to the OR. :eek: We were called for arteriograms for all traumas, or AAA's. The OR had to be called in for EVERY coronary balloon procedure. They even called us into place Swan's!!! (right heart cath). :cool:

ALL our pressures had to manually written and calculated. We had to figure out all the valve gradients ourselves. We had a printer for lab results, and that was it. Our equiptment would run the pressure wave forms as they were "burned on" the paper by a stylus. We then had to transpose the images ourselves to get gradients. Everything had to be mercury calibrated EVERY time. There was no EP lab or studies ....we did "Bundle of HIS" studies and to look for septal defects wer did "dye curves" with O2 Sats.....estimation of the cardiac output from dye dilution curves using Hamilton's method is time consuming when many curves require analysis.

http://www.anzcp.org/CCP/Instrumentation/Cardiac%20output%20measurement%20by%20indicator%20dilution.htm

http://redtail.net/owc/3.html

The 2 man call was BRUTAL!!!!!! The tech was sterile as was the MD and I would have to do all the monitoring, wave running, and equiptment/catheter retrivial as well as care for the patient. :eek: We complained loud enough and long enough,as did the MD's and surgeons, and they increased us to 3. we were able to go home but there were busy nights I would just go to sleep on the guerney. It was so bad that I would answer my home phone "WHAT!":devil:.

I am trying to remember I think I was on call every third day and "back up call" every third week. I worked my butt off!!!! BUt I loved every minute of it and I learned SOOOOOO much!!! It made me a much better critical care nurse overall.

I can't help you now or know how to guide you........

but I thought I would share a historical prespective........

hmnorwood · Jun 1, 2014

So I know this is 3 years later but I'll reply! I work for a large health network, we have 3 cath labs, we are the main one/largest volume located at our 46 bed heart hospital. We take one night of call per week and every 4th weekend. We have 30 minute call back time, and a 3 person call team made up of one RN and typically a tech and an RT. However it can be any mix of staff so long as there is one RN. We just rolled out Cupid, which is EPICS cath lab system. We were on EPIC and Maclab. We still use MACLAB for hemodynamics and vitals, so right hearts, FFR, etc is in Maclab and Cupid. So yes lots of scattered charting, I wouldn't call it double but its a pain charting some in maclab, some in cupid/epic.

tarotale · Jun 1, 2014

It was just 20 years ago and when the hospital I worked for went from a 2 man (1 RN 1 tech) to a 3 man (2 techs 1 RN) call to my urban Cath lab. I was recorder, circulator and nurse. Then when they went to a 3 man I was just circulator and nurse. We too had a 30 min response time. We didn't have computer charting and hand wrote all charting. We were the only cath lab for almost 80 miles. ANYTHING that stuck an artery for including "cut films" (which required film and developing) carotids, aortagrams,artieograms were all done in the cath lab.
ALL balloon work, including peripheral, and "LASER" was done in the (only) cath lab. Balloon angioplasty was in it's infancy and we disected ALOT of coronary's and did CPR to the OR. We were called for arteriograms for all traumas, or AAA's. The OR had to be called in for EVERY coronary balloon procedure. They even called us into place Swan's!!! (right heart cath).
ALL our pressures had to manually written and calculated. We had to figure out all the valve gradients ourselves. We had a printer for lab results, and that was it. Our equiptment would run the pressure wave forms as they were "burned on" the paper by a stylus. We then had to transpose the images ourselves to get gradients. Everything had to be mercury calibrated EVERY time. There was no EP lab or studies ....we did "Bundle of HIS" studies and to look for septal defects wer did "dye curves" with O2 Sats.....estimation of the cardiac output from dye dilution curves using Hamilton's method is time consuming when many curves require analysis.
http://www.anzcp.org/CCP/Instrumentation/Cardiac%20output%20measurement%20by%20indicator%20dilution.htm
http://redtail.net/owc/3.html
The 2 man call was BRUTAL!!!!!! The tech was sterile as was the MD and I would have to do all the monitoring, wave running, and equiptment/catheter retrivial as well as care for the patient. We complained loud enough and long enough,as did the MD's and surgeons, and they increased us to 3. we were able to go home but there were busy nights I would just go to sleep on the guerney. It was so bad that I would answer my home phone "WHAT!":devil:.
I am trying to remember I think I was on call every third day and "back up call" every third week. I worked my butt off!!!! BUt I loved every minute of it and I learned SOOOOOO much!!! It made me a much better critical care nurse overall.
I can't help you now or know how to guide you........
but I thought I would share a historical prespective........

I know this is old thread but popped up and caught my interest. Anyways, esme good grief that is some extensive nursing experience you had going(or still has). I went to see a cath procedure after work thanks to a friend in cath lab and the best advice cath lab nurses gave me was "go to ICU to get the grounds". I much rather prefer ER than ICU, and probably will join ER. Does cath lab hire from ER nurses at all? I know cath lab is one hell of coveted position and no one ever leaves!

kool-aide, RN · Jun 3, 2014

but I thought I would share a historical prespective........

Esme, you're damn impressive. I'm a new nurse starting in CCU at the hospital I worked as an aide, and I think I'll probably go to cath lab at some point. That experience sounds incredible, thank you for sharing.

Editorial Team / Admin · Jun 3, 2014

tarotale, we have hired from the ED.

Esme, we need to start a "Cath Lab -- Remember When????" thread, lol!

My first cath lab experience, we used an old E for M (Electronics for Medicine) machine, developed the paper ourselves in a dark room (mixed the chemicals ourselves too).

The docs did the valve calculations.

I remember "His" studies.

And mercury calibrations.

And NO sheaths, only catheter exchanges! (8Fr!!)

Developing cine film (and mixing the chemicals) ourselves.

Back to the original question:

I worked Interventional Radiology, but we scrubbed and set up for the caths too.

Had no Interventional Cardiology program till after I left there, so no call for heart work.

Call was for traumas for IR.

Usually one week every three.

Two of us on call.

Sometimes every other week, depending on staffing.

danimal99 · Jun 14, 2014

Hey,

We have a four person call team, two RN's and two techs. We take about 9 days of call per month. Call pay is $2/hr with time and a half if you are called in. We have a 30 minute window to make it to the lab if there is a STEMI. Charting is not bad at all for the RN, basically just medications. One of the TECHs records the case on Camtronics the other is scrubbed in. One of the nurses handles meds while the other circulates. 90% of the time two nurses is overkill and there will be talk of reducing the team to three, then a really bad case will come up and everyone is glad the extra hand was there.

Love the cath lab, best nursing job I have had.

redneknurse · Apr 19, 2018

Some cath labs don't even required critical care experience! Can you believe that? Yes, ER nurses commonly go to cath lab.