ICU for EP Lab?

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Specializes in Tele/Interventional/Non-Invasive Cardiology.

Hello all,

I’m a nurse who has two years of experience with EP/Cath post recovery. We took STEMIs, drips, etc. We were a PCU level Cardiac Intervention Unit. For the past year, I’ve been working outpatient stress lab.

I love EP and it is my passion. I have a phone interview for an EP position. All the jobs I see require ICU or ER experience. And I wanted to know why? On my old unit, a couple nurses transitioned there with no ICU experience.

Also when there was an emergency in the EP lab, the nurses would call a Rapid Response. Hell, I even had them transfer a post procedural patient from the EP lab for me to manage during a rapid response! So why ICU experience? Does this put me at a disadvantage? Any thoughts are greatly appreciated!

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I believe that we do require ICU experience but, I feel that almost all of EP is learned on the job. I'm also an EP nurse and I can tell you that after 17 years of working in an open heart ICU, I was lost in EP.

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EP is an animal that stands on it own. ICU or ER experience goes hand in hand just because the pts we get are sick, they might have a lot of disease processes and you need to be able to understand what is going on with the pt as a whole and what things can be affected. but its not required. it depends on the hospital.

and yes i agree EP will makes you feel as though you are lost but with time things start to piece together and you begin to understand why that person is getting an ablation. closing a PFO, putting a PPM. it might seem as a simple matter because drips are not being managed or pts are not on vents but think about the electricity of your heart its is literally the generator that makes sure things are running. if its not functioning right, there is no way it will have the right conduction to run smoothly.

EP is a mix or critical care, Surgical services, Cardiology, just to give you a rough surface overview. and there are specific EP things are are learned on the job.

in terms or managing a rapid in your holding area, great you were managing a pt that needed help! its not that EP cant do it. it perhaps occurred in transit once the procedure was done. when ever a pt de-compensates codes are in place to help the pt stabilize good job in helping stabilize those pts or even save them, that is the beauty of being a nurse.

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They want ICU/CCU experience so you have a good foundation of everything cardiac. Drips, 12 leads, anatomy, ect. in addition to good nursing skills. Some of our patients come from the ICU and you are expected to deliver the same quality of care along with the expertise of electrophysiology. We've had patients code on the table when PPM or ICDs are going in and it helps to remember your ACLS training. The thing that will take a year is getting comfortable reading EGMs and learning what the catheters are telling you.

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@MusicGuy I looked at some of your posts, most pertaining to EP, would it be ok to PM you? I'm an EP nurse as well i'd love to pick your brain about some stuff.

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19 hours ago, MiaGirl said:

@MusicGuy I looked at some of your posts, most pertaining to EP, would it be ok to PM you? I'm an EP nurse as well i'd love to pick your brain about some stuff.

Absolutely! If there's anything of my brain left after a 14 hour shift, it's yours!

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On 1/30/2020 at 2:28 PM, MusicGuy said:

Absolutely! If there's anything of my brain left after a 14 hour shift, it's yours!

MusicGuy, how does the EP Lab differ from regular Cath Lab? Are they two separate areas, or it depends on the facility? I work CL and am considering applying for EP at a different facility, however I have no idea what it entails.

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I work in the CL as well, most of our staff is cross trained. So, that aspect will be easier for you. I didn't have any CL experience when I was hired, and had to learn it in addition to EP. You need to read daily, and it takes at least a year to feel confident in EP diagnostic abilities. Daily EP duties fall into 2 categories in our facility and I suspect at most others as well.

First is pacemaker and ICD placement. There are two types, the traditional, in which a pocket is made, leads (wires) are screwed into the atria, ventricles and sometimes CS (for a bi-ventricular pacer/ICD). This is fun because you learn sterile technique and it resembles and operating room scenario. The other group is leadless pacemakers and left atrial appendage occlusion devices, both of which are inserted via a large bore catheter into the RV. In the case of a watchman or LAAO, transeptal into the LA.

The second job requires ablations and diagnostic electrophysiology. Catheters that are placed into the various chambers (RA, RV, CS and his bundle). The EGM displays the signals they generate. It takes a while to learn the standard EP study. It's fascinating because we get a complete look at the heart's electrical activity. The heart is physically mapped via a computer, and shows electrical activity in real time. This is how the Dr knows where to ablate. The neat thing is that there are different techniques for each of the arrhythmias. If like to read and have a basic understanding of electricity, I recommend making the switch to EP.

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