New to cath lab---advice please!

Specialties Cardiac

Published

Hi all,

I'll be starting in the cath lab in about six weeks and would like to hear from experienced cath lab RNs about how best to prepare for this role.

I have been an RN for 13 years, 11 in the ER and 1 year in a CCU/ICU about ten years ago. While I am comfortable in just about any emergency, I know I need to brush up on more advanced cardiac skills.

The cath lab I'll be working in does just about everything (cardiac, neuro, peripherals) and has an EP lab. They also employ CVTs.

Walk me through a day in the cath lab and tell me how I can best prepare myself. I would appreciate any resources you think would be helpful. I am very excited by this career change but also a little intimidated by all I'll need to learn. Where do I start?

Thanks in advance!

Christine !https://allnurses.com/forums/images/smilies/dance.gif

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The cath lab is a very differant place to work . I love it ! In my lab we rely on each other as an extension of each other. Every position is rotated( scrub,circ and monitor) , I work with cvts, rrt, rns. . Believe it or not it works great. There is no other place I would rather work>

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Specializes in Cath Lab, ICU's, Pediatric Critical Care.

Hi Christine,

I've been a Cath lab/EP lab nurse since '91. I've worked in 2 other labs. The work and responsibility can vary from lab to lab and state to state. The other labs I've worked were a bit different than where I'm at now. Here's some basic info on what I do now.

6:30-7am: Come in to holding area to check schedule. Nurses can start 'self' assigning themselves to cases, unless the charge nurse has changes she needs to make. We have 1 charge nurse, and then another nurse in the holding area. If a nurse doesn't have a case immediately, she can pick an empty room and start checking equipment and stock, help other staff, etc. We work Mon-Fri, and our first case is at 6:30 am. The nurse who was 'on call' the night before comes in with her team at 6am and does the first case.

The charge nurse helps coordinate who's doing what cases and how the lab flows, and directs what teams are taking the next cases as they come up. We do a variety of cases: cardiac, EP, vascular. The usual shift ends at 3-3:30, with the call nurse/team and the charge nurse staying to finish cases. The 'on call' nurse/team covers call till 6am the next morning. Teams are 1 nurse/2 xray techs.

Cardiac cases can be right and left hearts/diagnostic, interventions, emergencies, IABP's, temp pacers, etc. EP can be EP studies, Ablations, Pacers, defibrillators, Bi-V's. Vascular cases can be diagnostics and/or interventions mostly legs, renal grafts, carotids, IVC filters, Ashcaths, thrombolysis, etc.

Nurses look over the chart, check the labs, quickly assess the patient, log their info into the computer...we have our own 'desk' area with computer terminal and quick access to equipment. Our tech on the computer is responsible for logging everything not nursing related. Our techs do all the scrubbing. We pull meds for the patient, help set them up on the table prior to prepping, mix fluids, check the IV, all while talking and reassuring the patient. During the case we give IV conscious sedation, monitor the patient, watch the monitors, watch the fluoro images, gather any equipment as needed, anticipate what is coming next and what could go wrong, communicate with the other members of the team. More is involved, esp. if it's an intervention or IABP. After the procedure we gather paper work for the MD, finish our charting, assist the techs as needed. Instruct the patient for post care and give any explanations of what was found, etc.

Patients go to holding and stay only if they are admitted, otherwise they go back to their previous room. Their time in holding varies depending on how quickly we get inhouse beds. Everyday can be different depending on how it's scheduled. Some days can be very long and hectic and difficult to get through. Just remember to look at your patient and think 'this is why I'm here'...

There are lots of us out here that could give you tons of info....best of luck!:up:

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The cath lab is a very differant place to work . I love it ! In my lab we rely on each other as an extension of each other. Every position is rotated( scrub,circ and monitor) , I work with cvts, rrt, rns. . Believe it or not it works great. There is no other place I would rather work>

sorry off topic but when you scrub do you pan the table and II? i ask because i've been told only rrts and rcis are the only ones can pan.

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Specializes in Cardiology, Critical Care, Cath Lab.

Welcome to the Cath Lab....

I have been a cath lab nurse for a few years now..both as a traveler and a staff nurse in several states.

I thought I would recommend a couple of things to you. First is a great reference book.

It is called The Cardiac Catheterization Handbook by Morton Kern MD. It is an invaluable reference for cath lab staff.

http://www.amazon.com/Cardiac-Catheterization-Handbook-4th/dp/0323022472/ref=sr_1_1/181-0260180-4490015?ie=UTF8&s=books&qid=1264737499&sr=1-1

Second I highly recommend you subscribe to "Cath Lab Digest" it is a free magazine that keeps you up to date on cath lab changes.

http://cathlabdigest.com/Cath-Lab-Digest-Print-Subscription-Form

You are going into an area with constant change.....best wishes on your new job!!!!

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Specializes in MICU - CCRN, IR, Vascular Surgery.

I'm going to be a nurse intern this summer in the pre and post cath lab area so I'll check out those links! Thanks for the great information!

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Specializes in Critical Care, Cardiac Cath Lab.

I definitely agree with CathLabNursePA's recommendations. I own that book and also subscribe to Cath Lab Digest. Studying for the CCRN and CMC exams were another great way to increase my knowledge in this specialty area. Cath Lab is the BEST place to work in nursing! :)

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