New Grad in Cath Lab... any tips or advice?

Specialties Cardiac

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Specializes in Cardiac Cath Lab.

Hi everyone!

I just accepted a position as a new grad into a cardiac cath lab residency program and I couldn't be more excited! However, perhaps naturally, I am also terrified! I don't know what I don't know, and I want to come into this role as prepared as I can be as a new grad. I have a vague description and idea of what my days in the cath lab will be like (I do have 3 years of surgical tech experience), but anyone who has any descriptions of day to day life, advice, or tips, would be more greatly appreciated than you will ever know! Thanks in advance! ? 

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It helps to have ICU experience and comfort with critically ill (AKA SAS-sick as snot) patients. You will have to learn ED nursing during STEMIs and provide care to ICU patients when they come down for a cath. It's good to be terrified! A new RN that isn't is dangerous. The teams are usually small, so do your best to listen. One of the best lines I've ever heard is: "Take the cotton out of your ears and put it in your mouth". Start reading Kern's book on catheterization. Congrats and best of luck!

 

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Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

You might ask in the radiology nursing section too... interventional radiology often incorporates cath lab. 

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Specializes in ICU, Cath Lab.

Would you mind sharing what facility you are working in? My current lab is in the early stages of setting up a cardiac cath lab residency program and we are looking to reach out and see what other labs are doing across the country .

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Specializes in Physiology, CM, consulting, nsg edu, LNC, COB.

Suggest you also connect with the interventional radiology nursing association for suggestions, best practices, certification, and all else. They’re very helpful. 

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Specializes in CCL.

Hey there! I am a Cath lab nurse that went in as a new grad.  I've been in my lab for a little over a year now.  I am absolutely in love with the CCL!  I had no previous critical care experience and you don't need any either!  

Here is my best advice:

1. buy a hard copy of Dr. Morton Kern's Cath lab essentials and start reading. Honestly I read it cover to cover a 4 times before I started.

2. Get intimately familiar with cardiogenic shock resuscitation and assessment.  There are great up to date algorithms you can look at from Abiomed they make Impella and they are one of the leaders in this research.

3. Know these drugs like the back of your hand: Fentanyl/Versed, Heparin, Angiomax, Neosynephrine, levo, dopamine, dobutamine, nitro, adenosine, amio, epi, atropine, all CODE drugs, plavix, ASA, Bralinta, Ibutalide, integralin, lido, alll IV anti HTN RX.  That would a be a great start. 

4. Slow is smooth, smooth is fast. Don't rush, don't make mistakes.  Listen, ask questions, but read the room and don't be loud during cases.   

5.  Be very comfortable with manual airway management, RSI, Bipap/CPAP.  Start going over your hemodynamics and what it means when they are out  of normal limits. RA>RV>PA>WP>LV>Ao, LVEDP, 

6.   Know your ACLS REALLY well but understand that in the cath lab we run codes differently than any other unit. sometimes we do stuff that is not in the ACLS class so be prepared for curve ball orders from the doc when thigs go south.

7. Get familiar with normal coronary anatomy and the different view the C-arm gives you.  The more you know what you are looking at the bettter you can anticipate what will come next.

8. The cath lab is a flow state type of arena. There is a flow to the cases and a timing in all of your actions all based on how things develop.  When you understand the flow, things become much easier and its a very smooth process. 

That's what I have for now, let me know what you think and if you have questions I'm happy to answer them! Best of luck keep us updated!

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