Hey Cardiac NP - talk to me!!!

Columnist · Feb 4, 2007

I hope someone responds, as I also am interested in the cardiac NP route. I've seen a real upturn in job opportunities in my area for this particular specialty, and I also think it's a fascinating system to study.

Editorial Team / Admin · Feb 4, 2007

Hi!
After careful consideration, I have pretty much come to the conclusion that I want to be a cardiac NP. This may seem strange as I am still a relatively new nurse (have a little more than a year of med-surg experience) with very little cardiac experience (I did a 3 month orientation on a tele unit). I only know that the heart is a fascinating system and I did very well in this portion of study back in nursing school. So I am basically wanting to crystallize my conclusion by getting any input from those of you NPs working in cardio. Please, walk me through a typical day, what are your hours like, how much autonomy do you have, what do you like best, what do you like least, etc.
Also, I am wanting to transfer to a cardiac step-down unit within my health system to gain some cardio experience, but I am afraid of ticking off my current manager (weird story). So I am also wondering if doing much of my clinicals in a cardiac-based venue would suffice for later obtaining a job in the field once I complete my ACNP? What are your thoughts?
ANY input is welcomed!!! Thank you so much!
~Cher

Hello, Cher,

If you can get experience in the CCU, especially with hearts, you will fare well later on before going to your APN program as well as after APN graduation.

I hope someone responds, as I also am interested in the cardiac NP route. I've seen a real upturn in job opportunities in my area for this particular specialty, and I also think it's a fascinating system to study.

Yes, semisweetchick, the demands in this area of nursing is allowing many to choose this specialty track.

Here is an excellent article, Advance Practice Nursing in Heart Transplantation, from Medscape (you might have to register - free site).

There are programs for the Adult Cardiac APN as well as the Pediatric Cardiac APN (NP and CNS) as subspecialty of the ACNP.

Some states even allow the APN to practice in cardiac rehab centers.

Good luck with your individual careers.

Advanced Practice Columnist / Guide · Feb 6, 2007

I don't work in cardiology but I had a semester of cardiology rotation during my ACNP training. I had two NP preceptors from 2 different practices. The first one worked for a large private practice cardiology group composed of 14 cardiologists. A handful of the docs are interventional cardiologists and 2 of them are cardiac electrophysiologists. They practice in a well-respected tertiary hospital that touts itself as the leading hospital in the state in terms of cardiac care.

The group had 3 NP's at the time. The NP's have a rotating schedule that involved 3 days in the hospital and 2 days in the clinic during a 5-day week beginning on Monday and ending on Friday. Hospital duties included cardiology consults in the chest pain ER and in-patient units including the ICU's. They also admit and follow patients who are under the cardiology group's primary service. They get called throughout the day by nurses regarding issues with these patients. At the end of the day, the NP's finish their dictation. They basically work 10+ hours a day in the hospital.

In the clinic, the NP's see established patients, counsel them on lifestyle modification, review labs, check trends in vital signs, and adjust cardiac meds including antihypertensives, antiarrhythmics, lipid-lowering drugs, etc. The hours in the clinic tend to be shorther but there were a couple of times when the waiting area was overcrowded with patients and we didn't finish until late. The NP's were salaried, I did not have the nerve to ask how much they made but I could tell they were well appreciated by the cardiologists.

The other preceptor I had worked for a VA Hospital System. She sees patients in the clinic in the morning. She follows their labs, diet, exercise routine, and medications. She does a lot of health maintenance teaching. The patients are compliant with meds because the VA provides these meds free of charge and are even mailed to their home addresses. In the afternoon, she heads over to the cardiac stress lab and oversees the cardiac stress testing of patients there. She interprets initial treadmill or chemical stress EKG's. I didn't spend a whole lot of time with her because by the time I had her, the semester was almost done and I was pretty satisfied with my cardiology rotation.

NurseCherlove · Feb 6, 2007

I don't work in cardiology but I had a semester of cardiology rotation during my ACNP training. I had two NP preceptors from 2 different practices. The first one worked for a large private practice cardiology group composed of 14 cardiologists. A handful of the docs are interventional cardiologists and 2 of them are cardiac electrophysiologists. They practice in a well-respected tertiary hospital that touts itself as the leading hospital in the state in terms of cardiac care.
The group had 3 NP's at the time. The NP's have a rotating schedule that involved 3 days in the hospital and 2 days in the clinic during a 5-day week beginning on Monday and ending on Friday. Hospital duties included cardiology consults in the chest pain ER and in-patient units including the ICU's. They also admit and follow patients who are under the cardiology group's primary service. They get called throughout the day by nurses regarding issues with these patients. At the end of the day, the NP's finish their dictation. They basically work 10+ hours a day in the hospital.
In the clinic, the NP's see established patients, counsel them on lifestyle modification, review labs, check trends in vital signs, and adjust cardiac meds including antihypertensives, antiarrhythmics, lipid-lowering drugs, etc. The hours in the clinic tend to be shorther but there were a couple of times when the waiting area was overcrowded with patients and we didn't finish until late. The NP's were salaried, I did not have the nerve to ask how much they made but I could tell they were well appreciated by the cardiologists.
The other preceptor I had worked for a VA Hospital System. She sees patients in the clinic in the morning. She follows their labs, diet, exercise routine, and medications. She does a lot of health maintenance teaching. The patients are compliant with meds because the VA provides these meds free of charge and are even mailed to their home addresses. In the afternoon, she heads over to the cardiac stress lab and oversees the cardiac stress testing of patients there. She interprets initial treadmill or chemical stress EKG's. I didn't spend a whole lot of time with her because by the time I had her, the semester was almost done and I was pretty satisfied with my cardiology rotation.

Wow! Thank you PinoyNP! That was just the kind of info I was looking for - the day to day life of a cardiac NP. Now I just have to really stop and consider if this is indeed what I want to do for the rest of my working life (and I think it is). I have read a couple of replies you've made to other people on this forum before, and if I recall...you are a cardiovascular NP?? Interesting choice definitely. I think I also recall that you seem pretty happy with your choice as well, and that is awesome to hear. I hope you continue to thrive in your life and profession. Thank you again for sharing your observations.

NurseCherlove · Feb 6, 2007

Hello, Cher,
If you can get experience in the CCU, especially with hearts, you will fare well later on before going to your APN program as well as after APN graduation.
Here is an excellent article, Advance Practice Nursing in Heart Transplantation, from Medscape (you might have to register - free site).
Some states even allow the APN to practice in cardiac rehab centers.
Good luck with your individual careers.

Siri...thank you for the info - I plan to read this when my brain is not too fried (just got home from a very long shift!). Also, after thinking about it more, I think you are right, that CCU is probably the best experience vs. cardiac step-down.

Editorial Team / Admin · Feb 6, 2007

You are welcome, NurseCherLove!! Good luck.

Advanced Practice Columnist / Guide · Feb 6, 2007

...not a problem. Good luck to you!

I am actually not a cardiovascular NP per se. I work in a Cardiothoracic Surgery ICU setting as an NP under the intensivist service. Our clients are cardiac and lung patients who have undergone surgery. There are many similarities with the medical managment of our heart patients and those who are seen by the cardiologists. But the fact that patients' hearts have been subjected to surgery such as CABG, valve repair/replacement, or aneurysm removal, there is an added dimension to the management as the heart physiology is severely altered. It is not uncommon to see temporary heart pacing, use of IV inotropes and pressors, IABP, etc. in our setting which are commonly not seen in typical cardiac patients with the exception of those who are in CCU.

I agree with Siri that if this is something you wish to pursue, you should explore working in CCU, cath lab, or EP lab. You will be more marketable in this field if you do that.

MissBehavin · Feb 4, 2009

...not a problem. Good luck to you!
I am actually not a cardiovascular NP per se. I work in a Cardiothoracic Surgery ICU setting as an NP under the intensivist service. Our clients are cardiac and lung patients who have undergone surgery. There are many similarities with the medical managment of our heart patients and those who are seen by the cardiologists. But the fact that patients' hearts have been subjected to surgery such as CABG, valve repair/replacement, or aneurysm removal, there is an added dimension to the management as the heart physiology is severely altered. It is not uncommon to see temporary heart pacing, use of IV inotropes and pressors, IABP, etc. in our setting which are commonly not seen in typical cardiac patients with the exception of those who are in CCU.
I agree with Siri that if this is something you wish to pursue, you should explore working in CCU, cath lab, or EP lab. You will be more marketable in this field if you do that.

Could you tell me more about th details of what you do working in the cardiothoracic surgery area. I would love to know what your job entails, if any of you first assist ect. I have one year on a thoracic tele floor (lots of lung transplants) some time on cardiac tele and CVICU, and now trauma ICU. I have a love for this because I underwent open hear on bypass for a clot in my Right atrium (which turned into a pulmonary artery embolectomy with PFO closure). Ever since I have had a love for this field.

Advanced Practice Columnist / Guide · Feb 6, 2009

Could you tell me more about th details of what you do working in the cardiothoracic surgery area. I would love to know what your job entails, if any of you first assist ect. I have one year on a thoracic tele floor (lots of lung transplants) some time on cardiac tele and CVICU, and now trauma ICU. I have a love for this because I underwent open hear on bypass for a clot in my Right atrium (which turned into a pulmonary artery embolectomy with PFO closure). Ever since I have had a love for this field.

I work under the hospital's Division of Acute and Critical Care Surgery. We are part of a group of surgical intensivists and NP's who staff the Cardiothoracic Surgical Intensive Care Unit. We are involved in the immediate post-op management of cardiac and lung surgery patients and occasionally, the NP's cross-cover when the patients get transferred to the floor. As we are not under the Division of Cardiothoracic Surgery, we do not assist in the OR.

Some of the NP's in our group have previous experience in first assisting including saphenous vein harvesting but have preferred to stay in the ICU now. I am currently precepting an ACNP student who happens to be an RNFA for the cardiothoracic surgeons at another hospital system. There are quite possibly NP positions out there where your job may involve working across the spectrum of OR, ICU, and floor management in cardiothoracic surgery.

Joe NightingMale, MSN, RN · Feb 7, 2009

Hi!
After careful consideration, I have pretty much come to the conclusion that I want to be a cardiac NP. This may seem strange as I am still a relatively new nurse (have a little more than a year of med-surg experience) with very little cardiac experience (I did a 3 month orientation on a tele unit). I only know that the heart is a fascinating system and I did very well in this portion of study back in nursing school. So I am basically wanting to crystallize my conclusion by getting any input from those of you NPs working in cardio. Please, walk me through a typical day, what are your hours like, how much autonomy do you have, what do you like best, what do you like least, etc.
Also, I am wanting to transfer to a cardiac step-down unit within my health system to gain some cardio experience, but I am afraid of ticking off my current manager (weird story). So I am also wondering if doing much of my clinicals in a cardiac-based venue would suffice for later obtaining a job in the field once I complete my ACNP? What are your thoughts?
ANY input is welcomed!!! Thank you so much!
~Cher

Glad you started this thread. I'm not an NP...not even a nurse yet...but I'm considering the same route. I'm hoping to go Telemetry--CCU--Cardio NP

DaisyRN, ACNP · Feb 8, 2009

i posted this in a few other messages, but i copy/pasted here for you...

i'm an adult (ages 12 and up) acute care np in cardiology.

my days go like this:

m-f 7:30a-10:30 (give or take) - supervision of stress testing at hospital

m-f 11-whenever (usually 2-5pm) - i see clinic patients (hospital follow ups, chf patients, etc.) and because i'm still in this "orientation window," i'm not seeing a whole lot of patients on my schedule yet. today, i saw 8 which was higher than average for me, but i was seeing another physician's clinic patients because he was tied up at hospital today. i am usually the go-to person for someone that calls in having problems because my schedule is more open than most of the mds. the docs like that aspect of my being there. plus, the patients like knowing they dont have to rush to the er for every little thing if someone is available to them in the office.

mixed in during the day, but usually isolated to the mornings, i follow our inpatients with my supervising physician. he normally splits up his list patients for me to see and he sees the rest... then we discuss at clinic (sooner if i have questions/problems) and i write orders, discharge planning, interpret testing, etc. the new thing for us is weekend call, where i don't take actually nurse or er calls, but i am in the hospital doing rounds on all the patients left from the previous week so the on-call doctors don't have to do it, usually around 10-12 patients max.

i love my job. i get lots of variety in clinic and hospital... love it.