Nursing Aide to begin in Cardiac

ChristineN, BSN, RN · Jul 19, 2008

I started out as a PCT on a cardiac/med-surg floor. I learned alot there, and thought it gave me a good foundation. My floor got alot of general medical, and some surgical pts as well, and I personally always enjoyed seeing the variety, but your floor might be more strictly cardiac. I got very good at the protocals for post-cardiac cath, post-angiogram, CHF, as well as seeing what the nurses were assessing for in various cases (ie CHF pt might be edematous). As a PCT, you'll probably be keeping very accurate I&O, especially on your CHF'ers, and monitoring all your cardiac pts vital signs fairly regularly. Plus, I'm sure you'll see diabetes, COPD, and other diagnosis that are common in adults. That means frequent blood sugars and pulsle ox's.

Sometimes I kind of miss my old cardiac floor, but I'm glad I started there. :)

AishaMousgoy · Jul 27, 2008

Hi! I am a PCT on a cardiac floor. I was hired in late April of this year, just after I passed my CNA state test. I had no prior experience as a CNA. My only experience to speak of was that I was a health education volunteer in the Peace Corps. I am so grateful that I was hired, and I have been working so hard to prove that the unit made a good decision in hiring me. I love my job. That said, it can be very stressful. I was in orientation for a month, which was great, but there are still things that I would like to feel more confident doing. This might sound strange, but the PCTs on my floor are the ones who pull femoral sheaths post procedure (cardiac catheterization). There is always an RN in the room with the PCT during a sheath pull. The RN's job is to monitor the patient for vagal response, and chart vitals every five minutes until hemostasis has been achieved. We PCTs pull both arterial and venous sheaths. This is definitely the most stressful and difficult task that I do. On a typical day, I usually do about three separate sheath pulls. I really enjoy sheath pulls, but I do get nervous before doing them. Kinda like stage fright...

Are there any other PCTs/CNAs out there that pull sheaths?

I was taught to use manual pressure, and occasionally use the E-Z Hold if the patient is either very obese or their femoral pulse is very deep. I wonder if I will start to develop Carpal Tunnel Syndrome? I heard that can happen to people who pull sheaths, since we put so much stress on our fingers and wrists.

ChristineN, BSN, RN · Jul 27, 2008

Are there any other PCTs/CNAs out there that pull sheaths?
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Wow, I've never heard of PCT's doing sheath pulls before. On the cardiac floor I worked on, we did not get the sheath pts, we just got those that had caths and angios without sheaths. And vital signs q5min? Our hospital protocal was Q15min for 1hr, then Q30min for 2hr, then Q1hr for 4hr. I believe this was the same policy for pts with sheaths.

Virgo_RN, BSN, RN · Jul 28, 2008

the PCTs on my floor are the ones who pull femoral sheaths post procedure (cardiac catheterization). There is always an RN in the room with the PCT during a sheath pull. The RN's job is to monitor the patient for vagal response, and chart vitals every five minutes until hemostasis has been achieved. We PCTs pull both arterial and venous sheaths.

:eek: :eek: :eek:

casi, ASN, RN · Jul 28, 2008

Are there any other PCTs/CNAs out there that pull sheaths?

Whoa. I'm a CNA on a cardiac floor and the only people who pull sheaths are ICU nurses. Once the sheath is pulled and the patient isn't bleeding all over the place they come to us.

To the OP I'm happy as heck I'm working on a Cardiac Floor. It's simply fascinating.

Virgo_RN, BSN, RN · Jul 28, 2008

CNAs on our floor aren't even allowed to remove peripheral IVs (which I think is ridiculous). I cannot imagine allowing a CNA to remove a sheath. On our floor, the RNs are trained to do sheath pulls.

AishaMousgoy · Jul 31, 2008

Yup, it's true! I pulled three sheaths today in fact. Two were post-stent procedure, so the patient had been receiving IV blood thinner (angiomax), and one was post-diagnostic, so no IV blood thinner was given. I think sheath pulls are fun, for the most part! I did one EZ-hold and two manual pressure.

AishaMousgoy · Jul 31, 2008

On our floor, we have a lot of traveler nurses, and so they are not able to pull sheaths (because they aren't certified by our hospital). I know it sounds strange, but our system works really well! The PCTs on my floor are absolutely fantastic! I remember my first day, which was three months ago. I was shadowing one of the PCTs and when I saw her do a sheath pull, I started feeling faint, and had to leave the room so I didn't pass out! Now I do them myself, and I feel fine! I think I was really nervous and hadn't eaten much that morning. I still laugh about it with the nurses who were there that day... :)

Virgo_RN, BSN, RN · Jul 31, 2008

I see that you are a CNA. No offense intended, but I think it's nuts to have CNAs pulling sheaths, even with direct RN supervision. I am really surprised that the Washington BON even allows this.

1TachyRN, RN · Aug 3, 2008

MrsCD-

I really enjoy cardiac nursing, so of course I'm going to say that it is a good unit! Don't be afraid to ask questions (at appropriate times, of course) and show that you're willing to learn and you'll do well.

AishaMousgoy-

Regarding PCTs/aides pulling sheaths, YIKES!!! At my facility only RNs pull, and we have to be certified. Plus, not one, but two nurses must be present when the sheath comes out.

I'm sure that you're an excellent CNA, but sheath pulls are out of your scope of practice even with an RN in the room since it requires continual assessment.

Tippy-ta-ta · Aug 3, 2008

:heartbeatI worked ICU for 5 yrs at a by-pass hosp...you WILL learn alot. I loved it.