Wedgepressure

It depends on the lab. In my last lab RNs could scrub, circulate/ back circulate and monitor. We also suture pockets and place and pull arterial and venous sheaths. In my new lab we can do all the same roles just no sutures or access

Read Dr. Morton Kerns cath lab handbook. Best prep you can do!

Hey there! I went in to the lab as a new grad, no prior experience. I would suggest getting Dr. Morton Kerns cath lab hand book, read it 3 or 4 times front to back before your interview and mention that you have done so in your interview, it goes a long way in your interview. Cath labs want enthusiasm and eagerness to learn in their applicants. If you can show that it won't matter how much experience you have. Besides having ICU and er experiences doesn't make you a good cath lab nurse. I have none and I am the first to take the sickest of the sick patients, it's my favorite case to circulate, vents, drips, MCS, RSI it's all fun! I also scrub and monitor. Being a team player, comfortable with being uncomfortable and willing to be flexible with your job role and continuing to strive to learn more are some great cath lab traits. Good luck!

Oh jeez! That's a lot of stuff to happen! I'll tell you what, you're definitley dealing with a toxic person that should not be percepting. This is not "the industry" this is a crappy person. Anytime I have a student or im percepting a new nurse it's always in good faith, there's lots of really nice cath lab peeps. If your not being treated in good faith you just need to work with a new team or new group that will be OK with you being you and asking questions and not treating you bad because you don't know something. Don't give up, this is a test and you will get through it. Talk with your instructor, explain that you are feeling intimidated by your preceptor and see if there's a way you can be reassigned. Do you rotate with other staff in the lab? Is anyone treating you nicely? Do you change labs or crews ever? What about the manager? Can you write her an email about emsil your going through to set up a meeting? If you can email the manager cc your instructor and see if you can meet with them to work it out. If they are not scrubbing in with you it may be a good sign because that means they aren't scared that you will make a mistake every step of the case. If they are watching you like a hawk it may be because they don't trust your competency. If they let you do the case its because they trust you will be OK. If a student screwed up its on the preceptor to be watching as much as the student. Also this is temporary, your almost done! You don't have to work in this lab when you graduate and you may never see these people again. There is so much opportunity once you're out and you can pick where and who you work for. If you don't like the culture of a lab you can bounce! It's really fun when you work with a crew you enjoy being around. Honestly it doesn't even feel like work imo Haha! Do you have a tutor or someone you can talk with outside of this lab to bounce questions off of? If not DM me and I would be happy to chat with you over the phone or discord or something!

Honestly it sounds like a pretty random case with no definitive answer. I wouldn't lose sleep over it. You didn't do anything wrong and checking a mag level for infrequent PVCs is fine, but 2g mag IV is not fixing his problem imo. This may sound bad, but old people die even if you do everything you can to save them. By 87 that's pretty much a wrap, everyday is a gift and could be your last.

Hi we run 4 man teams in my lab. It's so that we can bill for moderate sedation by having a dedicated sedation nurse.

From your statements on the forum you come off as someone difficult to work with.

Yeah I can understand that. This may be a struggle that you have to work through for the rest of your career. I think how often you take things personally has a lot to do with personality and temperament. Everyone has a hot button and for me, the goal has always been to cool my hot buttons down so that I'm not overly sensitive if someone speaks rudely or questions me. Also one other thing regarding this social dynamic, if someone in ther group finds out that something specifically bothers you that's like throwing chum for the sharks. Try to take every comment with a grain of salt and just try not to take life to seriously. You gotta be your own best cheerleader and send yourself positive thoughts and encouragement before during and after your shift. Everywhere you go people will be testing your knowledge and questioning your decisions until trust is established. So just expect this to happen in most circumstances. And do your best to establish competency and trust early in your working relationships. IDK if any of this helped up keep me updated on how things go!

Here's my opinion for what it's worth: The cath lab is a cliquey place by its very nature. We work on a very close level with our colleagues, the good teams are tight and seamless. The goal during a case is to be thinking what everyone else is thinking all at the same time, often with out saying any words, anticipating needs and thinking 3 steps ahead at all times. Depending on how supportive your team is will determine your experience. If they are not supportive it will SUCK! If they are supportive it will be so much fun! So just know that there are some great labs out there with cool people, but there will always be someone who is competitive and dominant and trying to be the best in the group. Heck there might be 2 or 3 of them. This is the nature of the beast. Your goal is to learn as much as you can, be humble and study study study! Observe how everyone else does things and ask people, who are nice, for help. Don't ask the shark in the grotto l group for help they will eat you! Alos: The lab tends to weed out the weak links. Why, do you ask? Well, because if your lacking knowledge or skill, you are a LIABILITY not an asset. So under high stress circumstances we want to be able to trust that you will be cool, competent, and skilled and to know what the heck is going on and how to fix what ever needs to be fixed without having to ask someone else for help. So my advice is this keep studying, keep learning, stay humble, don't take things personally, don't worry what people think about you, have grace for yourself, do your best and forget the rest. Just remind yourself that when you finish you're geting the Eff out of that lab and finding a more supportive lab with a more fun and supportive crew. It sounds like your doing great, and you just have some lame people bullying you a little bit, it's all good, don't trip chocolate chip! Getting bullied is a thing that can happen and it's an opportunity for you to grow and get tough. You will toughen up and you will get better! Let me know if you have any thoughts or opinions on what I have said or if you have any specific questions about the lab or anything related to cath! Your safe with me ?

Hey there, I would recommend watching the Youtube channel "CCC live cases" it is a monthly live cath lab case Dr.Kini and Dr. Sharma perform from Mt. Sinai NY. They are incredible teachers and it's a great way to start to understand the cath lab process and lingo. Also the channel transradialworld is a wealth of knowledge. Also the channel Dr. Manos Brilakis, he talks really fast but just slow the speed down and he is amazing. If you check these channels out let me know what you think!

If you PM me I will send you a bunch of Good info!

Hi there! Our call is kind of hardcore compared to other labs. We do a whole week straight every 3rd week. We can do anywhere from 0 hrs of call back to 25+hrs. It's very hit or miss. We also take call for all IR procedures. Bigger labs often require much less call. I've seen a day or two every week and one weekend a month. We also run 4 can crews so it makes the call team's very fun and much lower stress than 3 man crews. Some hospitals have bonus incentive programs for MDs if they do a certain number of cases per quarter or yearly so they may be having call teams run at all hours of the night for stuff that could wait till the morning so depending on how your hospital runs you may be working all night on your call days or you could be only going in for emergencies every now and again or a mix of the two.

The CSTs proof of competency and training has nothing to do with a circulating RNs role or responsibilities. If there was a bad outcome, and you were brought in for a depo regarding a CST doing specific procedures outside of their scope all you would have to say is that it is not within my purview as a circulating nurse to know the CSTs scope of practice. Also if the MD signs off on it, it's as if the MD DID it in the documentation. The documentation will reflect that he did it. He will have to answer. The circulator is not responsible in any way. This truly is a non issue, and for the nurse to speak up about this and call out the entire CST staff can hinder the nurses ability to function optimally within the team dynamic. These actions can actually have the reverse affect on the circulating nurse. It can paint that nurse out to be untrustworthy by other staff and often times that nurses practice will begin to be scrutinized and they are at hirer risk for being reprimanded for things that otherwise would not be an issue had they not spoken up about other staff. By being too nosy in other peoples business you can actually make your personal and professional life much more difficult than it needs to be.

Honestly, it sounds like your making mountains out of mole hills. Inquiring about the CSTs scope isn't really in the purview of your scope. To me this really doesn't affect you or your license in any way and it's not even something that needs to be addressed by you.

Gj, it sounds like you did everything really well. Retrograde means the sheath is facing towards the aorta going against ther flow of blood. Antegrade means your going away from the aorta and with the flow of blood, this changes where the hole is in the artery and where you hold pressure. He probably wanted to leave the sheath for 2 hours to get the ACT lower to prevent bleeding, that's a great option. He can disregard her pain all he wants but you should always have a high suspicion for bleed if they are having excessive or referred pain. Pain in the thigh may be a concern for compartment syndrome but that's usually resolved with direct pressure. Retroperitineal bleeds are the doozies. That's what you don't want. Back, flank, abdominal, pubic pain, hard, stiff painful swelling, growing hematomas these are what to look for. If after 20 minutes your still oozing I keep holding pressure. Honestly for a 7F sheath with anticoagulation on board im probably holding for 35 minute post cath if we don't close with perclose or angioseal. Also you can set up pressure dressings with tape if your still concerned but the doc doesn't want a femstop. Great job over all. Also talk with your cardiologist to confirm it's OK to do this, but if you have any question about the access site take the dressing off, put some sterile gloves on and hold pressure directly over the artery. Let me know what you think and if you have any other thoughts!