I started doing ECMO in 1991. I had 5 years of adult ICU experience and 1 year of NICU experience. I moved to the combined PICU/CICU in 1993 and continued to do ECMO until 2001 when I took a management position. I started to do ECMO again almost two years ago when I left management. It is a huge responsibility. You must make sure you feel adequately educated and trained. Your patient can die in seconds if something goes wrong...and if you do it long enough, something will. You have to be ready to act autonomously and in an instant, because in most centers, there is not a perfusionist at the bedside. That being said, ECMO allows you to use your nursing skills to the fullest. It can be very rewarding and very sad. You become very close to the parent's of the kids. Make sure you are sure you want to do this. I suggest you spend a shift with an ECMO patient and really question the ECMO specialist about the responsibilities, training and ongoing education in your institution.