MusicGuy

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!

There's not many EP RN's! Mostly because there are few educational programs available, and most of us learn on the job which takes years. I've been in EP almost 3 years. I like it enough to stay. I would say if you like details and physiology, then go into it. Everything is in milliseconds and time in between catheters that are placed throughout the heart. We break up the PR interval in 3 pieces and study exactly how long it takes a signal to go through the AV node to the perkingies. It helps to have an understanding of electricity (e.g. Ohms law and how it behaves). I would spend a couple hours in one and see if you like it. The workflow is divided into two parts, ablations (creating scare tissue to correct an arrhythmia) and pacemaker/ICD placement. Ablations are not as immediately satisfying as caths when you open up an LAD during a STEMI. Sometimes take hours to study and ablate, especially PVC and afib ablations. The other half is CRM when you put in pacemakers. Single, dual, Bi-ventricular or leadless, they all improve a patient's cardiac output. What I like most is that we perform one of few procedures in which a patient can come off meds afterwards. It is one of the areas of healthcare that fixes a problem instead of leading to the use of more medication. Not that this is a factor, but good to know - the field is growing and number of procedures monthly are expected to increase 10-20% per year. We are a very busy lab and personally say I've seen this happen. If you ever want to talk just send a PM. I'd be happy to answer any your questions.

I work in the CL as well, most of our staff is cross trained. So, that aspect will be easier for you. I didn't have any CL experience when I was hired, and had to learn it in addition to EP. You need to read daily, and it takes at least a year to feel confident in EP diagnostic abilities. Daily EP duties fall into 2 categories in our facility and I suspect at most others as well. First is pacemaker and ICD placement. There are two types, the traditional, in which a pocket is made, leads (wires) are screwed into the atria, ventricles and sometimes CS (for a bi-ventricular pacer/ICD). This is fun because you learn sterile technique and it resembles and operating room scenario. The other group is leadless pacemakers and left atrial appendage occlusion devices, both of which are inserted via a large bore catheter into the RV. In the case of a watchman or LAAO, transeptal into the LA. The second job requires ablations and diagnostic electrophysiology. Catheters that are placed into the various chambers (RA, RV, CS and his bundle). The EGM displays the signals they generate. It takes a while to learn the standard EP study. It's fascinating because we get a complete look at the heart's electrical activity. The heart is physically mapped via a computer, and shows electrical activity in real time. This is how the Dr knows where to ablate. The neat thing is that there are different techniques for each of the arrhythmias. If like to read and have a basic understanding of electricity, I recommend making the switch to EP.

Absolutely! If there's anything of my brain left after a 14 hour shift, it's yours!

Skillstat!

They want ICU/CCU experience so you have a good foundation of everything cardiac. Drips, 12 leads, anatomy, ect. in addition to good nursing skills. Some of our patients come from the ICU and you are expected to deliver the same quality of care along with the expertise of electrophysiology. We've had patients code on the table when PPM or ICDs are going in and it helps to remember your ACLS training. The thing that will take a year is getting comfortable reading EGMs and learning what the catheters are telling you.

I would caution against nights unless you're seriously OK with being up all night. I started on nights and found that not too many happy people were around to answer questions, but your situation may be completely the opposite. Also ask yourself if you can learn while sleep deprived. Another thing to consider is that there is much less physician interaction on night shift. I learned the most on days when I was able to discuss plan of care and find out exactly what the physician wanted for a patient and why. 6 weeks is crazy if your patients post CABG or thoracic surgery. You'll have to learn about chest tubes, pacers, wire care ect. If you do take the job, I recommend to read as much as possible.

Congrats on the new job! I recommend becoming familiar with the process. Your patients might come back with an arterial sheath still in the groin. The art of pulling is fairly straight forward. Hold pressure for 20 minutes, gradually easing off after the first 7. However, closure devices are very popular and quickly deployed in the lab. The biggest danger is a hematoma or bleed at the femoral site. Depending on the doc, radial access is becoming popular due to lower risk of bleeding. Cath lab recovery has a much different work flow than a floor. You might love it, but even if you hate it learn everything you can and transition into the lab. Several at our facility have one that and love their job.

Yes, understanding is the key word. I'm week 5 in an EP lab and it's a big learning curve to simply read intracardiac ekgs, let alone interpret the pathways and jumps. Most RN's are unaware that there are 2 separate pathways in the AV node!

I was thinking the same thing! And little jealous too. I wish I had had a more involved preceptor during my orientation. I'm surprised most managers don't see this as a crucial role.

This was my path and I'm glad I did it. I started as a unit secretary and learned what labs and orders are used on different patients and why. Then I became a CNA and learned my rhythms and how to interpret a 12 lead. The only caveat here is that the job is extremely important. It's easy to get on the bad side of a nurse during busy times and when things go south. Keep focused on the patients first and RN's second!

As disturbing as the video is to watch, it baffles me that a security guard just stood and watched. Security officers are also mandated with protecting rights of patients in addition to rights of fellow employees. Clearly two people's rights where endangered. Why is the RN the only one who stood up? And why did security do nothing but watch?

RRT's prevent code blues! I'd rather have the RRT if my patient is not doing well.

Removed

Making them happy is doing them a disservice, and I would explain it that way. A jester can make them happy, but what our patients deserve is to be happy AFTER they leave us!