Cardiac Cath Lab Nursing is one of the specialisms that's not known to many. Some are not aware on how specialised the area is. What does a Cardiac Cath Lab Nurse do? What are their challenges and benefits of working in this unit?
Meet Barry, a Cardiac Cathlab Nurse in the UK. He will share us with his role, his usual day in the unit, including the challenges and perks that comes with the role.
I am Barry, a Cardiac Catheterization lab nurse working in one of the NHS teaching trusts & heart attack centres in London.
I have been here in the UK for a year now. Before moving to the UK, I was a nurse in one of the top tertiary hospitals in the Philippines. Back then, I did not know much about Cathlab. All I knew was that it was an outpatient unit that run 5 days a week, operating the normal office hours. It was not one of the specialist units I thought of pursuing. But this changed when my father had a Coronary Artery Bypass Graft (CABG).
Whilst taking care of my father, I was able to immerse myself to the world of cardiac nursing. I saw how the telemetry nurses took care of my father from preop to post op of the coronary angiogram and bypass surgery. Their work made me appreciate how delicate yet important the heart is and how specialised the required level of care is. I was inspired by these nurses that, a couple of years after, I became one of them. Later on, I was fortunate enough to land a Cathlab nursing role in the same hospital, which I have grown to love.
I initially had no plans of working overseas. I enjoyed my nursing job back home and I was not really keen in applying overseas. But I was encouraged by my trusted colleague to try it out & explore opportunities outside the country. So, I tried and fortunately, I passed and was offered a nursing role in the UK. When I started, I was initially assigned to the vascular ward. I was slightly disappointed as I was hoping that I will have the same role as I had back in the Philippines. I decided to submit a request for transfer and was fortunate enough to be transferred to where I am now- Cath Lab.
My Typical Day
A typical long day shift starts at 7:30 am with the unit hand-over with the outgoing night staff and incoming nurses for day shift, led by the charge nurse. After which, we dispersed ourselves into our respective allocations. I can be assigned to do either a circulating nursing role or a scrub nursing role. As a circulating nurse, I do observations, give medications and prepare the equipment needed for the procedure. As a scrub nurse, I assist the doctor/s in the procedure and maintain the sterile field. Aside from these two roles, I can also be involved in preparing the patient prior to the procedure such as inserting a cannula, obtaining bloods for laboratory testing, administering the needed medications and mentally preparing the patients. I can also be involved in post-op care, from giving discharge instructions, dispensing home medications and posting Cathlab procedure advise.
In terms of the procedural aspect of the work, Cathlab nurses observe and assist in minimally invasive procedures, mainly coronary angiogram/angioplasties and right heart catheterization. Also included are different kinds of pacemaker insertions and removals such as: ICD, CRTD, SCID ;electrophysiology studies, radio-frequency and cryo-ablations of different arrhythmias. Complex cases can include TAVI,PFO/PDA closures, thrombectomy, IABP insertion, temporary pacing wire and sometimes ECMO.
As a Cathlab nurse, we interact with a multidisciplinary team composed of the radiographers, cardiac physiologist who is in-charge of the monitoring all of the procedures, medical representatives, pharmacists and most importantly, the interventional doctors.
Challenges of a Cathlab Nurse
When I arrived here in the UK, adjusting to the country’s standards has been a challenge. As I have been used to the Philippine health care, which is based on the US system, I had to unlearn and learn the UK processes, protocols and even the terminologies used.
Being a Cathlab nurse is not easy. We need to have a strong presence of mind and keep our focus. A small mistake could cause an embolus, fatal arrhythmias, cardiac arrest and even worse, death.
My role can also be physically challenging. All staff are obliged to wear a lead gown, thyroid shield, lead goggles, and head cover every time we are in the procedure room. These PPEs may be heavy and uncomfortable, but we need to wear them to protect us from the effects of radiation.
On-calls are also part of our life as Cathlab nurses, just like in the Philippines. I had to accept that I will miss some of the important events in your family like birthdays, anniversaries and hanging out with friends. It’s because you will be tied up to the on-call shifts because heart attacks are unpredictable. Good thing that on-calls here in the UK are well distributed.
Benefits of working as a Cardiac Cathlab Nurse
Cardiac Cath lab is one of the in-demand specialties in the UK. Because it’s a specialised unit, opportunities for learning are available all year long. We are given opportunities to attend trainings, conventions, innovations to advance our knowledge & develop our skill in the said field. I was able to learn the basic manipulation of the C-arm machine and other specialised devices. The trainings and exposure we are getting from the unit makes us more skilled. We can use these skills to assist in procedures in various specialties such as vascular, interventional radiology and neurovascular.
Being in this field also allowed me to meet a lot of people, from nurses, doctors to orderliness. Being part of the multi-disciplinary team did not only teach me how to deal with different personalities but also taught me the importance of teamwork.
How to be a Cardiac Cathlab Nurse
Bedside nursing experience is an advantage if you want to be a Cardiac Cathlab nurse. Coronary Care Unit (CCU) is a good starting point as you can learn how to administer cardiac medications, read ECG, join other staff during codes, prepare and recover cathlab patients.
A good Cardiac Cathlab nurse must be spontaneous, open-minded, pro-active and a good team player. Anything can happen during a procedure. Being spontaneous means having the ability to think on your feet especially in instances of cardiac arrest on the table. Panic will not help.
Being a team player is important in this field especially as you’re working within the multidisciplinary team. Things will be a lot easier if you have a good working relationship with your colleagues.
Advice to Other Nurses
Some nurses think that being a Cathlab nurse is easy. We do not just assist doctors during the procedure. I encourage all nurses to try this specialty. It will be an eye-opener. There are lot more to learn and explore in the field of cardiology nursing.
You’ll be amazed how a fist-sized muscle influences different organs in the body. If you happen to pursue this field, brace yourself for the world of sheaths, wires, catheters, balloons and stents. Embrace your new playground and your career will be "going up" (term we use in deploying balloon and stents) until you reach your full potential.
About the Writer:
Barry is a Cardiac Cathlab Nurse in one of the NHS Trusts in London. Barry is a sporty and an outgoing person. His mantra in life is to always seek progress not perfection.