Is the cardiac cath lab the best-kept secret among nursing specialties? And what is it that makes nurses so happy in this setting?
The cardiac catheterization lab, most commonly known as the “cath lab,” is an area of the hospital where a team of specialists uses equipment to visualize parts of the heart and perform minimally invasive procedures. Among a team of interventional cardiologists, CRNAs, and scrub techs, nurses are at the center of the show. With their specialized training, cath lab nurses blend teamwork with critical thinking to help cases run smoothly and keep patients safe.
We spoke to Elie Kadosh, BSN, RN, who worked as a nurse in the Pediatric Cardiac Catheterization Lab at UCSF Benioff Children’s Hospital from 2020 to 2021. She shares the reality of what it means to be a cath lab nurse and what makes this nursing specialty so rewarding.
What Does a Cath Lab Nurse Do?
Patients with certain heart conditions require a cardiac catheterization procedure to determine the severity of their illness and receive interventions if necessary. Elie says the most common interventions in the pediatric cath lab are stent placements, dilations, and septal closures.
Cath lab nurses have 3 primary roles:
- Point of care testing. Throughout the procedure, this nurse uses point-of-care testing to tend to the needs of patients. This includes collecting and interpreting blood gasses, using the avoximeter (which assesses oxygen status in different areas of the heart and arteries), monitoring bleeding times, and checking blood glucose.
- Equipment. The equipment nurse retrieves equipment and tools to assist with the case, including catheters, guidewires, balloons, stents, vascular closure devices, and intravascular ultrasound. Elie says cath lab nurses must have a strong understanding of each tool and device because interventions change quickly based on the catheterization findings.
- Control room. Outside of the cath lab is an external “control room,” where a nurse communicates with the lab staff via headset. This individual functions similar to a charge nurse and is responsible for documenting the entire case and assisting the cardiologist, among other tasks.
While these roles are defined, nurses work in tandem and often finish each other’s tasks. Additionally, other facilities may have a different staffing structure. “This is what makes cath lab nurses’ roles different from bedside nurses,” Elie says. “You may be assigned to one role, but you are able to jump into any task.”
You know those shifts where it feels like you tended to your neighbor’s patients more than your own? That’s the nature of team nursing – if you enjoy that style, cath lab nursing might be a good fit for you.
Training and Experience Needed
To become a nurse in the cardiac cath lab, you need an RN license and special certifications. Most job postings for cath lab nurses require a minimum of 2 years of nursing experience in addition to BLS and ACLS (or PALS) certifications.
These emergency life support certifications are put to use in the cath lab because patients can decompensate quickly. Before making the move to the cath lab, ask yourself how comfortable you are managing an emergency by:
- Knowing how to navigate a code cart and knowledge of emergency meds
- Being familiar with the hospital’s protocols for giving blood
- Reaching the ECMO or surgical team
While not all cath lab positions require ICU experience, nurses should first consider working in a cardiac ICU or step down unit. Elie says having been a Cardiac Transitional Care Unit nurse for 6 years was a valuable prerequisite for joining the cath lab team. As a CTCU nurse, she developed an expertise in pediatric heart defects and treatments for this patient population. She says, “Some nurses may be hired directly into the cath lab but would require additional orientation as ICU skills are needed.”
Whichever unit you choose to build your cardiac knowledge base and skills, certain soft skills will help you thrive in this fast-paced procedural setting. To be successful in the cath lab, you’ll need good communication and teamwork skills in addition to emotional intelligence.
When an intervention needs to be made quickly, the cath lab nurse should be able to anticipate the tools and equipment the physician needs, even if it’s through nonverbal communication. “Every attending has different preferences with just about everything during the case, so you have to learn and be in tune with their needs,” Elie says.
What to Consider about the Cath Lab Setting
Before making the transition, consider whether the cath lab environment would be a fit for your nursing style. If you enjoy assisting with procedures, you may appreciate that the cath lab is a more controlled setting than the ICU but a less sterile environment than the operating room. (Yes, the cath lab team uses sterile technique, but unlike the OR, a patient will not undergo a major operation like open-heart surgery there.) Also, consider if being on-call is a fit for you as this is usually a requirement for the cath lab setting.
Another best-of-both-worlds perk of the cath lab is that you get a little patient interaction. Nurses often get to speak with patients pre and post cath. Some patients are even conscious throughout the case!
The pace may be less predictable than other units, though. In the cath lab, there may be long periods of watching and waiting after an intervention is performed followed by busy periods. But despite the unpredictable components of the job, cath lab nurses can count on seeing many of the same cardiac defects and procedures repeatedly. This allows them to become experts in a highly specialized unit.
The Benefits of Being a Cath Lab Nurse
One of the biggest perks of this specialty is a relatively normal schedule – as long as you’re up for a little variability. While the standard schedule for cath lab nurses is four 8-hour day shifts, Elie says the hours can change depending on the number of cases scheduled for the day. Depending on the facility, it’s also common to work rotating weekends or sign up to be on-call. “Some nurses truly love the unpredictability,” Elie says. “Every day is different, and you have to have some degree of flexibility.”
For many nurses, working in a highly specialized environment is a rewarding challenge. In exchange for a high-stress environment, cath lab nurses enjoy strong team dynamics and relationships with different disciplines like physicians and the anesthesia team.
The pay isn’t bad either. The average salary for cath lab nurses is around $70,000 annually, but states like with a higher cost of living see cath lab RN salaries well over $80,000. These nurses may bring home even more between overtime opportunities and on-call shifts.
You Can Become a Cath Lab Nurse
Are you interested in taking on a new challenge and becoming a cath lab nurse? Vivian Health helps match nurses to thousands of permanent, per diem, and travel jobs. Take a look at their job postings today to find the best fit for your nursing career.