Why cardiothoracic nursing

If nurses are interested in becoming a cardiovascular nurse, what advice would you give them? Be prepared to devote time away from your family in return for helping save lives. Work in telemetry or acute care settings right out of nursing school and enroll in a critical care course, with the goal of becoming a certified critical care nurse , as soon as possible.

With advance research always being conducted on how to help decrease, prevent, and treat cardiovascular disease, you will get to learn something new every day. Author Recent Posts. Michele Wojciechowski. Latest posts by Michele Wojciechowski see all.

Sign up now to get your free digital subscription to Minority Nurse. Get the Latest Issue. Life-threatening dysrhythmias and haemodynamic imbalance should be solved immediately.

Supporting the patient and family, especially in the face of obvious life-threatening conditions, is extremely important. Heart failure Patients may be hospitalised because of gradual deterioration in congestive heart failure CHF , acute decompensation in chronic stable CHF or acute heart failure syndrome.

The most common reason for heart failure syndrome is damage to the heart muscle induced by coronary artery disease. The risk of developing heart failure can be decreased by proper medical care. Qualified cardiac nurses can provide beneficial treatment for heart failure in all that is related to shortening the hospitalisation duration, preventing further hospitalisations, reducing costs and preventing death.

The contribution of the cardiac nurse is crucial to the successful functioning of any heart failure unit. Nursing intervention should include monitoring the vital signs eg, fever, pulse and blood pressure , weight and fluid balance and follow-up of laboratory results — especially for kidney function and electrolytes, glucose level, liver function and blood count.

Pharmacotherapy plays a major part in treating heart failure. The nurse should be familiar with the available pharmacotherapy and its use. In the acute syndrome this is composed mainly of diuretics, vasodilatation especially nitrates and positive inotropy only if absolutely mandatory.

In chronic cases pharmacotherapy is comprised mainly of beta-blockers, ACE inhibitors, angiotensin- receptor blockers and aldosterone blockers all shown to improve longevity , as well as diuretics, nitrates and cardiac glycosides, which may help to improve symptoms. Nurses have a major role in identifying patient habits that need to be changed.

Guiding the patient through the disease is all part of the treatment. Special attention should be given to patients prone to complications during and following the procedure, particularly those who are prone to renal failure, are sensitive to contrast medium, have severe unstable coronary syndrome, have unstable haemodynamic condition and those who are very elderly. On returning to the ward, the patient is then wired to a monitor and a nurse should check the blood pressure, heart rate and rhythm, the area of the percutaneous incision, peripheral pulse, leg skin temperature and colour, and urine output.

In the first 24 hours there should be good hydration to facilitate secretion of the contrast medium. The role of the cath lab nurse The purpose of the cath laboratory is to perform haemodynamic and angiographic evaluation of the heart and its coronary arteries, and to apply various percutaneous interventional techniques to improve the pathology. Electrophysiological procedures include electrical mapping of the heart, induction and interruption of cardiac arrhythmias, localised ablation of the source of arrhythmias and implantation of various electrical devices eg, pacemakers and defibrillators.

The cath lab nurse is expected to take care of the patient and assist the physician in performing the procedure.

Upon arrival the nurse admits the patient, gives sedative medications, shaves the area of the puncture site and prepares the patient on the table. During the procedure there should be a constant watch over vital signs, oxygen supply and anxiety management. The nurse is involved in all aspects of the treatment, including technical assistance and introduction of medications as required, and should be ready to participate in any emergency treatment that becomes necessary during the procedure eg, cardiopulmonary resuscitation.

Vital signs are continuously monitored postprocedure, with particular attention paid to possible chest pain and comfort while lying down especially passing urine. A full explanation should be given to both patient and family. Twelve-lead ECG will be performed and the introducer taken out with proper haemostatic care. The nurse will give the proper medication prescribed. After stabilisation the patient will be transferred to either the cardiology department or the ICCU.

Others suffer from severe rhythm disorders, acute heart failure or catheterisation complications. The nurse is expected to graduate a special intensive care course followed by continued updating in all aspects of acute cardiac care. The ICCU nursing team is the backbone of the unit. The ICCU nurse is required to be familiar with and able to handle the highly sophisticated and complex monitoring system with its central station as well as the ancillary equipment, including respirators, pacemakers, intra-aortic balloon pumping and ultrafiltration.

The nurse has to be intimately familiar with the lead ECG, the precise diagnosis of cardiac arrhythmias and invasive haemodynamics, including arterial lines, central venous pressure and pulmonary artery catheters.

Conclusion The contemporary cardiac nurse should present a variety of skills and proficiencies. The nurse is standing at the heart of the treatment and can be a full partner in the decision-making process. Nurses with at least six months cardiothoracic nursing, and eighteen months registered nursing experience, can enhance their professional development by applying for the St Vincent's Hospital month Postgraduate Course in Cardiothoracic and Heart Lung Transplant Nursing.

This course includes two clinical units provided at SVH with face-to-face teaching, paid study leave and an exciting clinical rotation programme. When combined with two online units from the Australian Catholic University, nurses will receive a recognised Graduate Certificate in Clinical Nursing.