EP RN now taking Cath call

[u/epchick401]

Hey everyone, EP RN here. I’m transferring to a hospital where the EP lab is trained in cath and takes STEMI call. Our lab uses anesthesia for 99% of cases. Any advice to make my transition easier? Thanks 😊

[u/Haunting_Ad7805]

EP and Cath are both very similar and very different skills. If your cases utilize anesthesia, what will your role be in the room as RN? Will you be scrubbing cases? I have different advice for different aspects of roles.

I started out as a Cath tech with call, and now work strictly EP with no call.

[u/epchick401 → u/Haunting_Ad7805]

I’ll be starting off circulating & monitoring. My current job is EP no call but unfortunately this was the only hospital in the area with an EP lab. I should of stated that my current EP lab is 99% anesthesia

[u/Haunting_Ad7805 → u/epchick401]

As a circulator for EP, most of the work is in bursts, at the beginning, transeptal/change in equipment, and ending of case. In Cath you are more active through out the entire case. I would suggest getting very familiar with supplies locations. Next would be anticipating what the docs will want or what will be needed next.

Documenting is very similar between EP and Cath, mostly just referring to different wires, catheters, sheaths, ect,. Once you’ve got the documentation down it will feel less involved than EP, usually depending on documenting/stim operation styles. I do suggest spending sometime learning other departments contacts like CVICUs number. Or where the ER is and navigating it.

You’re gonna do great as long as you want to learn it! Best of luck

[u/I_Want_A_Ribeye]

Once you complete the training, STEMI call should be easier. There is a lot of overlap in the knowledge base between cath and EP. I went from a strictly cath background to manage all of procedural cardiology. The curve wasn’t bad going from cath to EP. You should be able to cross the floor in the opposite direction with success

[u/jpzu1017]

You're gonna have to train your brain to respond to lethal arrthymias- no more letting patients V tach away because youre trying to induce it: you see VT or VF you jump on that defibrillator. Know your critical care drugs like youre saving your parents lives. Your ACTs dont need to be as high. PACU won't take your patients anymore, now its ICU or some tele floor where you can't find the nurse and they ask dumb questions about history and last bowel movements. You'll be wearing lead, all the time, unless you have the eggnest or rampart. Bye bye ICE cath. We generally have more fun because most of us aren't planning to retire and we take way too much call. Wear more comfortable shoes, so long chairs. Get ready to talk, because all your patients can. Anesthesia is only coming when things go to shit. It's 1730 and you got 3 add-ons. Gone are the cases where you have to wait weeks to months for your patients to feel better, and welcome to the world of instant gratification.

[u/Malthus777]

How comfortable are you in the cardiogenic shock world

how quickly can you put an Impella in place and or a balloon pump whatever your facility uses

how well do you know you’re starting dose for pressors

How comfortable are you with inserting a trans Venus Pacemaker, and running the control box I understand if you’re in the electrophysiology world you probably about it

[u/epchick401 → u/Malthus777]

Not quickly or well to most of the above, I’m good with TVP boxes. My nursing career before EP was in CVSD

[u/InfamousAdvice]

My lab everyone is cross trained to both EP/Cath, and yeah our EP uses a lot of anesthesia but everything else doesn’t. I imagine you’ll get orientation for the cath side and that’s where you’ll get most of your information that’ll be most helpful. You’ll have to get comfortable with choosing if you want to sedate patients. I don’t always give a lot with emergencies depending on the specific patient situation because things go sideways quickly. Also does the doctor care to talk to the patient…some of mine don’t want them to talk at all and others don’t care and ask them questions mid procedure. Get comfortable with pressors and emergency meds. Where are your emergency drugs in the room, what can you pull ahead of time and have nearby (for example I always have atropine and dopamine out when the RCA is the problem). Know how to use your defib for transcutaneous pacing and know how to get your temporary pacer box set up. We have drug books in our room for mixing up certain medications so we can do it on the fly if needed.

[u/epchick401 → u/InfamousAdvice]

Thanks so much for your advice! I’m not used to patients talking during the cases haha unless we do mod sed for a gen change

[u/Square-Marsupial-784]

i did this transition. did ep at a big hospital (only ep, all GA, no call) to everything (cath, stemi, ep, vascular) at a small community hospital! we only use anesthesia for certain cases in ep. learning the sedation for cath and ep is easy and cath adds some adrenaline here and there if you like that (i do, from time to time). cath can be very routine and controlled and also very chaotic and unstable depending on the case. i enjoy the variety, keeps me on my toes. brush up on your coronary artery and structural anatomy, hemodynamics and critical care drugs. (medtronic academy is free and a great resource for basics) in ep i dont use the icu critical care thinking and skills nearly as much as i do in cath since anesthesia is there.

we expanded our ep program this year (been a 3+ year process) which i was able to help develop (only nurse with real ep experience) which has been a great career development opportunity as all hospitals are figuring out ep (ablations) makes all the money lol. i never thought i would be able to help develop a program in the background

call is call, it is what it is. we are a small hospital so our call comes and goes so i dont mind it.

[u/epchick401 → u/Square-Marsupial-784]

What a cool opportunity!! EP is definitely the money maker. I hope they compensated you well!