How to Become a Cardiac Cath Lab Nurse

Cardiac cath lab nurses specialize in working with patients undergoing cardiac procedures in a catheterization lab. During cardiac catheterizations, these specially trained nurses assist the medical team and perform in distinct roles. 

This career guide will explain what a cardiac cath lab nurse is, how to become one, the current outlook, and the pay available to this specialty.

A cardiac cath lab nurse is a Registered Nurse who specializes in assisting with catheterizations. They monitor and examine patients prior to procedures, as well as during and after. They also administer medications and assist the medical team in whatever they may need during the procedure. 

Cardiac catheterizations can be used strictly for diagnostic reasons or for invasive procedures that do not require operating rooms. They take place in a catheterization lab -- an examination area of the hospital that specializes in procedures where doctors visualize specific aspects of the heart.

According to the American Nurses Association, Society for Vascular Nursing, cardiac cath lab nurses generally perform the following:

• Administer patient medications
• Assist in diagnostic procedures
• Assist in interventional procedures
• Be prepared for emergency situations
• Circulate and scrub during cardiac catheterization and electrophysiology procedures
• Discharge teaching with patients and families including procedural, medications, activities, and dietary
• Educate patients and their families before discharge regarding medication, lifestyle, and care of the surgical site
• Ensure consent paperwork is accurately completed
• Examination of the patient pre and post-catheterization
• Manage administrative aspects of cardiac catheterization and electrophysiology patients
• Monitor and document patient vital signs
• Monitor for signs and symptoms of infections or side effects of the procedure
• Monitor patient sedation levels during and after the procedure
• Prepare patients for procedures
• Update patient charting and document on the procedure

Patients may receive cardiac caths for a variety of reasons including:

• Diagnose heart disease of the heart muscle, valves, or coronary arteries
• Heart muscle biopsy sample
• Look for defects in the valves or chambers of the heart
• Measure the pressure and blood flow in the heart
• Perform a coronary angiography
• Procedures such as heart ablation, balloon valvuloplasty, valve replacement, balloon angioplasty, and stent placement
• Take blood samples from the four chambers of the heart to measure oxygen levels

Nurses interested in working in the cardiac cath lab should first ensure they have the proper experience to be considered for the position.

1. Become a Registered Nurse: The first step is becoming a registered nurse by earning either your Associate Degree in Nursing (ADN) or your Bachelor of Science of Nursing (BSN) through an accredited nursing program. 
2. Gain Experience: Your next step will be to find a position at a trauma hospital or major cardiac hospital in your area.
3. Build Relationships: After obtaining the proper experience, it is vital to build a strong working relationship with cardiac intensivists and cardiologists. This will enable a smooth transition into the cath lab. 
4. Find a Job: Cath lab nurses can work in the hospital setting or in a freestanding cardiac center. These centers are generally found in large cities such as New York City, Philadelphia, and Los Angeles. 

Nurses in this field are expected to maintain their RN licensure as well as their Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) and any other certifications required by the hospital. Classes for these certifications will be offered by your employer and are generally set up by a hospital or unit-based educator. Furthermore, they are general requirements of employment.

Cardiac Vascular Nursing Certification

Cardiac Cath lab nurses are highly encouraged to obtain additional certifications. One of which is the Cardiac Vascular Nursing Certification through the American Nurses Credentialing Center (ANCC).

Cardiac Vascular Nursing Certification Eligibility Requirements

In order to be eligible nurses must meet the following criteria:

1. Hold a current, active RN license in a state or territory of the United States or hold the professional, legally recognized equivalent in another country.
2. Have practiced the equivalent of 2 years full-time as a registered nurse.
3. Have a minimum of 2,000 hours of clinical practice in cardiac-vascular nursing within the last 3 years.
4. Have completed 30 hours of continuing education in cardiac-vascular nursing within the last 3 years.

Cardiac Vascular Nursing Certification Exam

The exam consists of 175 questions (150 scored plus 25 pretest questions) and must be done in 3.5 hours. The certification is good for five years and can be renewed online. The cost of the exam is $350 for non-members but discounted for members of the American Nurses Association ($250), Preventive Cardiovascular Nurses Association ($295), and Society for Vascular Nursing ($295).

CCRN Certification

Another less common certification is the CCRN (adult) through the American Association of Critical-Care Nurses.

CCRN Eligibility Requirements

To be eligible nurses must meet the following criteria:

1. Hold a current, active RN license in a state or territory of the United States or hold the professional, legally recognized equivalent in another country.
2. Practice as an RN or APRN for 1,750 hours in direct care of acutely/critically ill adult patients during the previous two years, with 875 of those hours accrued in the most recent year preceding application OR
3. Practice as an RN or APRN for at least five years with a minimum of 2,000 hours in direct care of acutely/critically ill adult patients, with 144 of those hours accrued in the most recent year preceding application.

The CCRN exams are 3-hour tests consisting of 150 multiple-choice items. Of the 150 items, 125 are scored and 25 are used to gather statistical data on item performance for future exams. The exam is $245 for AACN members and $360 for nonmembers. 

Cardiac cath lab nurses typically earn a higher than average pay. Because of the specialization, it is difficult to substitute other nurses from other units and this drives up the hourly wage.

According to Payscale.com, cath lab nurses earn an average wage of $37.83 per hour or $88,713 per year. The lowest-paid nurses earn approximately $68,000 per year. The highest wages were $115,000 per year. Experience can also increase salary opportunities. 

1. Less than 1 year of experience earn an average hourly salary of $29.19 
2. 1 to 4 years of experience earn an average hourly salary of $33.34
3. 5 to 9 years of experience earn an average hourly salary of $36.07 
4. 10 to 19 years of experience earn an average hourly salary of $40.05
5. 20 years or more of experience earn an average hourly salary of $413.19

Cardiac Cath Lab Salary by Region

A study done by Springboard Healthcare Staffing, a leader in placing cath lab nurses, does an annual evaluation of pay for cath lab nurses. This report breaks down the pay of cath lab nurses into different regions of the country.

1. The West was the region with the highest average income, at $51.69 per hour.
2. The Northeast region was second, at $43.56 per hour.
3. The South and Midwest were nearly identical, at $40.62 and $40.30 per hour, respectively.

Cardiac Cath Lab Salary by City & State

The U.S. Bureau of Labor Statistics provides salary figures for all registered nurses combined rather than for particular specializations. As of the May 2022 BLS report, the mean hourly wage for registered nurses was $39.05 while the average annual salary was $81,220, though conditions vary by area.

The BLS identifies the following as the highest paying states for nursing:

In the same year, the BLS ranked the highest mean annual salaries for nurses, and the top ten were in California. The top five from the list are as follows:

Ways to Increase Your Salary as a Cardiac Cath Lab Nurse

Salary vs Hourly Pay

Most healthcare systems pay nurses on an hourly scale while others have a fixed annual salary, such as nurses in a free-standing surgical center.

Those paid on an hourly scale are able to earn overtime pay whereas salary employees would need to discuss that with the hiring committee. Furthermore, cath lab nurses have the potential to earn on-call pay which can boost weekly income. 

Location

Overall, pay generally correlates with the cost of living for a specific geographical area as is evident in the pay in various parts of the country. Areas where the cost of living is higher will see a higher hourly rate than areas with lower costs. 

Experience

As with all jobs in the nursing field, earning potential increases with additional education and experience. Nurses typically are awarded a raise during annual employee performance reviews. Certifications can give nurses an additional bump in their paycheck. 

Cardiac Cath Lab Nurse Benefits

Regardless of the workplace setting, full-time, and part-time cardiac cath lab nurses enjoy similar benefits. While actual benefits may vary depending on the institution, most include the following:

1. Health insurance 
2. Retirement Options
3. Family Leave of Absence
4. Maternity Leave
5. Dental Insurance
6. Vision Insurance
7. Discounts
8. Certification membership benefits
9. Tuition Reimbursement
10. Attendance at nursing conferences

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Nurses working in this field are expected to have a great deal of experience working as a bedside nurse in either the Cardiac Unit or the Cardiac Intensive Care Unit. It is extremely rare that new nurses with no experience are hired into the cath lab.

Nurses are expected to have proficiency in cardiology nursing procedures, cardiac arrhythmia and dysrhythmia interpretation and extensive knowledge of the cardiovascular anatomy. 

Due to the specialization of the cath lab nurses, there is a remarkably high demand for them throughout the country.

With the increasing number of hospitals obtaining trauma certifications, as well as vascular certifications, the number of cath labs is increasing. All cath labs are required to have a full team of nurses in order to be fully operational. 

The U.S. Bureau of Labor Statistics (BLS) expects nursing careers to expand by 6% from 2022 to 2032. While there is not an exact number for the growth of cath lab nurses, is it inferred that the need for cardiac cath lab nurses will actually be higher than this figure. 

Cardiac disease accounts for approximately a quarter of all deaths in the United States. With the increasing age of the baby boomer generation and the rise of sedentary behavior and poor overall diets, there is an increasing number of cath lab procedures done each year. 

The U.S. National Institutes of Health estimates there are over million cardiac catheterizations done annually. As previously mentioned, this number will only continue to rise, making cath lab nurses in high demand!

Nurses interested in a career in the cardiac cath lab should reach out to their hospital's hiring department and clinical educators for additional information. Helpful information can also be found on the following websites:

• American Association of Cardiovascular and Pulmonary Rehabilitation
• American College of Cardiology Foundation
• American Nurses Association, Society for Vascular Nursing
• Preventive Cardiovascular Nurses Association
• Journal of Cardiovascular Nursing
• Progress in Cardiovascular Nursing
• Society for Vascular Nursing

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