Cardiac Cath Lab Registered Nurse Career Guide


    Cardiac Cath Lab Registered Nurse Career Guide

    By Kathleen Colduvell RN, BSN, BA, CBC

    The cardiac catheterization lab is an examination area of the hospital that specializes in procedures that allow doctors to visualize specific aspects of the heart. Cardiac catheterizations can be used strictly for diagnostic reasons or for invasive procedures that do not require operating rooms. 

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

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

    During cardiac catheterizations, specially trained nurses assist the medical team and perform in distinct roles. This Career Guide will help those interested in entering this field of nursing.

    Part One What is a Cardiac Cath Lab Registered Nurse?

    The cath lab nurse assists the team in the performing of the catheterizations. They will monitor and exam the patient prior to the procedure, during and after, as well as administer medications for the procedure, and assist the medical team in whatever they may need during the procedure. 

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

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

    Part Two What are the career opportunities?

    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 hospital obtaining trauma certifications, as wells 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. 

    Opportunities for cardiac cath lab nurses can be found on Nurse.org

    Part Three What is the salary range?

    In this field, because of the specialization, it is difficult to substitute other nurses from other units and this drives the hourly wage. In general, cardiac cath lab nurses earn a higher wage than other subspecialties of nursing. According to Payscale.com, cath lab nurses earn an average wage of $36.92 per hour or $76,793 per year. The lowest paid nurses earn approximately $19.32 per hour or $40,144 per year. The highest wages were $70.15 per hour or $145,912 per year.

    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.  The West was the region with the highest average income, at $42.79 per hour, or $89,003 per year. The Northeast region was second, at $37.50 per hour, or $78,000 per year. The South and Midwest were nearly identical, at $33.14 and $33.13 per hour, or $68,931 and $68,910 per year respectively. These figures are from the 2016 study that was recently released to the public.

    The U.S. Bureau of Labor Statistics provides salary figures for all registered nurses combined rather than for particular specializations. As of the May 2016 BLS report, the mean hourly wage for registered nurses, in general, was $32.91 while the average annual salary was $68,450.

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

    State Hourly mean wage Annual mean wage
    California $48.92 $101,750
    Massachusetts $42.82 $89,060
    Hawaii $42.75 $88,910
    Oregon $41.83 $87,000
    Alaska $41.56 $86,450

    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:

    Metropolitan area Hourly mean wage Annual mean wage
    San Francisco-Redwood City-South San Francisco, CA Metropolitan Division $65.68 $136,610
    Santa Cruz-Watsonville, CA $60.06 $124,920
    Vallejo-Fairfield, CA $59.80 $124,380
    San Jose-Sunnyvale-Santa Clara, CA $58.02 $120,680
    Salinas, CA $57.75 $120,120

    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. 

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

    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. 

    Regardless of 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:

    • Health insurance 
    • Retirement Options
    • Family Leave of Absence
    • Maternity Leave
    • Dental Insurance
    • Vision Insurance
    • Discounts
    • Certification membership benefits
    • Tuition Reimbursement
    • Attendance at nursing conferences

    Part Four What is the career outlook?

    According to the U.S Bureau of Labor Statistics, there is a 15% projected growth for Registered Nurses from 2016 to 2026. 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 thus requiring an increasing number of cath lab nurses.

    Part Five How do you become a nurse in this specialty?

    Nurses interested in working in the cardiac cath lab should first ensure they have the proper experience to be considered for the position. The first step is working in either a cardiac unit or the intensive care unit of a hospital. If there is a trauma hospital or major cardiac hospital in your area it is highly advised to look for positions at those specific hospitals. 

    After obtaining the proper experience, it is vital to build a strong working relationship with the cardiac intensivist and cardiologists. This will enable a smooth transition into the cath lab. 

    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. 

    Part Six What are the educational requirements?

    Those interested in working in the cath lab will first need to complete a BSN level Nursing Program and then successfully pass the NCLEX-RN license. 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. 

    Part Seven What certifications are required?

    Nurses in this field are expected to maintain their RN licensure as wells as their Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) and any other certifications required by the hospital. 

    Cardiac Cath lab nurses are highly encouraged to obtain additional certifications. These can include the Cardiac Vascular Nursing Certification through the American Nurses Credentialing Center (ANCC). In order to be eligible nurses must meet the following criteria:

    • 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.
    • Have practiced the equivalent of 2 years full-time as a registered nurse.
    • Have a minimum of 2,000 hours of clinical practice in cardiac-vascular nursing within the last 3 years.
    • Have completed 30 hours of continuing education in cardiac-vascular nursing within the last 3 years.

    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. 

    Another less common certification is the CCRN (adult) through the American Association of Critical Care Nurses. To be eligible nurses must meet the following criteria:

    • 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.
    • 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
    • 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.

    Part Eight Where can I learn more about this specialty?

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

    Nursing Scholarship

    Nurse.org

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