RN - Cath Lab

RN - Cath Lab

The Pre-Op/PACU RN provides skilled, compassionate care to patients before and after surgical, procedural (interventional radiology, bronchoscopy), and interventional cardiology cases. This role requires comprehensive assessment skills, close patient monitoring, and specialized management of patients undergoing surgery or cardiac/vascular cath lab procedures. The nurse safely administers medications, infusions, and blood products, adhering to provider orders and safety protocols. The nurse acts as a key liaison between surgeons, interventionalists, anesthesiologists, and the patient's family to ensure safety from admission to discharge. Position requires participation in an on-call rotation, weekend, and/or holiday schedule based on facility needs.

Key Responsibilities:

• Pre-Operative & Pre-Procedure Phase Assessment: Review patient medical history, allergies, lab results, and consents to ensure procedural readiness.
• Cath Lab Baseline: Verify antiplatelet/anticoagulant compliance, check renal labs (creatinine), and mark bilateral pedal pulses.
• Preparation: Start intravenous (IV) lines, initiate hydration protocols for contrast protection, and administer pre-medications per provider orders.
• Education: Educate patients and families on the surgical or cath lab process, anesthesia, and immediate recovery expectations.
• Post-Anesthesia & Post-Cath Lab Recovery Phase Handoffs: Receive detailed reports from OR and Cath Lab teams, noting intraoperative events, contrast volume, and medications.
• Airway & Vitals: Continuously monitor airway patency, oxygen saturation, vital signs, and telemetry for arrhythmias or ST-segment changes.
• Access Site Management: Monitor femoral, radial, or brachial access sites for bleeding, hematomas, or pseudoaneurysms. Apply manual atrial pressure in emergent situations, bleeding.
• Hemostasis/Sheath Management: Perform sheath assessment, manage specialized vascular closure devices. Coordinate sheath removal with trained clinical staff.
• Post-Op Care: Enforce post-femoral bed rest protocols, manage emergence delirium or severe shivering, and push fluids to clear contrast dye per provider orders.
• Discharge: Evaluate patients against strict discharge or transfer criteria and provide comprehensive caregiver instructions.
• Medication Administration & Infusion Titration: Safe Administration: Administer scheduled and emergent medications per provider orders via oral, IV, IM, and subcutaneous routes using strict barcode verification.
• High-Alert Management: Safely prepare, verify, and administer high-alert medications, including sedatives, narcotics, paralytics, and antiarrhythmics per provider orders.
• Infusion Titration: Manage and titrate continuous intravenous infusions (e.g., vasoactive drips, nitroglycerin, heparin) based on provider orders and hemodynamic parameters.
• Dual-Verification: Perform independent dual-verification with another licensed RN for designated high-alert medications and pediatric dosing per policy.
• Blood & Blood Product Administration: Pre-Transfusion Verification: Complete mandatory two-nurse bedside verification of patient identity, blood type, unit number, and compatibility per policy.
• Baseline Assessment: Obtain vital signs immediately before starting a transfusion and remain at the bedside for the critical first 15 minutes.
• Reaction Interventions: Identify signs of transfusion reactions (e.g., hemolytic, anaphylactic, TRALI), immediately stop the infusion, and initiate emergency treatment as ordered.
• Emergent Transfusions: Rapidly administer uncrossed blood products during massive hemorrhage events using rapid infusers and pressure bags per provider order.
• Accurate Documentation: Maintain meticulous documentation of transfusion times, unit identification numbers, total volume infused, and patient tolerance.
• Clinical Care Excellence & General Nursing Standards: Safety & Compliance: Maintain universal precautions and comply with all OSHA, clinic standards, and evidence-based safety guidelines.
• Vascular Access: Proficiently initiate and maintain peripheral intravenous (IV) infusions to secure dependable vascular access per provider order.
• Specimen Collection: Correctly collect and process blood, body fluids, and other diagnostic specimens according to policy and provider order.
• Anesthesia Recovery: Systematically assist patients back to baseline physiologic status during post-procedural anesthesia recovery.
• Symptom Management: Demonstrate advanced clinical capability to effectively monitor, evaluate, and control post-operative pain and nausea.
• Cardiovascular Monitoring: Interpret electrocardiogram (ECG) telemetry rhythm strips and review diagnostic 12-lead ECGs to identify acute ischemic or arrhythmic events and notify provider.
• Professional Communication & Documentation: Interdisciplinary Collaboration: Demonstrate advanced verbal, written, and active listening skills to foster professional collaboration with patients, providers, and allied health staff.
• Care Coordination: Collaborate actively with the House Supervisor, Charge Nurse, Cardiac Cath Lab and Operating Room personnel to facilitate seamless patient transitions and maintain efficient department workflow.
• Clinical Documentation: Maintain clear, concise, and legally compliant electronic health records (EHR) detailing all care delivered across both the pre-operative and post-operative phases.
• Regulatory Compliance: Utilize appropriate, standardized institutional forms and electronic health record.
• Equipment, Technology, & Workspace Stewardship: Medical Equipment Competency: Demonstrate technical proficiency in the correct operation, maintenance, and clinical application of specialized patient care equipment, including: Diagnostic 12-Lead ECG machines, Capillary Blood Sampling (CBS) tools, and I-Stat point-of-care devices. Urine pregnancy test kits and Bladder Volume Indicators (BVI). Mechanical patient lifts, automated vital signs monitors, and suction systems. Emergency defibrillators, crash cart components, and supplementary oxygen delivery equipment. Office Technology Proficiency: Properly utilize standard workplace hardware, including computers, clinical printers, copiers, fax machines, and telecommunication systems. Asset Management: Ensure all facility-owned healthcare equipment and resources are utilized strictly for authorized business and professional clinical purposes.
• Comprehensive Patient Education: Pre-Procedural Telephone Outreach: Contact patients pre-operatively to deliver preparatory guidance, clarify instructions, and alleviate anxiety regarding the Cath Lab, Operating Room, and anesthesia experience. Discharge & Caregiver Instructions: Deliver in-depth, structured education to patients and designated caregivers regarding the post-surgical and/or procedural course, groin/access site care, and physical limitations. Post-Operative Follow-Up: Conduct follow-up telephone calls to patients to assess outcomes, troubleshoot clinical needs, coordinate resources, and measure patient satisfaction.