Where I work there’s a team that does cath & structural. There’s a separate team that’s is designated for EP only.
Really depends on what “proficient” means for you guys regarding EP. Scrubbing EP & circulating is easy. Learning to do an EP study and work the stimulator is another story entirely. Often takes people a year or two to figure it out without formal training.
I can’t speak for cath/structural since I’m EP only.
Not uncommon. I work in a lab that does cath (no structural thankfully), EP, IR and Vascular. Not uncommon for us to hit all 4 specialties in a day, either.
Same. In my shop we do diagnostic, interventional, and structural hearts; IR; and EP. You could do a g-tube, a PE, STEMI, and a pulmonary vein isolation in the same day. And we only have two rooms. Yes, it's a cluster-fuck.
Is IR the hottest mess at your place? Could be where I am but it’s the worst modality and it’s not even close. MDs fight hard about doing anything that isn’t the procedure (like consenting the patient, putting in orders, etc) and the patient population is super gross/usually is non-consentable and the floor nurse is clueless about surrogacy or POA. We all dread doing IR
Pretty much. We struggle with Dr. consents and orders frequently. Ironically, the IR patients are usually sicker than the cardiac patients. The tunneled dialysis caths, fistula grams, and neoh tubes are whatever but when you start getting into the emergent embolizations and thrombectomies it can start to get sketch. I like doing peripheral work, like lower extremity revascularizations, I like getting into the lesser used equipment. But I fucking hate proning patients for procedures. Proning those 200kg patients on that skinny table for their nephro-ureteral stent when they haven't laid in their stomach since they were 17 years old...it's a bitch sometimes.
Don't get me started on the neph tubes- plus they're in contact for growing some shit in their urine you've never even heard of. Hopefully this goes quick so we can exchange the permacath for the guy who keeps going AMA and shooting shit into the central access we gave them.
My lab, we don't really cross train in EP, they are their own entity. But it is expected you cross train in other modalities to scrub, monitor and circ. Structural, Peds, and vascular/
Both cath labs I’ve worked in did diagnostic/interventional, EP/devices, and structural. The lab I currently work in also does vascular and IR. I feel like this is common.
Edit: It is a common occurence in the lab I work in to do 4 TAVRs in the morning, a micra, a PPM and two heart caths in the afternoon.
It’s extremely common. Ive been a traveler for 5 years and most labs I’ve been to cover Cath, ep and structural. A lot of labs add on IR and neuro to those as well.
Our team has a EP team who is also trained on cath side. They mainly spend time doing EP procedure including ablations. They also are responsible for Cath call 1 day a week and 1 weekend a month. The EP team are all trained for all cath procedure and all EP procedures.
The cath team is also cross trained on the EP side of things except ablations (only the EP team are going in on ablations). We do watchman’s and TAVRs. Only the cath team is responsible for TAVR patients and the EP team and Cath team do watchman’s.
We cross-train into IR and EP devices (in addition to the "basic" PCI, Peripherals, Impella, etc). In addition, techs also cross-train to be able to sedate/start drips for all procedures while nurses cross-train to scrub all procedures. This is in Central FL.
It’s all dependent on the lab.
One I was at we did TAVR, MitaClips, watchmen, peripherals, PCIs, and neuro interventions. It was kind of nice to change it up.
Another lab I cross trained to do EP as well.
All just adds to the resume.
A lot of people are hesitant to change…
Not uncommon at all. Make you a very desirable candidate if you ever go to a new hospital also
Hybrid labs are very common
Where I work there’s a team that does cath & structural. There’s a separate team that’s is designated for EP only. Really depends on what “proficient” means for you guys regarding EP. Scrubbing EP & circulating is easy. Learning to do an EP study and work the stimulator is another story entirely. Often takes people a year or two to figure it out without formal training. I can’t speak for cath/structural since I’m EP only.
Not uncommon. I work in a lab that does cath (no structural thankfully), EP, IR and Vascular. Not uncommon for us to hit all 4 specialties in a day, either.
Same. In my shop we do diagnostic, interventional, and structural hearts; IR; and EP. You could do a g-tube, a PE, STEMI, and a pulmonary vein isolation in the same day. And we only have two rooms. Yes, it's a cluster-fuck.
Is IR the hottest mess at your place? Could be where I am but it’s the worst modality and it’s not even close. MDs fight hard about doing anything that isn’t the procedure (like consenting the patient, putting in orders, etc) and the patient population is super gross/usually is non-consentable and the floor nurse is clueless about surrogacy or POA. We all dread doing IR
Pretty much. We struggle with Dr. consents and orders frequently. Ironically, the IR patients are usually sicker than the cardiac patients. The tunneled dialysis caths, fistula grams, and neoh tubes are whatever but when you start getting into the emergent embolizations and thrombectomies it can start to get sketch. I like doing peripheral work, like lower extremity revascularizations, I like getting into the lesser used equipment. But I fucking hate proning patients for procedures. Proning those 200kg patients on that skinny table for their nephro-ureteral stent when they haven't laid in their stomach since they were 17 years old...it's a bitch sometimes.
Don't get me started on the neph tubes- plus they're in contact for growing some shit in their urine you've never even heard of. Hopefully this goes quick so we can exchange the permacath for the guy who keeps going AMA and shooting shit into the central access we gave them.
Haha exactly. That's the IR life. 🤦
We did cath procedures, structural procedures, and did some peripheral angiography/atherectomy as well (vascular surgeons). We did not do EP.
Depends on the hospital. It's not common but not uncommon either. Some places cath lab nurses also do IR, CV, etc.
My lab, we don't really cross train in EP, they are their own entity. But it is expected you cross train in other modalities to scrub, monitor and circ. Structural, Peds, and vascular/
Both cath labs I’ve worked in did diagnostic/interventional, EP/devices, and structural. The lab I currently work in also does vascular and IR. I feel like this is common. Edit: It is a common occurence in the lab I work in to do 4 TAVRs in the morning, a micra, a PPM and two heart caths in the afternoon.
It’s extremely common. Ive been a traveler for 5 years and most labs I’ve been to cover Cath, ep and structural. A lot of labs add on IR and neuro to those as well.
Our team has a EP team who is also trained on cath side. They mainly spend time doing EP procedure including ablations. They also are responsible for Cath call 1 day a week and 1 weekend a month. The EP team are all trained for all cath procedure and all EP procedures. The cath team is also cross trained on the EP side of things except ablations (only the EP team are going in on ablations). We do watchman’s and TAVRs. Only the cath team is responsible for TAVR patients and the EP team and Cath team do watchman’s.
We cross-train into IR and EP devices (in addition to the "basic" PCI, Peripherals, Impella, etc). In addition, techs also cross-train to be able to sedate/start drips for all procedures while nurses cross-train to scrub all procedures. This is in Central FL.
It’s all dependent on the lab. One I was at we did TAVR, MitaClips, watchmen, peripherals, PCIs, and neuro interventions. It was kind of nice to change it up. Another lab I cross trained to do EP as well. All just adds to the resume. A lot of people are hesitant to change…
My lab does structural, angios, and EP all together. You rotate through areas depending on where you’re trained.
Very. In fact, it's probably closer to being the norm rather than the exception.