“Breaking Into Cath Lab Nursing” is the forty-eighth episode of The College Handoff. The episode features Wendy Bentley, a former cath lab nurse and clinical account specialist for Biosense Webster, a cardiac electrophysiology company owned by Johnson and Johnson.
While the idea of a cath lab may be familiar to some nurses, the actual procedures done in a cath lab are stereotypically foreign to those who work outside of the high-tech cardiac lab. Wendy thoroughly explains the standard process done in a cath lab, which she has nicknamed “the plumbing side of the heart.”
“When somebody has chest pains, and they come into the ER, they’re tested. They get EKG testing. They get a drug test to look at their cardiac enzymes. Sometimes they’ll have an echocardiogram done, and the doctors will just figure out is this urgent? Acute? Can they sit on this overnight? Can we do this as an outpatient? So depending on the scale of acuity, we’ll bring them into the lab either outpatient or right away if they’re dying in the ER of a heart attack… Normally we just have our outpatients who’ve seen a doctor and had an abnormal EKG or stress test. They come into the cath lab. We put them on the procedure table and prep them. And as a nurse, I’m giving sedation and helping them to be calm and relaxed, and they usually go to sleep,” she describes. “They bring in an x-ray camera, which is built in the room. It just kind of comes across the track and is over the patient’s chest. And the doctor and scrub tech get access either in the groin and femoral artery, or they go into the radial artery of the writ, and advance catheters up into the aorta and cannulate the coronary arteries one at a time. And they inject contrast dye into the artery so we can see the plumbing and see what the arteries are doing wrapping around the heart. And we can find, I mean instant, we know instantly if there’s a blockage or if they’re clear. And so, if there’s a blockage, it gets treated with a balloon device that also gets threaded up that catheter into the artery. They inflate the balloon. It opens up that blockage or crushes that plaque that kind of artery stenosis. And then they’ll put in a stent, which is also the same kind of delivery as the balloon. There’s a balloon underneath the stent piece, so when it goes up into the artery, we inflate the balloon, and the stent expands, and then it adheres to the artery’s wall. It helps keep that artery open. And then they’re put on an oral blood thinner they’ll take every day just to keep that artery open and fresh because we’ve put something foreign in there. And usually, outpatients can go home the same day. If it’s, like, a lot of stents or just a more complicated procedure, they may stay overnight in a cardiac unit, but that’s basically what we do with the plumbing side of the heart.”
With a complicated and precise procedure, it’s no wonder that working in a cath lab takes months of training. “When I eventually was doing cath lab every day, they had me circulating every case, helping put the patient to sleep, getting blood thinners ready for the stent procedures, and things like that. It took a lot of preceptorships. I probably did that with my preceptor for about a month before I passed off circulating,” Wendy explains. “And then you go on to learning how to monitor the case and charting what’s going on. And I probably did that for about a month. And then you go on to the scrubbing portion. You learn how to scrub in with the doctor and handle all the equipment. And you learn that for about a month. And then, when you pretty much have all three roles down, you are on your own. You’re in there as your nurse.”
While most days in the cath lab are average, they will occasionally receive patients experiencing a heart attack and are in desperate need of help, patients that Wendy refers to as “crash and burn patients.” “The situation can be very stressful,” she admits. “So you have to remember your training. You have to remember your advanced cardiac life support. And you have to remember your drugs. It’s just something we do, something you have to run through the back of your mind every day. Where’s the bag we put over the patient, the mask, and the bag? Where’s the oxygen? Where’s the crash cart? Those things are always right there in the room. It’s just being able to focus on the task at hand.”
Unfortunately, part of working in the cath lab (and indeed any area of the hospital) is witnessing the death of patients. However, Wendy strongly believes her strong faith keeps her positive and happy while navigating difficult situations. “We don’t often think about being spiritually ready in our workplace for death. But we as nurses sometimes are those bridges, unfortunately, to the other side, for these people. And I think just being close to the spirit, knowing how to hear Him, like President Nelson encourages us to do, doing the things that we should be doing so we can hear the spirit, which is reading the scripture, saying your prayers, following the Prophet. Being close to your testimony will help you know what to do for these patients. Because you’re an example, and you’re showing light to your patients that they may not have seen before. And I’ve had many patients ask me, Why are you so happy all the time? So it gives you that opportunity even to share what you believe in. I just remember writing about having the opportunity to be a missionary. You have to be close to the Spirit. That’s the only way you can shine your light. And then at those instances, when things like this happen, where you need to be focused and try to save someone’s life, the Spirit can be there to help you do what you need to do.”
If you want to listen to Episode 48 of The College Handoff that features the full interview and more insights into cath lab nursing and Wendy’s experience at BYU and her current position as a clinical account specialist for Biosense Webster, go to https://thecollegehandoff.podbean.com/e/breaking-into-cath-lab-nursing/ or anywhere you listen to podcasts.