The role of a cardiovascular nurse
Cardiovascular nurses specialize in working with patients who have been diagnosed with cardiac and cardiovascular diseases. This includes a wide range of patient populations and provides many varied clinical settings in which to work. Most cardiovascular nurses work in specialty critical care units or step-down telemetry units. Others prefer congestive heart failure or chest pain clinics and outpatient programs, such as cardiac rehab and preventive cardiac care.
Critical care specialty units
The majority of cardiovascular nurses work in acute care facilities, specifically in specialty units, where they focus on treating patients with serious cardiovascular disease and cardiac emergencies. Nurses working in CVICU and CCU are highly skilled practitioners who work with the highest-acuity patients in fast-paced settings. Their level of expertise and ability to make quick autonomous decisions identifies them as specialized nurses.
The care of patients in these units typically includes the recovery of open-heart surgery patients, such as coronary artery bypass graft procedures and valve repair and replacement. Cardiovascular nurses in these units care for patients with aortic aneurysm repair, cardiogenic shock, post-cardiac arrest and myocardial infarctions. They also manage intra-aortic balloon pumps, ventricular assist devices and care for patients requiring open-chest resuscitation and heart transplants.
Step-down/telemetry units
Cardiovascular nurses also provide nursing care to patients requiring cardiac stents, implantable cardioverter defibrillators (ICDs) and pacemakers, managing patients with lethal arrhythmias. Depending on the size and structure of the facility, patients may be admitted either to critical care or step-down units.
Cath lab/electrophysiology lab
Other specialty areas include the cardiac cath lab and electrophysiology (EP) lab, where a cardiovascular nurse functions in a different role. In these settings, although a physician is present, cardiovascular nurses must meet rigid criteria to be able to work as part of the interventional cardiology team. A major part of this role is to respond to emergencies in a setting with few personnel.
Outpatient settings
Cardiac rehab programs and congestive heart failure clinics are specialties unto themselves. In these settings, cardiovascular nurses monitor patients on an exercise regimen or chronic inotropic medication therapeutic regime and provide ongoing patient education during the process. Their expertise allows them to recognize emergencies and respond to them appropriately.
Competencies and education
Cardiovascular nurses have the opportunity to educate in whatever setting they are working at all levels, whether it be the patient, family or both. Cardiovascular nurses pride themselves on staying current in the latest trends in cardiac medicine and surgery, as new technologies, medications and medical devices are developed every week. They maintain annual unit-specific competencies in specialized procedures, as well as keeping current ACLS (and PALS if working with pediatric populations) certifications as required.
Advanced practice programs
Advanced practice nurses can choose to specialize in cardiovascular nursing. Most graduate-level nursing programs include a track with this specialty, with a focus towards clinical nurse specialist. Some schools offer a Master of Science in Nursing with a focus in cardiovascular health and disease management.
According to Mary Anne Dumas, Ph.D., Clinical Professor at the School of Nursing at Stony Brook University, "There are master's degree programs in nursing that offer a major in cardiovascular nursing", but "a majority of the clinical master's degrees in nursing have as their focus nurse practitioner (NP) and/or clinical nurse specialist (CNS) preparation." In adult NP programs, a graduate student can "perform clinical rotations in either medical cardiology or cardiothoracic surgery." In the CNS focus, students have the same rotation choices, but different role preparations. Nurses obtaining advanced degrees have the capability to conduct cardiovascular research, as well as practice in acute care facilities in clinical roles.
