Cath Lab Digest

Cath Lab Digest talks with some of the many experienced, dedicated and passionate staff and physicians who have helped build the Nurse and Technologist Symposium at the Transcatheter Cardiovascular Therapeutics (TCT) meeting.

History: The First “Round Table”

Twenty years ago, Dr. Martin Leon visited the research nurses’ office at the Washington Hospital Center (WHC) and suggested they share their expertise at the Transcatheter Cardiovascular Therapeutics (TCT) meeting, then only in its fourth year. Regina Deible, RN, BSN, recalls, “[At the time,] I was one of the research nurses at the WHC and Marty Leon was putting together t

he TCT meeting. We would help him pull together data for his slides or pull films, and one day he strolled into the nurses’ office and said to us, ‘You know, why don’t you share your expertise? You are privy to technology that lots of local hospitals haven’t yet seen. Wouldn’t that be a great avenue for the nurses and techs to explore?’

“It was an extremely informal venue that first year. We had a side conference room with a round table. We brought Rotablators, Palmaz-Schatz stents, directional coronary atherectomy catheters, and lasers, and essentially sat in the room, networking. If 12 people came in, that was a big turnout. It was a fun, exploratory venture to see if it would work.”

“I have to give full credit to Marty Leon,” said Regina. “He was the vision behind everything. He nurtured the program to match the current needs and spotlight advances in our field. As things progressed, he picked new directors each year that he thought would send it into a new direction. Ultimately, when Tom Maloney and Chris Nelson came on board, the nurse-tech meeting concept was exploding and they were ready to take the reins and propel the meeting to yet another level.”

Sue Apple, PhD, RN, was a clinical nurse specialist at the WHC. She notes, “At that time (the early 90s), all the medical leaders of TCT were part of the Washington Cardiology Center (WCC) running the cath lab. TCT took place at the Hyatt in downtown DC. The first Nurse/Tech meeting was actually a lunchtime breakout session, consisting of maybe 10 people at a table! Probably all of them were from the WHC.

“After this start, Marty Leon and others envisioned a separate, all-day nurse/tech symposium within TCT, and I became a co-director along with other nurses from WCC and later from the cath lab. At this point, it was still largely a WHC endeavor, but now we had a whole day of lectures, as well as formal continuing education credits for the nurses and later the techs attending the meeting. From a small breakout room at the Hilton, we soon moved to the old DC convention center across the street. Nurse/Tech by this time was really expanding. We had morning sessions in a room to hold over 1,000, and breakout sessions of several hundred each during the afternoon. About this time, the Nurse/Tech Symposium started to include personnel from other cath labs, such as Baltimore, Maryland (Johns Hopkins) and San Diego, California (Scripps Clinic). By 2002, we celebrated the 10th anniversary of Nurse/Tech, and the meeting was held in the grand ballroom at the Hilton, in the same room where I attended my first TCT all those years ago! My opening PowerPoint held greetings in many languages to reflect the international scope of the current conference.”

Nancy Morris, RN, MSN, MBA, worked as a research coordinator at Scripps Clinic with Dr. Paul Teirstein. She recalls, “There were very few people working on stents then — there were 10 primary sites, and we were all friends and helped each other out. We were in an exploding world. Then the WHC said they wanted to do a nurse/tech meeting. Really, Regina Deible was the impetus for putting together the whole meeting. Many of us worked together, and we are still all friends.

“The Nurse/Tech Symposium started really small, with (seriously) just a room and a roundtable discussion, and it is amazing to see what it has now evolved into. We began our planning by saying, okay, what would nurses and techs want to know? When we started, there was a great deal to talk about in regard to care of the patient with a stent, a patient with only an angioplasty, with post care, etc. There were just a few of us at that time, including Ann Greenberg and Regina Deible, getting up and giving talks.”

After that first year, Regina said, “It was completely terrifying — being in a room with a podium up front and a big screen, and talking about what we did. You didn’t know how many people knew what you were talking about and if this was going to be boring to them, or really innovative. In retrospect, it really was cutting-edge, because nobody had the devices; they were all completely investigational. It was an exciting time then, and the meeting just kept growing and expanding, year after year.”

“The Nurse/Tech Symposium started out almost like a book club in someone’s living room,” said Nancy Morris. “And it has just grown and evolved to where it is now, which is pretty much a behemoth. I always get amazed when I look in that room and think of what it was in the beginning, with a couple of us standing there, and what it is now, which is absolutely packed.”

Gregg W. Stone, MD, who for the last 10 years has been overseeing the organization of the annual Nurse-Tech meeting at TCT, is proud of the growth of this session and its contributions to TCT, and to improving patient outcomes. "The annual TCT Nurse-Tech course provides an invaluable opportunity for catheterization laboratory nurses, technologists, physician assistants, hospital administrators and other allied healthcare personnel to be exposed to the most contemporary advances in the field, and to learn from each other. The Nurse-Tech course has been the perfect complement to physician education at TCT, which together have contributed to improved outcomes for patients with cardiovascular disease," Stone commented.

Dr. Gary Mintz has been involved with the TCT and Cardiovascular Research Foundation since 1991. He comments, “We think [the Nurse and Tech Symposium is] a very important component of TCT for lots of reasons. We’ve always believed that nurses and technologists are our partners in the cath lab and quite frankly, throughout the hospital. We can’t function without them. There are things in the general TCT sessions that are clearly applicable to the nurses and technologists, but they also have concerns of their own that are, if you will, beyond what physicians understand. This is why we created a nurse and technologist program at TCT, a program that is organized by their peers, that addresses their needs, and of course, has physicians as some of the faculty because of physicians’ expertise, but is not just for physicians talking to nurses and technologists.”

Planning: Glamour?

Tom Maloney, MHA, RCIS, has been a meeting co-chair with Marian Hawkey, RN, for the past several years. He said, “Everyone thinks that coordinating a meeting like the Nurse and Technologist Symposium is a glamorous thing to do, and maybe for one day out of the year, it might be. But let me tell you, you start planning that meeting about 51 weeks in advance. You get the week after TCT off, but the next week, the CRF staff, led by Colleen Whelan (towards whom I have the utmost gratitude), are gathering evaluations, and the directors get a debrief of how the meeting went. Each comment on every evaluation is personally read and weighed for the subsequent year. Then, we are almost simultaneously rolling into what will happen next year. In fact, during the meeting, I will be writing notes about what worked, what didn’t work, and what we can do for the following year. Really, it’s 51 weeks of planning. During those 51 weeks, there are numerous conference calls, emails, phone calls, and documents you are writing and trying to coordinate, as well as figuring out who is the right speaker for a particular topic. I couldn’t count the number of hours that are put into it. It’s a passion and it’s been what I feel is my baby for a long time. If you were to ask my wife, Angie, she would tell you the hours put into it are far too many, especially since all the effort is done for the better of the field and not for pay…it is all volunteer.”

“I think it’s really important to note how much time and energy people put into making this meeting special,” notes co-chair Marian Hawkey. “It is a ton of work, but everybody involved is really committed. From the very first year, it’s purely been the interest and energy of the involved parties that has helped to bring it forward. It’s been an unbroken chain.”

Chris Nelson was a co-director for 12 years. He notes, “I think probably the greatest development I have seen has been the strength of the team leading the initiative. The meeting started out with one or two people basically coordinating the event. We would make phone calls to different faculty members, put together a program, submit that to Marty Leon, he would say yay or nay, and it was up to us to physically contact everyone and make sure we had it. Over the years, we added to the team, and we have had program directors and co-directors. Today, this group remains very dynamic, puts together an amazing program, and reaches out to their colleagues. We have been able to target all levels of clinicians, so that we have programs that are directed toward the novice who is just entering the cath lab, whether a nurse or a technologist, up to those individuals who are working in advanced research centers. Additionally, we now have outreach to specialty groups like the managers and the nurse practitioners. That evolved year after year.”

Tom Maloney says, “The one moment I love the most is the morning of TCT. The course directors and the co-directors all get together in the faculty lounge to have breakfast. It’s never been planned, but we do come together. At that moment, we have been going 51 weeks to get this ready. Everything is done, and everyone is in their suits and dresses, and the feeling is, ‘It’s game time!’”

Oh, the Memories!

Sue Apple commented, “Those of us of a certain age will never forget the slides! The A/V room in the WCC offices turned into a nonstop slide development room for at least a week or two before the meeting. You always had to make sure the slides were lined up correctly in the carousel, with your name and lecture time in tape on the side. In 1998, I successfully defended my PhD dissertation on Tuesday, wrote my TCT lecture Tuesday night (this was still during the time of slide presentations) and gave my lecture on Thursday with simple black-and-white slides, due to a camera malfunction. PowerPoint sure changed everything.”