The Ten-Minute Interview with… Erik Hushelpeck, RCIS, FSICP
I have lived in Utica, New York, Ashville, North Carolina, and Denver, Colorado, among other places, but I have been living in Gainesville, Florida, since 1980. I graduated from the CVT (cardiovascular technology) program at Santa Fe College in 1998 and worked for Shands teaching hospital at the University of Florida. While at Shands, I focused on adult interventional/heart failure, electrophysiology (EP) and pediatric procedures. I still live in Gainesville, home of the Gators, and for the last five years I have been the invasive cardiology instructor at Santa Fe College.
Why did you choose to work in the invasive cardiology field?
Invasive cardiology actually found me. I had never even heard of a cardiac cath lab until one of my friends dated a girl who was going through a CVT program. I started asking her questions and truly became interested when I found out what the job was like and what it paid. I originally wanted to go into echo, but changed my mind after doing some clinical time in a cath lab and seeing the variety of procedures and toys the technologists get to play with. I tend to get bored quickly, but saw invasive cardiology as a field that would be able to keep my interest.
Can you describe your role in the cardiovascular lab?
When I was working in the cath lab, my main role was in pediatrics. I spent a lot of time in EP and adult interventional procedures as well, but I slowly transitioned into pediatrics and eventually was put on the team full time. The nice thing about working at a teaching hospital is that you get exposure to a variety of specialties. Since I started teaching, my role has changed. Now my goal is to prepare students and hopefully teach them everything they will need to know to function in today’s labs. This is becoming a challenge in the time we have allotted, because of the increasing amount of training required for the large variety of procedures now done in the cath lab.
What is the biggest challenge you see regarding your educational role?
One of the biggest challenges for me as a teacher is dealing with students if they see things that bother them on clinical rotations, such as incorrect sterile technique, patient care, etc. When students come to me with these concerns, I tell them to stick to their standards and hopefully, others will follow suit. I try to have the students to understand it is not a choice, but a duty, to maintain a high standard of care for their patients. Everyone knows that it’s easy to get burned out and complacent in the lab, but if you lose focus, something bad will eventually happen at the expense of a patient who has put their trust in you.
What motivates you to continue your involvement with the cath lab?
When I worked at Shands, a powerful motivating factor for me was my involvement with the pediatric transplant patients. We would see these kids on a fairly regular basis because they needed frequent biopsies. It was amazing to see so many stories of joy and heartache through the years. You can get quite attached to these kids and it was great to see them doing well, but it also can crush you when things turned bad.
Now that I work at Santa Fe, my motivation has changed. It touches me to see the non-traditional students in our program graduate (single mothers/older students), because for some of them and their families, this means independence and financial security for the first time in their lives. It’s extremely difficult for these people to find the time and money it takes to go through this program. Knowing all of this is big part of what gets me out of bed in the morning.
What is the most unusual case you have ever been involved with?
I have seen quite a few things over the years I could call bizarre, but this one takes the cake. We were called in for an acute myocardial infarction case. The patient was having a massive anterior infarct and we started the cath, but everything we did seemed to have no effect. His pressure started to tank and we had already opened what we thought was the culprit artery. After a while of running the code, the physician called it and left the room to start the paperwork. The EKG was throwing an occasional beat but there wasn’t anything abnormal about it. The respiratory tech unhooked him from the respirator, but I hadn’t unhooked the patient from the EKG because I was trying to clean up some before we brought the family in — you all know how messy the lab looks after a code, and we usually try and let the family see the patient. A good five to ten minutes later, I looked up and couldn’t believe what I was seeing. The patient was in sinus bradycardia and when I put my ear on the end of his ET tube, I could hear him breathing. I banged on the glass and the nurse and physician looked up at the recording monitor and ran back in. We hooked him back up to the respirator and the arterial sheath was still in, so we hooked up the manifold. His pressures were low, but okay. We took another look at his arteries and nothing looked any different, or at least nothing that could account for this. The patient’s pressures kept rising, along with his heart rate, until the point that we were worried about them being too high.
Eventually, however, he stabilized and we sent him to the floor. I still don’t know what exactly happened that brought him back, but the physician’s theory was that the IV might have been blocked or kinked, and somehow it opened, giving him a huge bolus of epi, because during the procedure it seemed not to have any effect. He also thought there was the possibility of some distal embolization or reperfusion problems from the stents we put in. I tell you, I have never seen anything like it since and I don’t know if that theory is true or not. It was surreal going to the patient’s room and talking to him the next day. I often wonder what the physician told him happened that night and if he knew how close it was, because if I had just disconnected the EKG, most likely the patient wouldn’t have made it.
When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high?
There are a lot of things that can distract me when things get tough. If it’s football season, I can focus on the most important thing — the mighty Florida Gators. Otherwise, I can look back at all the jobs I had before this and remember why I chose this field. Every job has its ups and downs, but I feel very lucky to have found a place where I like the people and the work is something that I consider interesting and enjoy doing. Like the saying goes, “Do what you love and you will never work a day in your life.”
Are you involved with the SICP or any other cardiovascular societies?
In late August, I was awarded SICP fellowship. I am also on the Cardiovascular Credentialing International (CCI) item writing committee for the invasive registry exam. Being on the committee gives me the opportunity to work with some great people from all over the country. It’s also quite an honor to have been chosen as someone who will have input on an exam that sets the standard for technologists in our field. I am also the advisor for our college’s student government association, called CVTSA (Cardiovascular Technology Student Association). We are very active in the community, do volunteer work and participate in annual events like the March of Dimes, Heart Walk and support many other local charities. Last year, we received an award called “The Work of Heart” award. We were the one group recognized for outstanding community service from over 300 student organizations representing Santa Fe College and the University of Florida.
Are there websites or texts that you would recommend to other cardiovascular labs?
I am amazed at the amount of resources available on the internet today. I wish I had been able to access these sites when I was a student. Here are a few that I recommend to my students and visit regularly myself:
• urbanhealth.udmercy.edu/ ekg/learn.html
• med.yale.edu (do a search for cardiothoracic imaging)
Do you remember participating in your first invasive procedure?
I don’t remember the exact procedure, but I do remember my general state of fear and dread when starting my clinical rotations. I felt completely in the way and I was so nervous about messing up that I couldn’t focus. I finally learned to relax. It helped knowing that most of my preceptors were former graduates of our program, so they knew exactly what I was going through. I finally got it into my head that these people were not going to put me into a situation I wasn’t ready to handle or where I could hurt someone.
If you could send a message back to yourself at the beginning of your cardiovascular career, what advice would you give?
Buy some eBay, YouTube and Exxon stock. Other than that, I would tell myself to slow down a little and not try and do so much at once. People who know me would label me as someone rather laid back, but when it comes to my job, I’m focused and driven to a point that sometimes it’s hard to put things down. I would also like to tell myself that you can’t please everyone all the time — but, if nothing else, please don’t forget to buy some eBay and Exxon.
Where do you hope to be in your career when it is time to retire?
I definitely see myself teaching for some time. It’s fun and I meet a lot of interesting people. To be honest, I have never learned as much as I have since I’ve been teaching. Beyond that, I can’t say I have thought about it much. My career has pretty much guided itself so far and I feel I’m on the right track, so I will just see where it takes me.
Has anyone in particular been helpful to you in your growth as a cardiovascular professional?
I would hate to leave anyone out because there have been so many people who have helped me. Obviously the support of my family was absolutely necessary, but as far as professionally, I would have to say everyone at Shands hospital, from the doctors, administration and everyone that worked in the trenches with me, has been helpful. Working at a teaching hospital gives you the rare opportunity to learn right along with the cardiology fellows, if you’re smart enough to pay attention.
Since I’ve been at Santa Fe, I would have to highlight my director, Rheeda Fullington. You could not ask to work for a better person. She creates an environment where we are free to develop our own curriculum and excel without being micromanaged. It’s extremely motivating to have someone confident enough in you to give you that amount of freedom. I find myself more motivated because I am completely responsible for my own successes and failures. I don’t think many people give their employees that type of independence. Sometimes it’s not what a person does for you, but their ability to give you the rare opportunity to show what you’re made of.
Where do you think the invasive cardiovascular field is headed in the future?
I know it wouldn’t be good for business, but I would like to see more of a focus on preventative medicine. Since that’s probably not going to happen, I see invasive cardiology continuing to expand as fast as they can build labs. There’s a lot of talk about computed tomography (CT) taking over, and I think it will play some role, but that there will always be a need for cath labs, especially for interventional work. All you really have to do is look at the data on the general health of people in this country. It points toward a serious heath care crisis and a bleak future which are not too far away, unless we start making drastic changes in our eating and exercise habits.
Erik Hushelpeck can be contacted at firstname.lastname@example.org