The Ten-Minute Interview with… James Combs, RCIS, RCES, EMTP
- 8 Aug 2008
- Posted on: 9/10/08
- 3 Comments
- 2104 reads
My career in the field of cardiovascular services began as an opportunity that has been one of the most significant and rewarding decisions I have ever made. As a 16-year veteran in the field of emergency services, I worked as a paramedic and paramedic educator for programs in Las Vegas, Nevada and Carlisle, Pennsylvania. Eventually, I returned home to Rockford, Illinois and after a short time working as a paramedic was asked to interview for a position in the cardiac cath lab at Rockford Memorial Hospital. Twelve years later, I am still here. At the time, as a new cath lab professional, I felt compelled to validate my position in the department and passed the registered cardiovascular invasive specialist (RCIS) exam early on and recently, the registered cardiac electrophysiology specialist (RCES) exam. My position in the cardiac cath lab has evolved over the past 12 years, and I now work collaboratively with the cath lab manager to supervise day-to-day operations of the electrophysiology lab. I am still active in education, instructing ACLS, PALS, EKG interpretation, and on occasion, work with the hospital’s paramedic program. I am married to a wonderful nurse, Jennifer, and am a proud first-time father of a baby boy, Dominic. As an avid angler, I spend much of my free time participating in tournament fishing and absolutely love the outdoors.
Why did you choose to work in the invasive cardiology field?
As a career paramedic, one of my favorite subjects was cardiology and I often spent my free time studying to become proficient in that subject matter. When the opportunity to move into a new position in the cath lab became available, it did not take me long to recognize the advantages of working in that environment. I spent a few days shadowing some of the cath lab personnel and truly realized my potential in the position. Career moves from the pre-hospital setting are few and far between, and I was blessed to be given the opportunity.
Can you describe your role in the cardiovascular lab?
My initial position in the lab has evolved. I actually began as a computer person due to limitations in state law. Thanks to fellow RCIS professional, Tracy Simpson, who challenged those laws in Ohio, other states, including my own, have changed their position and now allow non-radiological personnel to function at a more involved level within the cath lab setting. One of the reasons I took the RCIS exam was to validate my position in the cath lab and to become an advocate for advancing the profession beyond the belief that only an x-ray technologist can function in this setting. Our lab is integrated, so we perform cardiovascular, peripheral vascular and electrophysiology procedures in one setting. My current role is supervising the electrophysiology lab’s day-to-day operations collaboratively with the cath lab manager, Bill Anderson. As a cath lab staff member, I also participate in cardiovascular and peripheral vascular procedures when necessary. As an associate ACLS and PALS instructor within the health system, I remain active in the education of other health care professionals.
What is the biggest challenge you see regarding your role in the cardiovascular lab?
Challenging other staff members to become more actively involved in their careers has been one of my biggest challenges. I believe in leading by example and have always made the most of educational and professional opportunities. Attending conferences and taking advantage of educational offerings, obtaining professional certifications, and promoting an environment of open dialogue between staff members and physicians are a few of the areas that we consistently look to improve upon.
What motivates you to continue working in the cardiovascular lab?
There is no doubt that the driving force of technology that challenges us is what motivates most to remain in the profession and keeps our minds fluid. My manager, whose management style offers everyone the opportunity to be a successful team member and advance within the program at their own pace, has always been instrumental in my career. He is not only a great mentor and effective manager, but a good friend. My co-workers, who I consider family along with the patients in whose lives we make such a difference, are truly motivating factors that keep me interested in this career field.
What is the most unusual case you have ever been involved with?
Many cases come to mind, but interestingly enough, I had the opportunity to be involved in a patient’s care from the very beginning. I am an avid tournament angler and would never expect to participate in patient care while at a tournament. Arriving at the weigh-in at a recent tournament, I was approached by friends who knew I was a paramedic. They said a man was down and CPR was in progress. I ran to the area and found a 52-year-old angler in cardiac arrest. We continued effective CPR and assisted the police when they arrived with an AED. We shocked him twice, regaining a pulse and spontaneous breathing. He was still unconscious when the ambulance arrived for transport to a local hospital where he regained consciousness. After an angiogram confirmed the cause of his cardiac arrest, he was transferred to a regional hospital for multi-vessel bypass and valve replacement, and is doing well. He plans to fish in our August tournament.
When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high?





Just found out RCIS is being phased out in some of our Nevada unless we petition it to become a license instead of a credential. Any suggestions on how I could do that? Don't wait two years of college to be wasted.
Reply to this comment »We just passed the first law in the United States that give the RCIS a liscence to operate. I am currently working on an articl for cath lab digest to talk about the whole process of what happened. It took a long time and a lot of fight.
We had seveal things work in our favor but the main was a Washington
State Represenative who was a part time cath lab nurse named Dawn Morrell and she sent the bill through congress and we had an outdated law from the radiation techs that needed updated. (Hint They could inject contrast under doctors orders from a Radiologist but not a Cardiologist) Soo we hooked the RCIS into a special category of the Radiation Technologist license
I have the new law title at home and will be happy to send it to you if you like.
Meantime please tell me more about what is happening in Nevada because California is a mess as well and we cant let this happen
Reply to this comment »I am faced with the same issue. I completed the two year RCIS program through Hudson Valley and struggled to pass my registry and it is upsetting to find out that my registry is not recognized as a license. Place help anyway possible.
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