By Bernie Blocker, RCIS, Banner Good Samaritan Medical Center, Phoenix, Arizona
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By: Doug Langager, RCIS, Winchester Medical Center, Winchester, Virginia
Over the past 20 years, I have been involved in training cath lab techs and nurses in some capacity or another. Throughout my total 30 years of cardiac catheterization experience, I have found one of the greatest deficiencies across labs to be the variation and disjointedness of the new hires orientation process.
The orientation models currently in use typically leave new hires feeling overwhelmed. Many labs have adopted a sink-or-swim orientation process where definitive, didactic training plans are frequently thrown aside in favor of lab time. Physician demand for laboratory time and the patient load require efficiency, job knowledge, and manual and intellectual dexterity. Given current working conditions and employee expectations, new employees are required to develop quickly, since "time is muscle" in emergency cardiac medicine.
November 3-4, 2012, Ahmedabad, Gujarat, India
By Kintur Sanghvi, MD, Deborah Heart & Lung Institute, Browns Mills, New Jersey
I am posting this on my way back from the world’s biggest dedicated transradial course. Similar to the previous seven annual Trans Radial Intervention Courses (TRICOs), TRICO 2012 was another huge success story. Conferences like this are responsible for the worldwide rapid spread of radial access in last 5 years.
This year (2012) it is 20 years ago that I performed the first transradial coronary intervention at the Onze Lieve Vrouwe Gasthuis in Amsterdam. Since then, this technique has undergone a very interesting maturation process. Now transradial intervention (TRI) is recognized as a safe alternative for transfemoral intervention (TFI), and is gaining in acceptance and popularity. Reduction of bleeding complications and all the associated advantages of TRI, such as early ambulation, patient friendliness, cost reduction and even mortality reduction, makes this technique most suitable for coronary interventions.
Last week, I was in the beautiful city of Québec for AIM Radial 2012. The experience was one of a kind, with the breathtaking architecture of the city and the extravagant hospitality of the organizing team. As a true “master class” of the radial technique, we went beyond the basics and discussed why one should do radial in all difference subsets of interventional procedures. Dr. Olivier Bertrand and the whole international organizing team had a tremendous three-day program inclusive of live telecasts from Japan, France, Canada and US.
I have a fascination with computers and technology. My wife loves to say my iPad is my new wife.
There may be “no wrong way to eat a Reese’s”, but there is a wrong way to leave your current position…regardless as to whether it’s full-time, travel, or even registry. In the age of social media and the excess of information available on the internet, we have all either heard first-hand or seen horror stories of people leaving jobs in the worst of ways. Remember, the cath lab community is small and word travels fast because there are many common threads from one lab to another. Even if you harbor bad feelings to your current lab, leaving the ‘wrong way’ almost always comes back to haunt you when looking for future employment or if things change and you wish to return to your current facility.
Regardless of the situation, there is a proper way to go about moving on. Here are three things to consider when moving on to help you leave on good terms:
• Always try to give ample notice (2 weeks is usually acceptable, a month is better)
Having been in the travel business for 10 years, it’s no surprise that we frequently get calls from RNs and techs asking how to get started as a travel professional in the Cath, I/R, or EP labs.
The questioners usually all want to start traveling, but they generally have four areas of concern: compensation, whether or not there is consistent work, what type of benefits are offered, and the work environment involved with such a position.
While hot, humid air may be outside, a temperature of 68 degrees and humidity less than 50% is ideal for cardiac cath and electrophysiology laboratories. On occasion, the loss of air conditioning can occur and our hospital environment becomes hot and humid quickly. This has happened twice in my career. The first time at University of Pittsburgh Medical Center (UPMC) in Pittsburgh, Pennsylvania, we took a chance, turned on equipment and blew the x-ray tube. I remembered that scenario and was able to avoid damage to equipment with my second loss of air conditioning. I thought my experience might be useful information for other cardiac cath labs during the hot and humid summer.
Below is a copy of my email to the staff.
“Make a habit of two things: to help — or at least to do no harm.”
As a registered cardiovascular invasive specialist (RCIS) who is tableside for most cases, I have been programmed to anticipate the needs of the physician with whom I am working. In the presence of an angiographically significant stenosis, my thoughts begin to churn. What guiders and wires will the physician want? Are they going to request intravascular ultrasound (IVUS) or fractional flow reserve (FFR) measurements? What size and type of stent will the physician request? Will they post dilate? If the patient has multiple lesions, will they request a surgical consult? The list goes on and on. In the midst of these typical tableside ruminations, I often wonder about the treatment standards in light of the patient on the table before me.
1) IVUS and FFR