10 Minute Interview with...Annie Ruppert, RN, BSN,San Diego, California

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Why did you choose to work in the invasive cardiology field?

I find this field to be interesting and forever changing. I graduated from a 3-year diploma nursing school in 1976 and obtained my BSN from Regents College. I have worked at Sharp Hospital since 1978, first in the MICU and CCU and then in the cardiac cath lab. Currently, I do case management and follow all the interventional patients who have percutaneous interventions.

Can you describe your role in your CV lab?

My role is primarily to circulate and take care of the patient’s needs. I do the assessments pre and post, monitor the patient during the procedure, administer conscious sedation and monitor its effects, as well as administer medications such as IIb/IIIa infusions, heparin, and Angiomax, and monitor ACT levels. Basically, I attend to all the patient’s needs during the procedure and evaluate how the patient is tolerating the procedure.

What is the biggest challenge you see regarding your role in the CV lab?

The biggest challenge I see in my role in the CV lab is trying to stay on top of all the new equipment, devices, medications and latest research coming out in cardiology. Every day there is a new product, a new research study, and/or a new medication.

Sometimes it is difficult to be knowledgeable about it all. We do get training and inservices on all new devices and products, which helps a great deal.

What motivates you to continue working in the CV lab?

1) Working in the CV lab helps to keep me updated on new equipment and procedures, and this helps me with teaching and follow up with the interventional patients.

2) It assists me in maintaining my skill levels and critical thinking skills.

3) I can make extra money that I always can use, being a single parent.

4) I can continue to grow and learn every day.

What is the most bizarre case you have ever been involved in?

Once, while doing an interventional procedure on a patient, the burr got dislodged somehow. They tried to use a snare to retrieve it but without success. The patient ended up having to go to surgery to get it removed.

Describe the relationship between physicians and staff at your lab.

The MDs are very willing to teach the staff. I think our staff and MDs work well together and are a strong team.

The physicians that I work with are very good. They keep themselves updated on new research and practice evidence-based medicine. We have a weekly cardiac conference where difficult cases are presented, and the cardiologists and surgeons discuss the best treatment options. Also, we have a conference once a week on various topics, like antihypertensives, new treatments for CHF, DM, etc. You get continuing education credits for attending. There is also an M&M conference once a month.

Are you involved with the SICP or any other cardiovascular societies?

Unfortunately, at this time I am not involved in SICP or any other cardiovascular societies. In the near future, I would like to become a member.

Are there any websites or texts you would recommend to other labs?

There are many good textbooks available now for cath lab staff. Some of the ones that I find most helpful are:

Wes Todd’s CV Review
Sue Apple, Principles and Practice of Interventional Cardiology
Sandy Watson, Invasive Cardiology: A Manual for Cath Lab Personnel
www.cathlabdigest.com [5].

I also really like the Cath Lab Digest Email Discussion Group questions. It helps to hear from other cath lab employees what they do and how they handle certain issues within the lab.

If you could send a message back to yourself at the beginning of your cath lab career, what advice would you give?

I guess the one message would be to pay more attention to and learn more from my fellow colleagues. There are employees in the lab who have a wealth of knowledge and expertise. I would make sure I spent more time learning from their years of experience.

Where do you see yourself professionally when it is time to retire?

When I retire, I would like to see myself on an island with a cool drink in my hand. Actually, I would like to go back and get a master’s degree in nursing or become a NP. I would also like to become more involved in the management aspect of the cath lab.

What changes do you think will occur in the field of cardiology in the future?

In the coming decades, I think the field of interventional cardiology will continue to grow. I think there will be a less invasive approach in a lot of instances. I think the field of peripheral vascular interventions will continue to grow. All the data that you have in the cath lab will become more integrated and systems will become more automated. There will be more evidence-based practice in regards to devices and products. Continued research, more advanced technology¦the possibilities are endless. Improvements will continue to come and will enable us to offer our patients more treatment options.

Annie Ruppert can be contacted at:
Annie.Ruppert@sharp.com