All staff at Geisinger Medical Center’s Cath Lab in Danville, Pennsylvania, holds the RCIS credential.
What is the RCIS?
The Registered Cardiovascular Invasive Specialist (RCIS) is a nationally recognized credential. It serves the purpose of implementing a specific skill set and knowledge necessary to those staff providing care for patients in the cardiac catheterization laboratory (CCL). This may include administering medication, fluoroscopic injections, hemodynamic monitoring, and panning of the x-ray system. These individuals are a unique extension of the doctor’s resources. As such, this knowledge may be conducive during procedures in finding clinical diagnoses.
Credentialing in the healthcare setting has grown proportionally as advancing technologies continue to develop new forms of treatment. There are currently over 200 specialties related to nursing, many of which did not exist in prior years. New procedures are being trialed and put into everyday practice, year in and year out. As these procedures evolve, the necessary education to maintain competency also evolves. Many of these specialties and subspecialties have national exams for which healthcare workers can sit and potentially add to their list of credentials. Not only is specializing encouraged by hospital administrators, but it is also required, in many instances. For instance, an RN working in an intensive care unit (ICU) or critical care unit (CCU) is often required to become critical care certified (CCRN) within a given timeframe. Many nurses working in the pediatric intensive care unit (PICU) have gone through formal pediatric training leading to certification as a pediatric nurse (CPN).
The cardiac catheterization lab is a unique setting in which new equipment, procedures, and protocols regularly present themselves. Just as the work requirements for this specialty are unique, the education is as well. Proper credentialing provides workers with the best skills and education, resulting in better patient outcomes. Many employees are compensated for their advancement in education and are also more marketable.
An all-RCIS cath lab
Geisinger Medical Center (GMC) sits within the rural landscape of the state of Pennsylvania. Despite its quaint surroundings, GMC is a teaching hospital that fully supports the area. It is a 404-bed, level 1 trauma center and among the top-ranked 66 hospitals across the United States for health and hygiene protocols. Within the hospital, a fully credentialed CCL and cardiac electrophysiology (EP) laboratory provide superior care to the area population. An average of 10-15 cardiac catheterizations are performed daily, including diagnostic and interventional cases. Specialty procedures are also performed, including but not limited to: TAVI/TAVR (transcutaneous aortic valve insertion/replacement), peripheral, and pediatric cases. An accredited cardiovascular school offers students the discipline of didactic and extensive clinical experiences while immersed with the staff at GMC. The head of the CCL, Dr. James Blankenship*, an interventional cardiologist, continues to steer the department towards innovation and excellence. He has had over 20 years experience at GMC and supports the importance of having a fully RCIS-credentialed staff.
GMC is a unique establishment in that the CCL is staffed by all-RCIS personnel. The entirety of the RCIS scope of practice is performed daily without a mixed platform in staffing. When the scope of practice of the RCIS credential came into question under the PA legislature in the 1990’s, Dr. Blankenship supported the addition of the RCIS credential to the allied health list of professionals. In the state of Pennsylvania, an allied health professional possesses the ability of medication administration within their scope of practice. However, hospital administration may either recognize this ability or not. Since GMC possessed a uniform platform of allied health professionals within the CCL and no changes to the RCIS scope of practice were state-mandated, the GMC CCL was allowed to continue with its practice. Therefore, over the past 20 years, Dr. Blankenship has seen the CCL staff exist as a cohesive family without turf wars between the separations of the staff ‘job descriptions.’ Patient quality of care has never been compromised or even lessened by the presence of all-RCIS personnel. Due to the ease of scheduling and workflow, GMC’s resources are used efficiently and prudently. Essentially, there are “no peaks and troughs that have to be filtered out.”
Though liability issues may be a concern to some, it has never been an issue with Dr. Blankenship due to his “captain of the ship” principle, where the doctor, the head of the lab, will take full responsibility for the lab no matter whom is present, whether other doctors, nurses, or staff. For whoever is in charge in the lab, all repercussions will fall upon their shoulders, no matter the staff present. At the lab, there have been situations where an experienced and credentialed RCIS has been able to lend suggestions and aid that have facilitated successful outcomes. A credentialed RCIS staff possesses the knowledge necessary to not only perform the job required, but to be able to be an extension of the doctor’s own knowledge. The role of the RCIS is to not only aid the doctor, but to be able to provide the best environment and resources necessary to promote success. It is only possible with experience, interest, and above all, knowledge. “With a fully credentialed RCIS lab,” states Dr. Blankenship, “there is a healthy environment filled with experience and heads of knowledge, all of which are fully engaged in each and every case.”
In every field of occupation, from the medical world to the world of construction, there are specialists who are credentialed for that occupation; they are the experts of their trade. Everyone has their own specialty for a reason. The carpenter can construct a beautiful house, but would the carpenter also install all the plumbing? Society in general refers to masters at their crafts and their teams in order to achieve a successful outcome, no matter what the field. As such, the RCIS credential is essential for the specialty of care needed within the CCL.
*Disclaimer: The views of Dr. Blankenship only reflect personal views and not that of any society or professional organization.
This article was written by four cardiovascular technologist (CVT) students from the Geisinger Cardiovascular Technology Program in the hope of inspiring labs across the country to see the importance of having the RCIS credential, regardless of your previous educational/professional background.
Amanda A. Allanah, BS, RCIS (Received prior to graduation June 2013)
Matt R. Brode, BS, RCIS (Received prior to graduation June 2013)
Brittany A. McNeil, BS, RCIS (Received prior to graduation June 2013)
Ashley D. Olley, BS, RCIS (Received prior to graduation June 2013)