The Ten-Minute Interview: Rick Meece, RCIS, RCS, FSICP, Secretary, Society of Invasive Cardiovascular Professionals,Nashvil

A snapshot of one cardiac cath lab professional's experiences, ideas and work
A snapshot of one cardiac cath lab professional's experiences, ideas and work
Why did you choose to work in the field of invasive cardiology? I spent a lot of my early employment years in various medically-related positions. At age fifteen, I landed my first job working in radiology on weekends in Lexington, Kentucky. There was only myself, a radiology PA, and two rad tech students on the weekends. It was an environment where I worked in many different capacities, and learned all the elements of diagnostic and invasive radiological procedures right along with the students, especially in emergency situations. In those days, CT and MRI did not exist, and most cardiac caths were performed in radiology departments, so we received just about everything urgent that came through the door. That environment the ability to work deeply embedded in science and technology, and the desire to minister and give peace to those who are injured or in acute medical conditions stuck with me. After spending another three years as a Recovery Room Technician and another two as Operations Manager for a home health corporation, my wife and I decided to move to Nashville, Tennessee, where I studied and received a degree in Invasive Cardiovascular Technology, with an additional rotation in Echocardiography. I am currently continuing my education in Nursing and Radiological Science (BS). This year begins my fourteenth year in the invasive arena. What is the most bizarre case you have ever been involved in? Rather than tell one from my own experiences, I will tell one from my first on-the-job mentor, Gene Goforth, a CVT who helped convert me from simply book-smart to a real CVT practitioner. To this day, every time I am teaching someone intra-procedure, I smile to think of him thumping me on the shoulder or head to pay attention to the hemodynamic monitor and EKG instead of the recording notes. Gene once told me of a case where a prominent attorney was on the table in an emergent situation. Apparently, the lawyer possessed an animated personality as it was, and proceeded to fibrillate while on the table. After a couple of shocks, he converted back to sinus rhythm. He then woke, and raising up his head, said, If you let me die here on this table, I will come back and haunt every d**n one of you! and immediately went back into ventricular fibrillation. After a couple of very panicky further shocks, he was converted again to a stable rhythm, and much to the relief of the staff, remained so or so the story goes. Where do you see yourself professionally when it is time to retire? We now are seeing the dawn of a new medical millennium. It will bring far-reaching changes to the way we interact with and implement science and technology at the patient care level. Non-invasive modalities will increasingly merge with invasive modalities at different levels. The type of minimum-level didactic education and required credentialing shifts even as we speak. As the level of technology increases, so will the responsibility of physicians and institutions. They must possess the staff who best represent their needs in providing quality assurance and patient safety in both diagnostic and interventional cardiology. As my career expands and changes with that technology, I see myself shifting towards performance in those areas, and consulting where my talents are needed. I have always believed that hard work and commitment to excellence pay off long term, as long as the core spirit that drives you is providing a ministry to the patients who need our talents to survive. As privatization continues in the healthcare setting, I believe more and more of us will be working closely with physicians’ practices in multiple settings. The reality is that institutions will begin to look at outsourced personnel services in the future. Those who are knowledgeable about outsourced management and services, and liasoning that service between physicians’ practice and institutions will be valuable. Privatization of medical services demands well-educated and cross-trained personnel. I plan to position myself as someone who offers the most value to their patients’ care for the best investment on their part. I believe those individuals will be well compensated, and worth every penny to their employer. Why did you choose to get involved with the SICP? How did it happen? Roughly five years ago, I was very frustrated with what I perceived to be undue lack of recognition for the RCVT (now RCIS) on both a local and national level. I had previously left a position where I received no raise or recognition for passing both the invasive and non-invasive registry exams. I could not believe I had done all that work and study for nothing. Happily, I now am employed at a place where that recognition exists in most areas, including pay scale. It gave me a springboard to work on advancing professional practice nationally. About four years ago, I approached Chris Nelson (the SICP past president) at one of the Cath Lab Regional programs. I asked what I could do to start an SICP chapter in the Nashville area. Chris informed me that the SICP was involved in a number of initiatives aimed at strengthening its infrastructure and it was not ready to formally support state or local chapters. He suggested I attempt to keep my regional group non-denominational in the beginning and focus on gathering nurses and technologists to discuss topics relevant to our practice in Tennessee. Not long after that, our Clinical Nurse Specialist, Carol Parsons, asked me if I would like to work with her on a local cath lab society, providing education and networking. Hmmmm¦sounded familiar! From that point on, the CCP (Cardiac Cath Professionals) Nashville was born, and has been successful ever since. We have hosted two successful Invasive Registry Review Courses, sponsored by the Saint Thomas Heart Institute and Cath Lab. In 2000, Roger Siegfried (RCIS, FSICP) took over as President of the SICP, and on recommendation from Chris Nelson, offered me the position of Secretary. Along with being the historian, I am directly involved with membership and marketing activities, and recently was appointed to the Cardiovascular Technologists Committee for the ACC/SCA&I physicians’ societies. Your work for the SICP is volunteer. What motivates you to continue? Personally, I believe volunteerism should be an ingrained trait, carefully parented from early on. Sometimes we adopt the get something for everything I do mentality, which suppresses volunteerism, and denies us the valuable self-fulfillment that volunteerism offers. Although I am proud of my current on paper accomplishments, I find as I grow older that I look more and more for things that ask we go the extra mile. What you say you believe in should actually carry through in your personal actions, whether public or private. After helping others using the gifts you have been given, you walk away with a much greater sense of purpose and direction. We have started a lot of important, exciting work in the SICP during the last year. I firmly believe that we can make tremendous strides in the areas of maximum integrity, efficiency, and education of the invasive cardiovascular professional, translating to the best patient care possible. The physicians’ societies, the ACC and the SCA&I, have asked for and included us on their committees in these areas, and we are ready to do the work with their guidance. What is the biggest challenge you see regarding your role with the SICP? As an optimist, I always refer to challenges as goals. Roger Siegfried has done a phenomenal job of reaching goals in expanding the board to a global field perspective, with strong recent additions in positions of Education and Professional Practice. My near-term goal is getting the new SICP membership package out to both the potential and loyal members of the SICP. It is very indicative of the new SICP, with benefits moving to a broader focus than just association and regional education. The SICP offers real benefits that members can take advantage of, well beyond the cost for annual membership. I feel it is vital for members to understand that the quiet SICP of the last two years has actually contained some of the most fruitful and busy work since its inception. Editor’s Note: A detailed report from the SICP President will be forthcoming in an upcoming issue of Cath Lab Digest. It will include information on the new membership package. My other goal is to pray I’ll have the time to continue the work, which is always the real behind-the-scenes challenge all volunteers struggle with. Again, Roger Siegfried and the SICP’s work in contracting with a more focused management firm for the society enables us to concentrate our efforts without the diversions of day in/day out business challenges, which the new management firm now handles for us. Also, our new office location, near Washington, D.C., gives us excellent proximity to important entities in legislation. I certainly here must thank again my institution, and particularly my team leaders for working with me when I have needed time to travel on short notice. This is volunteerism on their part, and much appreciated. The last and one of the bigger goals is to use effective communication to bring together all the entities involved in invasive cardiology into one body of collective thought and process. The crisis in obtaining and retaining qualified personnel has already taken root, and yet we are not even close to the critical mass of demand that will surge with the aging baby boomer population. Too many turf wars exist on the premise of biased opinion rather than facts, particularly on issues that involve the difference between state practice acts, which involve law, and simple position statements or institutional policies, which do not. It is critical and I stress, critical that we as a body of invasive cardiovascular professionals physicians, staff, and administrators come together and form a long-term communication platform that will create, support, and define the needs of the invasive arena before a lack of cohesion forces others to attempt to define them for us. The SICP has begun a physician-directed initiative, and we look forward to accomplishing the work ahead. If you could send a message back to yourself at the beginning of your cath lab career, what advice would you give? Don’t sell yourself short based on the opinions of others. Should I repeat that? One of my favorite discussions is the perception is reality misnomer. Perception is rarely truth because it continually changes as a result of experience and the learning curve. For example, how do you perceive a homeless person on the street? Is a well-dressed individual truly happy and successful? However, perception does count when it comes from the patients we care for, and the people we work for and with. Because of that, we have to work as a team in the cath lab, irregardless of how we perceive each other as professionals or individuals. We may be biased against each other for reasons like sex, race, and religious or political views. Staff members may seek to crucify excellent managers because they are not visible, and therefore don’t care about the staff, even though they are still in meetings hours after the staff has left. It goes on and on. First, my advice is to give each other a break. We are all seeking to make a living and have the privilege to touch peoples’ lives in the process. How many can say that? Make it a daily personal goal to lift others up in spite of personal challenges you may be going through. One destructive element of human nature continues to hamper team work and affects the quality of care in cath labs across the country persecution without justification. If you are educated, credentialed, competent, and committed to excellence, you are a tremendous asset for the continuum of care in your workplace. Don’t let biased personal issues be perceived as professional issues, and if they are, be bold enough to seek resolution rather than revolution. Treat everyone well, but especially those who persecute you, and the reward will be great. Secondly, join the SICP immediately. Because you do have to go into work everyday, you can’t fight the fight in the workplace. It’s inappropriate and inhibits good patient care. That’s why societies exist, to voice your concerns about responsibility, recognition, and education. But what we can accomplish and offer is directly related to membership and involvement on your part. If you are a cath lab nurse and don’t feel your issues are being heard, join and become involved. We just appointed two more RNs to the board to ensure balance in this area. Physicians, CCRNs, RCVT/RCISs, RTR/CVs, RRTs, and MHAs are all involved on our board and always have been. In other words, be an architect of the future, not a spectator of it. What changes do you think will occur in the field of cardiology in the coming decades? Non-invasive and invasive technologies will merge in new and different ways. Magnetic Resonance Angiography is going to have a big impact in diagnostic cardiology, as is the increased use of contrast stress echocardiography. Invasive cardiovascular labs will, in my opinion, be primarily interventional in the near future, with most diagnostic services taking place in physicians’ practice facilities, whether private or joint ventured. Low-risk interventional cases will be performed in regional facilities more than in the past. Cardiac and vascular institutes will continue to merge into singular, commonly-staffed units. Drug-eluting stents and brachytherapy will increase the return time for compliant patients who have received stent implantation(s), which in turn may reduce suite and staffing needs after the baby boom curve has peaked somewhat. In order to keep the compensation high enough to continue to attract students to medicine, particularly cardiology, I believe federal government support for privatization will continue; hence, there will be more joint venturing, outsourced services, etc., on the part of physician practices. This is the only way the government can continue to lower reimbursements and keep physicians adequately compensated. It seems a return to power is taking place from big insurance back to physicians, and I applaud that loudly. In my opinion, decisions on our care should be made by the people who have accepted ultimate legal and moral responsibility for it, not those watching the bottom line at corporations. Ultimately, genetic technologies will take root along with new intelligent mechanical devices, prolonging life to new levels, and giving us time to solve the real problem… Ourselves.