Interventional Radiology

IR Journal

David (Kim) Tang

California State San Marco ABSN Cohort 22

Interventional Radiology (Cath Lab)

        The nurse that I shadowed and observed for the day was M, a cardiac cath lab nurse. Her role is essentially perioperative care for the patient undergoing cardiac catheterization procedures. She would provide care prior to, during and after the surgery. She would gather the patient history and data to figure out what operation will be performed and the indications. Other details, such as previous medical history, current medications and pre-clearance material, such as lab work, EKG and chest x-ray results will be gathered. After that, the nurse and I proceeded to room to meet the patient. She would go over all the paperwork with the patient, clarify any questions that they would have and ensure that the patient is signing the form of consent with confidence. Our first client was an elderly man, had lots of concerns and was visibly anxious. It was during this moment that I observed the nurse in the teaching role and M was a very knowledgeable nurse. However, there was more to M than just being able answer questions. She had a very comforting nature and it really helped soothe the client. I’ve always heard that nursing is a mix of science and art, and I certainly witnessed the latter during that moment. Once the orientation was complete, we would then place the identification bracelets and stickers on the client’s wrist, then proceed to preparing the patient for surgery which included: connecting the patient to vitals machine (blood pressure, oxygen saturation and EKG), starting an IV, shaving the inguinal regions and cleaning the sites with chlorhexidine. She told me that although the chart says that they will go in one side, it is best to prep both in case there are complications advancing the cath. The doctor would have the option of making a second attempt at the other site without stopping the surgery.  

        During the catheterization procedure, there are a lot of things going on.  For obvious reasons, there is a team of approximately five to seven care providers. For the initial one that I observed, I joined during the middle of the session and it all seemed a bit chaotic and I remember just wanting to know what was happening as the doctor was standing next over the client with bloody gloves. M would snap me out of my daze and tell me to “Slap on some lead.” After putting on some attire that would protect me from radiation, I noticed that M had chosen matching purple ones for us, in which she found amusing. All would be forgiven when she described to me in detail exactly what was happening, the roles of everyone and what a nurse does. She would even make the cath technicians, and even the doctor explain things to me. M’s talent for comforting was not reserved just for the clients, as she would always include me in everything. During the procedures, M would anticipate the medication needs of the doctors and administer if needed. She would also screen calls and pages to the doctor, resolving them to the best of her abilities. The one thing that no one else did, and possibly due to different roles, is tend to the conscious client undergoing the procedure. M would occasionally go over to assess and check on them. In one case, knowing that the patient wanted to “see the procedure,” she had the doctor reposition the radiological screen so that the patient would watch. The role of M as an advocator was observed numerous times during this day for patients and for nursing students. She had no concerns of appearing annoying, or a nuisance, to the medical providers, as long as it was for the betterment of the patient. A few observations of activities from the nurse that abided to state regulations was the quiet area used for calculating medications and the time-out checklist that she used to brief all members of the team prior to the surgery.