What Do You Think?

LVNs in the Cath Lab Does anyone have any information on staffing a cath lab with LVNs? I currently have a LVN working as a scrub and in the holding area. Can’t the LVN monitor cases? Any policies or protocols out there? Thanks, Kathy.Nugent@LoneStarHealth.com Dear Kathy, I am an LPN/RCIS. I’ve been in the cath lab 17 years. At the time I was hired, our policy for personnel in cath lab included RNs, LPNs, RTs, and Resp. Techs. Also, at that time everyone was trained to scrub, monitor, x-ray, and circulate. As the technology grew, we included CVT/RCVT. As we approached the 1990s, our lab became more specific in personnel. We still hired RNs, RTs, and CVT/RCVTs, but dropped LPNs and Resp. Techs unless they became RCVT/RCIS. Since then, only our RNs circulate, but all are trained to monitor, scrub and help RNs (help in getting products and in caring for patients). Over the years, we have become even more specific in that we hire nurses only from an intensive care unit and respiratory techs who graduated from a 4-year program that included cath lab as clinicals. We dropped the LPN only because they did not have intensive care background. As for myself, the only LPN, I was originally trained to do all the jobs and got my RCIS. I can help nurses in circulation (I can give PO meds and start I.V. assess for conscious sedation). But yes, the LPN in your lab can monitor because they already had EKG training and pharmacology and can also aid the RN in circulating. Roberta Naden Baton Rouge General Baton Rouge, Louisiana ACS/Acute MI Clinical Pathway We are working on a clinical pathway for ACS/Acute MI and would like to categorize the hospital stay by phases, rather than day by day. Are there any definitions for the acute phase vs. the intermediate phase? Thanks, Patty.Newsom@carolinashealthcare.org Dear Patty, Have you been to the Strive workshop yet? There are pathways for acute coronary syndrome (AMI and non-Q MI). They give you all of the information and you just need to personalize it for your hospital. They follow the American College of Cardiolgy/ American Heart Association guidelines. They are written in phases rather than days, although days and times are sometimes attached. ED (phase 1) Cath Lab (x # of hours) etc. Their website address is: www.strive.ncme.com Anna Smith, RN Clinical Educator Cardiac Cath Lab annasmith@chi-east.org

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