Stephanie Cody (second from Left) with Cath Lab Team

Cath Lab Nurses -- High-Tech Nursing Helping To Heal Hearts

 If you’re looking for innovative, high-tech nursing, a career as a Cardiac Catheterization Lab (cath lab) nurse may be your ticket. 

It’s certainly what attracted Stephanie Cody, charge nurse in Des Peres Hospital’s interventional cath lab, to the field. A former cardiovascular recovery nurse, Cody was drawn to the cath lab because of its fast pace and because “it is immediate – you can see what you’re fixing and that is enormously gratifying.”

Cardiac cath lab nurses aid in the diagnosis of heart disease and help administer interventional procedures, including cardiac catheterizations, angioplasties, and stents. They help doctors in the implantation of pacemakers and implantable cardioverter-defibrillators (ICDs), and must keep up on the latest technologies of this rapidly evolving field.

Cardiac cath lab nurses at Des Peres Hospital typically work four ten-hour shifts and can do from between ten and fifteen cases a shift.  In addition to regular shifts and scheduled procedures, cardiac cath lab nurses can be on call to help care for victims of heart attacks and other emergency procedures.

“You need to be flexible, be able to work within a team, and be able to deal with stress,” said Cody, “because your original schedule can change on a dime.” Cardiac cath lab nurses are responsible for preparing the patients before the doctor arrives: greeting them, letting them know what to expect and calming any nerves before bringing them into a procedure room, hooking them up to the heart and blood pressure monitoring equipment and providing them with intravenous sedation and other medications.  During procedures, they also lead two other people who support the doctor, the cardiovascular technician and the radiology technician.

“Every RN here in the cardiac cath lab at Des Peres Hospital is oriented to all the equipment and can perform any of the team’s duties,” said Cody.  “We have to update our cardiac cath lab competencies annually to stay on top of new technologies and techniques in addition to our annual general nursing competencies and Advanced Cardiovascular Life Support (ACLS) certification.”

As charge nurse, Cody also has administrative duties that include scheduling staff and coordinating the “traffic” in the cardiac cath lab’s three procedure rooms. “I always wanted to be a nurse,” said Cody, a 12 year veteran. “I thought it would be the ‘coolest’ career and I was right – there is a lot of opportunity to do many different things within nursing.”

	Glenda Pessetti gets ready for surgery

Surgical Technologists -- Ensuring a Safe and Sterile Operating Room

Glenda Pessetti never dreamed she’d one day be working in an operating room.  For twenty-five years she had worked in a photoelectronics factory.  But one day her job at the factory was gone, victim of international competition, and she found herself contemplating a second career. So Pessetti signed up for a retraining program offered through St. Louis Community College. 

“I was going through the catalog of careers, and it just caught my eye,” she said of her decision to take the 12-month Surgical Technologist course.  She said that she had always been fascinated by anatomy and enjoyed watching medical shows on television.  “Now I would be the gal who answered ‘Scalpel!’ when the doctor called for a scalpel,” she laughed.

Surgical technologists are members of the operating room team.  It is their responsibility to help prepare the operating room before an operation by setting up surgical instruments and equipment, sterile drapes, and sterile solutions.  They assemble both sterile and nonsterile equipment, as well as adjust and check it to ensure it is working properly.  Pessetti said she typically gets to her room about an hour before her first surgery to set up.

Technologists also get patients ready for surgery by washing, shaving, and disinfecting incision sites.  They help position them on the operating table, and cover them with sterile surgical drapes.  Technologists also observe patients’ vital signs, check charts, and assist the surgical team with putting on sterile gowns and gloves.

During surgery, technologists pass instruments and other sterile supplies to surgeons and surgeon assistants.  They may hold retractors, cut sutures, and help count sponges, needles, supplies, and instruments.  Surgical technologists help prepare, care for, and dispose of specimens taken for laboratory analysis and help apply dressings.  Some operate sterilizers, lights, or suction machines, and help operate diagnostic equipment.

After an operation, surgical technologists may help transfer patients to the recovery room and clean and restock the operating room.

Pessetti has been a Surgical Tech at Des Peres Hospital since 2002.  She assists primarily with orthopedic surgeries, however she also gets called in for general surgery cases.

When asked what makes a good surgical technologist, Pessetti listed a few qualities:  “Be well-organized, have lots of stamina -- because you could be on your feet and in an operating room for hours at a time -- and be highly ethical and conscientious about your work because you are responsible for infection control in the room and the moment something is contaminated you have to discard it.”

Sabrina Bell in the CT Lab

Radiologic Technologists -- Helping Physicians Peer into the Body

Sabrina Bell was a senior in high school, sitting at the Walgreen’s deli counter in Normandy when she noticed a staffer from the nearby hospital wearing an armband that read “Radiologic Technologist.”   It intrigued her so much, that, at that very moment she decided she would pursue Radiology as a career.

According to the American Registry of Radiologic Technologists (ARRT), radiologic technologists are the third largest category of health care professionals, surpassed only by physicians and nurses.  “Rad Techs” perform procedures such as X-rays for broken bones, mammograms to detect cancer, computed tomography (CT) scans to view cross-sectional images of the body, bone density scans to check for osteoporosis, magnetic resonance imaging (MRI) to identify soft tissue damage, nuclear medicine to determine the presence of disease in a particular organ, and ultrasounds to monitor a pregnancy. The images they produce help physicians “peer into the body” to diagnose many diseases and conditions.

When she first began working in 1978, Bell performed what she calls “basic” radiography – the standard broken bone and chest x-rays as well as upper and lower gastrointestinal (GI) series, a set of X-rays taken to examine the esophagus and stomach or intestines after the patient has swallowed a contrast medium.  She also handled certain special procedures, such as angiographies, where a contrast material is injected into one of the arteries, allowing the health care provider to see the vessel.T

he year the hospital got a CT scanner, Bell learned how to use it.  In CT, a thin X-ray beam rotates as small detectors measure the amount of X-rays which make it through the patient or particular area of interest.  A computer analyzes the data to construct a cross-sectional image. These images can be stored, viewed on a monitor or printed on film. Stacking individual images can create three-dimensional models of organs.

Today, Bell focuses solely on CT – doing biopsies for cancer patients, scans of the abdomen, chest, pelvis and head.  Over the years, she says that advances in technology have made some aspects of her work a bit easier – “Because much of the equipment is computerized, we have to do less calculations to determine how to get the best image,” she said.

Once she has completed the procedure, she prints out the film for the radiologist to interpret.  That interpretation is then faxed or mailed to the attending physician’s office so that he or she can determine the proper course of treatment.

In addition to strong technical abilities, Bell notes that a good radiologic technologist has to have compassion and be able to explain each procedure to patients.  “The equipment, the unfamiliar environment and the sometimes uncomfortable testing process, like the side effects of a contrast medium, can be stressful to a patient,” said Bell, “so I see it as my job to reassure them and help them understand each step.”

	Cindy Rice outside the OR

Registered Nurses -- Operating Room Nurses Manage Patient Safety

Cindy Rice has already put several hours into her day before many people have had their morning coffee.  A registered nurse who works as a circulator in the operating room, Rice is at work by 6 a.m., reviewing her surgery schedule and getting all equipment and supplies organized for the day.

“You have to make sure you anticipate your needs from the get go,” said Rice, “because things get fairly busy once the day gets rolling.”

As nurse circulator, Rice has multiple duties, all revolving around keeping the patient safe and ensuring a successful procedure.  First, she is responsible for making sure the patient is ready for surgery:  she meets the patient in holding, double checks that all pre-operative testing and blood work are on the chart, and does a correct site identification.  Before surgery begins, Rice makes sure that all trays and equipment are ready and in the operating room and positions the patient correctly on the operating table.  She is also responsible for conducting the important pre-surgery “time out,” where the team and surgeon again double-check the patient's name, procedure, and which body part will be operated on.

During surgery, the nurse circulator keeps all documentation, provides updates to the family, and “generally acts as a patient advocate,” said Rice.  Because all other team members are working in the sterile operating field, the nurse circulator is the only person who can get supplies, wipe sweaty brows or otherwise leave the room.

Before any incisions are closed up, the nurse circulator counts all instruments and supplies with the scrub nurse to make sure nothing is left in the wound. 

When the surgery is complete, the nurse circulator accompanies the patient to recovery and gives a report before turning the patient over to the recovery room nurses’ care.

Operating room nurses can work 8, 10 or 12-hour shifts.  Rice works three 12-hour shifts a week, primarily on orthopedics cases, including knee, hip and spine.  She moved into her position as operating room nurse five years ago, after spending 20 years as a nurse in same day surgery and in the recovery room.  What she loves about nursing is that it has allowed her to try new things.  “With a nursing degree, your career can take many different directions,” Rice said. 

When asked what makes a good operating room nurse, Rice listed good organizational skills, the ability to work well in a team, and the humility to ask for help when you need it.  “You can’t be afraid to ask for help – this can be a very physically demanding job and you have to take the time to make sure the patient is safe and that you are doing things right,” she said.