Cardiac nursing is known as one of the most challenging specialties. A cardiac nurse who works in these units often cares for incredibly sick and complicated patients. He or she must have an in-depth understanding of cardiac rhythms, advanced cardiac life support, electrolyte imbalances, and even mechanical circulatory devices.
Nurses who specialize in cardiac care may choose to work in a clinic, an acute care floor, or an intensive care unit. While each of these units seems very different, the concepts and theories cardiac nurses must understand are very similar.
Related: Cardiovascular Specialty CE Courses for Nursing Professionals
Clinical cardiac nursing
Cardiac nurses who work in a clinic usually specialize in educating patients. They help them manage chronic conditions, avoid exacerbations of their heart disease, and prevent the development of life-threatening problems.
A clinical cardiac nurse educates patients on the following:
Hypertension
Patients can be taught about the different stages of hypertension including;
| Stage 1: Occasional, infrequent blood pressure elevations and mild cardiovascular disease | Stage 2: Consistent blood pressure elevations or progressive cardiovascular disease | Stage 3: Significant and sustained blood pressure elevations or severe cardiovascular disease |
Heart failure
There are many different types of heart failure, all of which require different management strategies. The cardiac nurse needs to understand many types of heart failure including:
- Right heart failure
- Left heart failure
- Biventricular failure
- Restrictive cardiomyopathy
- Dilated cardiomyopathy
- Non-ischemic cardiomyopathy
- Ischemic cardiomyopathy
Medication management
Like many other highly specialized nurses, there are a few medications that are especially important for the cardiac nurse to understand. These include:
- Beta-blockers. Medications that control the heart rate but may lower blood pressure.
- Diuretics. Many patients with heart failure retain water and need to take “water pills” to avoid overloading the heart with too much fluid
- Ace inhibitors: These medications help your blood vessels to relax and lower your blood pressure.
- Statins. These are cholesterol-reducing medications that may help prevent heart attacks or strokes.
- Blood thinners. Patients with cardiac disease need to be taught about the importance of blood thinning medications, and how to manage excess bleeding if it happens.
Genetic risk
Some families are surprised to know that heart diseases and congenital malformations are often passed down through genetics. Nurses who pursue a cardiac career may spend their time talking to families and helping them assess their risk of passing these genes to other family members.
Lifestyle changes
Most people understand that eating healthier foods and exercising is the best way to keep their hearts healthy. However, many patients find that making good lifestyle changes is a challenge. Cardiac nurses can help patients identify their strengths and weaknesses, and then build a manageable plan to improve their health.
Pacemakers, mechanical valves, and left-ventricular assist devices
Patients with cardiac disease often leave the hospital with life-saving devices such as mechanical valves, pacemakers, internal defibrillators, or even mechanical circulatory devices. Cardiac nurses must become experts in all these devices so that they can teach their patients about the management of the device, what to do in case of an emergency, and what symptoms warrant a trip to the emergency department.
Related: Cardiac Rehabilitation: The Nurses’ Integral Role in Heart Recovery
Acute care cardiac nurses
Nurses working in the hospital care for many of the same patient populations as those that are seen in cardiac clinics. However, patients in the hospital have typically had some kind of complication related to their heart disease or exacerbation of their symptoms.
Hospital cardiac nurses usually have patients hooked up to telemetry monitors, meaning they are always watching for changes in cardiac rhythms. Telemetry nurses have an in-depth understanding of different heart rhythms, 12-lead EKG interpretation, and electrolyte imbalances.
Hospital cardiac nurses may also deal with chest tubes, pericardial drains, epicardial wires, and more. Most hospital cardiac nurses must also have their advanced cardiac life support certification.
Intensive care cardiac nurses
Cardiac patients who need the intensive care unit are some of the most critically ill patients in the hospital. These are patients who may be in cardiogenic shock, have had a myocardial infarction, or are recently recovering from cardiac surgery.
There are several devices that are specific to cardiac intensive care. These include:
- Impella
- Intra-aortic balloon pump
- Right ventricular assist device
- Total artificial heart
- Extracorporeal membrane oxygenation
These devices require advanced knowledge of hemodynamics, anatomy and physiology, and critical care IV drip medications. Most hospitals require nurses to have several years of experience in other cardiac units before they are allowed to care for these types of patients.
Cardiac nurse certifications
Nurses who are interested in becoming cardiac care RNs often need to get some experience and earn a few certifications beyond what is typically required. Cardiac nurses may need to earn their ACLS, CCRN, PALS, or CVNC.
Many nurses who work in cardiac care units, especially in the ICU, return to school to become nurse practitioners or certified registered nurse anesthesiologists.
