One thing that’s been hard for me while working in the cath lab is the lack of education I’m able to give to my patients. I love educating. I really think that patient education is a highlight of what nurses can do to make a difference in the lives of their patients.
Working in a procedural area, it’s not breaking news that we don’t get to spend much time with our patients (while they’re awake anyways). When we roll patients into the cath lab, they are usually nervous, so I focus on small talk to take their mind off of the procedure or do some pre-procedural education about what to expect at the start of the procedure (deciding between the two is based on a quick judgement about how the patient is feeling as I first meet them in their room before the cath). Then, they’re sedated for the procedure…
After the cath, they are usually groggy which leads to short term memory issues (they can barely remember that we told them the procedure was over, let alone information about which artery has blockage). If the patient’s post-sedation state of mind isn’t the issue, the patient has often gotten news they might not have been expecting, such as needed open heart surgery or receiving stents, which cause the patient to focus on those facts and limits their ability to take in other information.
So, that’s been one of my issues. I would love to educate patients on the importance of taking their Aspirin and Plavix, or the importance of risk factor modification based on the results of the cath. I miss having that opportunity.
During a recent on-call shift, we were called in to cath a 38 year old female who was having a heart attack. She has a significant medical history of high blood pressure, smoking, diabetes, and obesity as well as noncompliance of medication. Her cath showed a stumped off LAD (completely blocked coronary artery) and partial blockage in her other two arteries. When asked, she admitted that she often had trouble paying for her medications. There is an obscene amount of education that this patient needs: importance of taking her plavix, financial resources for medications, smoking cessation, importance of diabetes control (her glucose was 360), and the effect that smoking, obesity, and noncompliance with blood pressure/diabetic medications have on the arteries in the body.
But, after opening up her LAD with a stent, we took her to the ICU for recovery. Chances are that I’ll never see her again or know what happens in her life.
This is my motivation for becoming a nurse practitioner… continuity of care.
