Cardiovascular Nursing

THE ULTIMATE GUIDE TO THE CARDIOVASCULAR NURSING

Around the world, cardiovascular diseases (CVDs) cause more deaths than any other disease or condition. According to the World Health Organization (WHO), approximately 17.9 million people died from CVDs in 2019, constituting 32% of all deaths worldwide. Heart disease is also the leading cause of death in the United States. Every thirty-four seconds, someone in the US dies from heart disease. In fact, in 2020, cardiovascular diseases caused 20% of all deaths in the country. 

heart attack

Wondering why to choose Cardiac nursing? The prevalence and gravity of heart disease make cardiovascular or cardiac nursing one of the most essential nursing specialties today. Nevertheless, to decide on the best specialty for you, you must consider more than relevance and demand. Read on to find the answers to all your questions regarding cardiac nursing, from how to become a cardiac nurse to responsibilities, salary, and much more.

Table of Contents

What Does Cardiovascular Nursing Mean in Medical Terms?

The definition of cardiac is “of, relating to, situated near, or acting on the heart;” therefore, cardiac nursing refers to the care of patients with heart diseases or conditions. Cardiac nurses are trained to diagnose, treat, and manage diseases and conditions of the cardiovascular system. They also work toward disease prevention through strategies such as screenings, stress tests, and health counseling. 

Patients of cardiac nurses might suffer from any of these cardiovascular diseases:

  • Coronary heart disease: This is a disease of the blood vessels that supply the heart muscle.
  • Cerebrovascular disease: This condition affects the blood vessels supplying the brain.
  • Peripheral arterial disease: This disease affects the blood vessels that supply the arms and legs.
  • Rheumatic heart disease: Rheumatic fever, caused by streptococcal bacteria, damages the heart muscle and valves.
  • Congenital heart disease: Some people are born with malformations that alter the normal development and functioning of the heart. 
  • Deep vein thrombosis and pulmonary embolism: These conditions refer to blood clots in veins of the legs, which can move to the heart and lungs.

Where Do Cardiac Nurses Work?

Cardiology nurses can work in many healthcare facilities, such as hospitals, medical clinics, long-term care facilities, and cardiac rehabilitation centers. They can also work in educational institutions carrying out clinical research.

What Is a Cardiac Unit in a Hospital?

In the hospital setting, cardiac nurses can work in several units, including the cardiology, intensive care, and surgical units. In each of these units, cardiac nurses carry out different roles.

What Does a Cardiac Nurse Do?

Cardiac nurse teaches patient

Many cardiac nurse duties are the same as those of any other registered nurse (RN): They evaluate and treat patients, administer medication, prepare patients for surgery, care for them after surgery, and educate patients and their families. Nevertheless, many cardiovascular nurse responsibilities are specific to this nursing specialty, including the following: 

  • Diagnosing chronic and acute cardiovascular diseases through physical examinations
  • Evaluating cardiac tests, such as stress tests, exercise stress tests, stress echocardiograms, PET/dipyridamole stress tests, and CT coronary angiograms
  • Monitoring heart devices, including defibrillators and pacemakers
  • Interpreting results of cardiac tests and laboratory results
  • Managing heart conditions, such as arrhythmias, hypertension, and congestive heart failure
  • Managing cardiac medications and other treatments
  • Educating and motivating patients to maintain heart-healthy lifestyles

What Is the Role of a Cardiac Nurse in Each Hospital Unit?

Here are some hospital units where cardiac nurses can work and some responsibilities they might carry out in each unit.

  • Intensive Care Unit (ICU): Cardiac nurses working in ICUs may have to treat patients post heart attack using a defibrillator or administering medications. They also monitor patients and use intracardiac devices such as balloons and catheters. They may also care for patients who are recovering from surgery.
Heart surgery
  • Cardiology Unit: In these units, cardiac nurses monitor electrocardiograms and heart activity, manage medication and other treatments, and educate patients and family members.
  • Surgical Unit: Cardiac nurses who work in surgical units prepare patients for surgery, assist surgeons during surgery, and help patients recover after operations.

What Does CVICU Stand For?

CVICU is an abbreviation that stands for cardiovascular intensive care unit. It is often used interchangeably with CCU, which may stand for coronary or cardiac care unit. Patients are admitted into these units after surgery or to receive treatment for heart or vascular conditions.

How to Become a Cardiac Nurse and How Long Does It Take

RNs can land jobs in cardiovascular units after nursing school, which takes approximately two years for an associate’s degree or about four years for a bachelor’s degree in nursing. After working in a CVICU for a few years, nurses acquire extensive knowledge and experience caring for cardiac patients and are considered cardiac nurses. However, nurses must pass a few more hurdles before obtaining cardiac nurse credentials.

Cardiac Nurse Certifications

A basic certification that all nurses should have is the Basic Life Support (BLS) certification, which nurses can obtain in a day through the American Red Cross or the American Heart Association. Another basic certification that all cardiac nurses should have is the Advanced Cardiovascular Life Support (ACLS) certification. Nurses can also obtain this certification through the American Heart Association.

Besides these basic certifications, nurses working in cardiac nursing can obtain many other credentials.

The American Association of Critical-Care Nurses (AACN) offers two certifications:

  • Cardiac Medicine Certification (CMC): This subspecialty certification is meant for RNs or advanced practice registered nurses (APRNs) who work with adult cardiac patients in critical conditions. Nurses with this qualification may work in CCUs, ICUs, telemetry, progressive care, home care, cardiac cath labs, heart failure clinics, interventional cardiology, and electrophysiology.
  • Cardiac Surgery Certification (CSC): This subspecialty is also available for RNs and APRNs. After obtaining this certification, nurses are prepared to care for adult cardiac surgery patients immediately after surgery in cardiovascular surgery, cardiothoracic surgery, and post-anesthesia care units.
Cardiovascular certification

The American Nurses Credentialing Center (ANCC) offers two certifications for cardiac nurses: 

  • Cardiac Rehabilitation Nursing Certification (RN-BC): This certification is currently only available for renewal.  
  • Cardiac Vascular Nursing Certification (CV-BC™): RNs are eligible for this certification if they meet the following requirements:
    • They have practiced nursing for at least two years, accruing a minimum of 2,000 clinical hours in cardiac nursing in the previous three years.
    • They have completed thirty hours of continuing education in cardiac-vascular nursing within the past three years. 

The American Association of Heart Failure Nurses offers the following certification:

  • Certified Heart Failure Nurse (CHFN): This certification is available for RNs and APRNs working in clinical and non-clinical settings.

The American Board of Cardiovascular Medicine (ABCM) offers the following progressive certifications for cardiac nurses: 

  • CVRN Level 1: This exam in non-acute cardiology care is available for cardiac nurses at any level of practice.
  • CVRN Level 2: These acute care cardiovascular nursing exams are available for all acute care cardiac nurses
  • CVRN Level 3: Interventional and cath lab nursing staff are eligible for these cardiovascular nursing certification awards once they have completed level two exams.
  • CVNP-BC or CVPA-BC Level IV: This certification is for cardiac nurse practitioners and physician assistants.
  • CVNE-BC Level V: This upcoming certification will be available for cardiovascular nursing educators.

Some nursing certifications are available for APRNs, nurses who have completed graduate degrees in nursing. These advanced practice cardiac nurse practitioners have extensive knowledge and experience in nursing. In fact, the average nursing experience for nurse practitioners is eleven and a half years. Therefore, it is unsurprising that APRNs have greater autonomy and may even see their own patients in private practice cardiology clinics

How Much Do Cardiac Nurses Make?

A cardiac nurse’s salary depends on many factors, such as education, experience, and work setting. Many cardiac nurses are RNs and, as such, earn an average of $82,750 per year. Furthermore, even among RNs, average salary can vary significantly depending on the type of healthcare facility where they work. Here are average salaries of RNs in different settings:

  • Outpatient care centers: $93,070
  • General medical and surgical hospitals: $85,020
  • Specialty hospitals except for psychiatric and substance abuse hospitals: $84,800
  • Psychiatric and substance abuse hospitals: $80,260
  • Home health care services: $78,190
  • Offices of physicians: $73,860
  • Nursing care facilities (skilled nursing facilities): $72,260

However, cardiac nurses who pursue higher education to become nurse practitioners earn on average $118,040 per year. Still, among cardiac nurse practitioners, there are also significant variations in salary. The following salaries represent averages for nurse practitioners in different healthcare settings:

  • Home health care services: $133,170
  • Psychiatric and substance abuse hospitals: $131,830
  • Outpatient care centers: $129,190
  • General medical and surgical hospitals: $122,960
  • Offices of physicians: $114,870
  • Offices of other health practitioners: $108,890

What Is Cardiac Nursing Like?

With heart disease being the leading cause of death in the US, cardiac nurses can legitimately feel that their work is necessary. Furthermore, patients are often under significant stress while at the hospital for cardiovascular conditions, and nurses have the opportunity to offer the emotional support that patients need. 

“What a day in patient care ❤️ One nurse stands out. An elderly pt was admitted through ER. She was in huge distress w/cardiac issues, unstable & scared. The pt wrapped her arms around my colleague, held her tight & wept. Hard. My colleague hugged her back. Time stood still. #RPN”

Tweet by DebraLefebvre

In addition, through education and motivation, cardiac nurses can do their part to tip the balance toward improved heart health in the United States, one patient at a time.  

Is Cardiovascular Nursing Hard?

Each nursing specialty has its challenges. In the case of cardiac nursing, since cardiovascular diseases are the leading cause of death in the United States and most of these deaths occur in medical facilities, cardiac nurses naturally witness many deaths. Furthermore, according to the American Heart Association, although medical advancements and public health initiatives effectively reduced mortality rates due to CVD over many decades, recently, mortality rates are plateauing and, in some cases, even increasing, as is the case with rural, middle-aged white Americans. Even in the hospital setting, heart failure mortality rates have remained nearly constant since 2010.   

Nurse getting pulse

This current situation can be frustrating for nurses who dedicate their careers to helping people who, in many cases, do not follow healthcare workers’ recommendations regarding the lifestyle changes that could save their lives. For example, a 2008 study found that one month after hospital discharge following a heart attack, 20% of patients did not fill at least one of their prescribed cardiac medications, and nearly half did not fill their antiplatelet therapy afterward. 

What Makes a Good Cardiovascular Nurse?

Rasmussen University examined over 50,000 cardiac nursing job postings to identify the skills that healthcare facilities look for in a cardiac nurse. The following are the most sought technical skills for cardiac nurses:

  • Life support skills, including ACLS certification
  • Catheterization Laboratory (Cath Lab)
  • Treatment planning
  • Patient care
  • Acute care
  • Telemetry
  • Critical care nursing
  • Cardiology
  • Pediatrics

Furthermore, facilities also seek cardiac nurses with these soft or transferable skills: 

  • Critical thinking and problem-solving skills
  • Organization, planning, and time management
  • Communication and teamwork
  • Physical ability
  • Research and computer literacy

Tips for New Cardiac Nurses

Nurses interested in pursuing careers in cardiovascular nursing should begin by obtaining the two basic certifications most cardiac nursing jobs will require: BLS and ACLS (See Cardiac Nurse Certifications). With those certifications, new nurses can begin searching for jobs in cardiac units. That said, at this point, new nurses must be wondering, “How can I find a job with little to no experience in cardiac nursing?” Well, you are in luck: Nowadays, obtaining nursing experience in the type of facility or unit you like is easier than ever. With Nursa’s healthcare staffing app, nurses can browse available per diem jobs near them and request as many shifts as they want. This way, nurses can accrue experience in the areas that interest them the most, even if they are currently working in other areas. Alternatively, nurses can also decide to work per diem full time, either to reach specialization goals more quickly or because they enjoy the flexibility that this type of work offers.

Once nurses are working in cardiac units full time or working in this setting occasionally through PRN shifts, here are some tips to help new nurses get the most out of their cardiac nursing jobs:

Cardiovascular nurse teaches patient
  • Take full advantage of orientation periods and preceptors. Your main goal as a new nurse in a cardiac care setting is to learn. Therefore, learn as much as possible from your preceptor during orientation and try to take as many notes as you can.
  • Ask questions. Your preceptor will show and explain many things to you, but you must also ask questions. Your preceptor has so much experience working as a cardiac nurse that they might not realize that some procedures are not common sense or second nature to other nurses. Therefore, it is up to you to ask. Don’t worry! New nurses are not supposed to know everything.
  • Ask for help and offer to help. In almost all nursing settings, nurses must work as a team to provide their patients the best possible care and, frankly, to survive shifts. Head nurses do their best to assign other nurses adequate patient loads, but inevitably, you will sometimes end up with more responsibilities than you can handle. Especially as a new nurse, you will need to ask for help to ensure your patients are receiving the best possible care, but also try to offer other nurses help whenever you can. If you offer to help more experienced nurses with small tasks, they will be much more willing to help you when you need assistance. 
  • Each patient is an opportunity to learn. Reading up on all cardiovascular diseases during or between shifts is not realistic, but you can become an expert on your current patients’ conditions. Read about their conditions and possible treatments and ask physicians any questions you have regarding their treatment plans.
  • Review and practice basic CVICU skills. Nurses in cardiac units must master electrocardiogram (ECG) interpretation, basic hemodynamic monitoring, and baseline values. Study at home but also ask physicians at work how they would like you to treat abnormal results.
  • Stay up-to-date on the latest technology and innovation. As a new nurse, there is a lot you can learn from more experienced nurses. However, since new nurses are in a state of active learning, they will likely read up on new devices or medications before even their preceptors, head nurses, or other members of the healthcare team. Therefore, don’t be afraid to share what you have learned. The new procedures or treatments you have read about could save your patients’ lives. That said, make sure you share your findings with the healthcare team before proposing a change in treatment to your patients. Also, remember to maintain an attitude of humility and respect when you share your findings. The physician in charge might have already considered and discarded your procedure or treatment plan for reasons unknown to you. 

Ready to Pursue a Career in Cardiac Nursing?

Cardiovascular nurse comforts patient

Now that you have the answers to all your questions about cardiac nursing, you are closer to deciding if this is the right career path for you. However, even if you are feeling inclined to pursue this path, make sure you explore all your options before making a decision; cardiac nursing is only one of many nursing specialties you can choose from. Furthermore, get your feet wet before you take the definitive plunge by picking up per diem shifts in cardiac nursing settings, such as intensive care, surgical, and telemetry units. Armed with both information and experience, you will no doubt be able to choose the ideal nursing specialty for you. 

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