How to Become a Cardiac Nurse

Are you interested in becoming a cardiac nurse? Let’s begin with defining what a cardiac nurse actually is.

A cardiac nurse works with patients who are suffering from various issues related to the cardiovascular system. These patients could be in the hospital (acute care) or in a clinic (outpatient care). For the purposes of this post, we’ll focus on acute care cardiac nursing.

Cardiac nurses in hospitals could work in the following units:

• Cardiology
• Cardiovascular surgery
• Cardiovascular intensive care
• Cardiovascular operating room and/or recovery unit
• Cath labs

Cardiac patients are also seen in the emergency room and perioperative areas, but true “cardiac nurses” work in cardiac-speciality nursing units. You can also become a Cardiac Nurse Practitioner, which is a different ball game than a more general cardiac nurse, which we will discuss.

Becoming a Cardiac Nurse

To become a cardiac nurse, you must first of all be a registered nurse! I go over this in detail in this blog post.

After obtaining your nursing license, you can apply to work in a hospital’s cardiac unit. Ultimately, it’s as simple as that! However, the challenge can come in if you’re applying to work on a cardiac unit at a competitive hospital.

(If you need help landing that job, check this out.)

Education Requirements for Cardiac Nurses

There are no special additional educational requirements to begin to work on a cardiac unit, although additional certifications and experience do help. Regardless, many newly licensed nurses begin their career on a cardiac unit. Actually, that was my first job as a nurse back in 2010 and I had no extra cardiac-specific training.

While there is not specialty training required prior to landing a job as a cardiac nurse, let’s outline some experience and education that can really set you apart from the rest of the applicants.

Helpful Certifications

While you cannot sit for a cardiac-specific certification until you’ve worked as a cardiac nurse for a specific amount of time, you can ensure you have your BLS and ACLS.

(And if you want to learn more about those specialty certifications specifically for experienced cardiac nurses, click here.)

Basic Life Support (BLS) will be a requirement for you as a bedside nurse. Hospitals will provide this for you upon hire, but it is great to have it completed beforehand.

Advanced Cardiac Life Support (ACLS) is like a step-up from BLS. Basic life support is how you keep someone alive until more advanced help arrives with chest compressions and possibly the use of an AED. However, in a hospital we have access to life-saving medications and equipment. Because of the emergent nature of these situations, we have to have evidence-based processes in place to immediately respond when someone’s heart stops or flips into a lethal arrhythmia, or if they stop breathing. There’s no paging and waiting for a doctor’s order!

The ACLS algorithm essentially tells you what to do in the situation based on the patient’s assessment findings. You don’t need to call a doctor to get an order to push 1mg of Epinephrine in this code situation, you’d follow the algorithm. But, to be certified to be able to do this, you have to take a course first. It’s a short course that has both a skills test and a written exam component. While not required before starting, it looks very good on a resume if you already have this certification!

(If interested in doing this, I highly recommend taking a course from a major organization like the American Hospitals Association to ensure your employer will recognize it. Not all ACLS courses are created equal!)

Other Helpful Prep Courses

When you want to look AND feel prepared to work on a cardiac unit, unfortunately simply reviewing your cardiac chapters of your nursing school textbooks aren’t going to cut it. Here are some helpful cardiac resources:

• Telemetry Basics Brush-Up a mini course from FreshRN
• Cardiac Confidence: A Crash Course for New Cardiac Nurses from FreshRN
• ECG Rhythm Mastery: A full in-depth EKG review from FreshRN
• ECCO from the AACN

A word about ECCO. If you are hired to a hospital and are going to work with critically ill patients, you may be required to take ECCO as a part of your mandatory hospital education. It is designed to prepare you for caring for very sick patients, however they are highly technical and do not provide instruction things like report and time management.

If interested in working in CVICU, I recommend becoming a member of the AACN (American Association of Critical Care Nurses). They have a ton of helpful resources, are who you will go through for any specialty certifications in the future, and it looks phenomenal on a resume.

Getting ready to have patients on telemetry, but need a little refresher first?

Telemetry Basics Brush-Up from FreshRN is a self-paced mini-course where we walk through the basics of cardiac electrical conductivity and how that is reflected on your telemetry strips, discuss rhythms based on the level of urgency you should have, go over insider tips and tricks, and more.

Start Lesson #1

Why Become a Cardiac Nurse?

People enjoy cardiac nursing for various reasons. First, cardiac units see more emergent situations than other units. The heart pumps blood and does so in a rhythmic fashion because we have an electrical pathway that stimulates it. However, this pathway can become disturbed for a myriad of reasons. Cardiac nurses are responsible for identifying those issues quickly with the appropriate level of urgency, communicate to the medical team, and educate the patient and family about what the heck is going on. Cardiac pathophysiology can get complex quickly, so it can be difficult to translate this to a layperson, which is why nurses are often phenomenal teachers as well!

Nurses who enjoy both highly complex medical situations, responding to cardiac codes, and ready for things to change in an instant will thrive in this environment.

Let’s juxtapose this to a neuro unit. When neuro patients start to decline or do poorly, the changes are often more subtle and happen over time. While codes do happen in neuro units, they are not nearly as frequent.

Also, it can be extraordinarily rewarding to have the advanced skills to be able to recognize when a cardiac emergency is happening, respond appropriately, and provide care and education to the patient. You’re literally saving lives during a normal day at work, and that is a pretty incredible feeling.

Cardiovascular Nurse Career Outlook

Overall, one can expect the outlook for nursing to continue to be an in-demand field. Nursing is on-par with other occupations, in that we’re expected to see approximately a 6% growth from 2021-2031, with around 200,000 job openings each year (source).

Further, the cardiovascular service line of a hospital is lucrative. Therefore, hospitals tend to have a well-funded cardiac resources and units, which continue to expand. While a typical hospital may have a normal cardiology unit, many are expanding to add cardiovascular intensive care, cardiovascular and thoracic surgery units with dedicated operating and recovery rooms, cardiac procedural centers, cardiac rehabilitation, cath labs, and much more.

Do Nurses Make Six Figures?

Yes and no. It really depends on a lot of factors. First, the salaries for nurses vary widely across the United States. A nurse working rural Iowa will make substantially less than a nurse in New Jersey. The 2021 average median pay was $77,600, or $37.31 per hour.

If you work night shift, you also can make more money per hour. This can equate to $10K+ more per year based on the shift differential.

If you’re a travel nurse, depending on the contracts, you can easily make over $100,000 in a calendar year.

However, night shift and travel nursing do come with trade-offs that need to be considered. Night shift work impacts your normal sleeping schedule, and travel contracts often require you to relocate, are not long-term, may not come with various benefits, and often units who are so understaffed that they need to hire travel nurses are that way for a reason.

Finally, if you’re a nurse practitioner, you are much more likely to earn over $100,000 sooner. Keep in mind, being an NP means you would need to go to graduate school, which is an added large cost.

Where Do Cardiac Care Nurses Work?

Cardiac nurses in hospitals could work in the following hospital units:

• Cardiology
• Cardiovascular surgery
• Cardiovascular stepdown/intermediate care
• Cardiovascular intensive care
• Cardiovascular operating room and/or recovery unit
• Cath labs
• Transplant intensive care (heart transplants)

You may also see cardiac nurses working in combination units. Examples of these could be a cardio-pulmonary floor, cardiac-neuro, or others. This depends on how the hospital is organized and patient need.

Cardiac nurses could also work in the outpatient environment. These areas can include:

• Cardiology clinics
• Cardiac rehab
• Cardiac procedural centers
• Heart failure clinics

Also, don’t forget about the entire field of pediatric cardiology. While there is some similarities, adult and pediatric cardiology specialities are vastly different.

What Are the Roles and Duties of a Cardiac Nurse?

I discussed a typical day of a cardiac nurse in this YouTube video that you can view below.

Your responsibilities will depend on which unit you’re working on. Generally speaking, here are some commonalities:

• Perform head-to-toe assessments at regular intervals
• Observe their cardiac monitoring, intervene when necessary
• Administer medications
• Perform basic procedures (insert urinary catheters, insert IVs, clean central lines, etc)
• Work with advanced technology (arterial lines, impellas, CRRT)
• Work closely with the medical team to update them on changes in the patient’s condition, unexpected responses to treatment, new needs as they arise
• Educating patients and families on the care you’re performing and why, and also about their cardiac disease process(es)
• Facilitate diagnostics (cardiac caths, CTs, MRIs, echocardiograms, ECGs, etc)
• Facilitate cardiac surgery (prepping and sending patients to OR, recovering them afterwards)
• Assist with bedside procedures (chest tube insertions, central line insertion, cardioversion, and more)

There are many more things cardiac nurses are responsible for, but those are some of the highlights!

How Do Cardiac Nurses Work With Other Healthcare Professionals?

When you’re a nurse on a cardiac unit, you’re the patient’s home base. You’re the one who is on the unit with them the entire shift. You are closest to them in proximity all day, assessing and monitoring them closely. You will be responsible for a few patients on that same unit, and for the most part will physically be on that unit the entire time.

Other members of the healthcare team are different. They have a list of patients they need to see who are located in many different areas of the hospital. So, they’ll come to see your patient, write some information in the chart, and leave to go to the next patient. If he or she needs something, they’ll call you directly. Essentially, you’re like the gatekeeper to the rest of the healthcare team.

These healthcare team members can include: The physician and his or her medical team, physical therapy, occupational therapy, speech therapy, dietician, social work, case management, and respiratory therapy.

The only other healthcare team members who are on the unit with you would be your nursing assistants. You will work together with them to provide care to your patient, and delegate tasks to them as needed (like ambulation, feeding, toileting, obtaining vital signs, and more).

More Resources for How to Become a Cardiac Nurse:

• Top Tips for a New Cardiac Nurse
• 5-Lead ECG Interpretation, Electrocardiogram Tips for Nurses
• Cardiac Nursing For Beginners