Cardiac Care Nurse

There is something very exciting about the prospect of working in the Cardiac care unit of a hospital.   The heart as we all know is the life source of our body.  Learning to assess, help and treat dangerous cardiac conditions is a very stressful, yet rewarding career field.  Lisa Haupert has an amazing career history as a CCU nurse.

It would seem Lisa has done just about everything with her nursing career.  From working on a Neurosurgical floor, to trying out administrative duties, (switching to a singing career) and then  working in the CCU.

We asked Lisa to share her experiences with us and to help us further understand her journey through her career, and her in depth understanding of life as a cardiac care nurse.

Can you start off by telling us a bit about your career path as a nurse?

I began my nursing career at Emory Hospital in Atlanta, GA on the neurological and neurosurgical floor. It was there that I learned the true value of being fully present with my patients. There I was taught the importance of listening beyond just the words, taking the extra moment to clarify and verify what I was hearing, seeing, feeling and smelling, and treating the patient as a person instead of a diagnosis or condition.

After that, I spent about 6 more years working on a neuro/neurosurgical floor in a hospital in Arkansas. But then I decided that it was time to move into an area of nursing I felt I wanted to be more knowledgeable about.

I transferred to a brand new 24 hour observation chest pain center and short stay cardiac floor. Within a year I became the manager for the Cardiac Observation Unit. Then the administration decided to consolidate their first tier managers and asked me to manage the Cath Lab as well. I graciously declined and took a job as a Cardiac Case Manager and went back to school to get my Masters in Nursing.

Shortly after receiving my Masters degree I moved to California and worked part-time at Stanford Hospitals in their cardiac step-down unit. Within a year I became the manager of Stanford’s trans-telephonic heart monitoring program. And then my career took a very interesting twist.

I had started teaching singing on a very part-time basis in addition to my nursing career. My singing business took off. I quit my nursing job and taught singing full time for four years. I moved to the U.K. and taught singing at a performing arts university for two years.

What is it that lead you to want to work in the CCU?

When I moved back to the U.S. I decided to return to nursing. I had never worked in critical care and wanted the challenge. There was something in me that felt I would not have “done it all” in nursing if I didn’t have that experience. So at the age of 50 I jumped in with both feet to the CCU. I wanted to more fully understand pathophysiology and the impact that nurses could have on the recovery and comfort of patients in such dire health.

Can you describe what a day in the life of a Cardiac Care Nurse is like?  What are some of your main concerns and duties while working in that department?

Our patients fell into two primary categories. Those that were temporarily or potentially critical and would most likely only be in the CCU for a short time and those that were as sick as sick can be. Most often our assignment was to care for one of each of these two categories of patients. As long as the “temporarily” critical patient did well, I usually felt as if I was giving the best quality of care. But the reality is the “weller” patient in CCU can take a turn for the worse very easily, or they wouldn’t be in CCU to begin with.

Assessment skills are the most important skills for a nurse in the CCU. Catching the subtle changes in a patient’s behavior, heart rate and rhythm, color, and breathing early on can completely change the outcome for that patient. Any of us can learn to operate the fancy machines and tools we now have, but using our five senses to notice subtle changes is the true life-saver.

The other life-safer is teamwork among the nurses. When a patient takes a turn for the worse in critical care it takes more than one nurse to attend to that patient and get done what needs to be done to help stabilize the patient. If the unit nurses have a strong sense of team, all goes much better. If one of my patient’s was “crashing”, it might be hours before I would be able to check on my other patient. I knew that our nursing “team” would step up to the challenge and either do it themselves or get another nurse sent to our unit to assist. That allowed me to direct and give the care for my “crashing” patient without distraction.

On the rare days when the attitude of teamwork wasn’t what it should be I would be deeply concerned for us all. There were times I would be working with my very sick patient and yelling out the door to see if someone would check on my other patient and get their vital signs or give their meds. Those days would scare me. They were infrequent, but they should never occur.

The primary job of the critical care nurse is to be the “champion” for the patient. It is to make sure they get what they need. It is to ask questions of the doctor if you don’t understand what the goal and treatment plan is. It is to coordinate all of the patient’s care, including family involvement.

What is usually needed in order to get a job in a CCU unit?

To get a job in CCU you need to have experience on a Cardiac Step-Down or Monitoring unit.  You must be very proficient in interpreting heart rhythm strips and 12-lead ECG’s. You need not only a strong understanding of physiology, but also pathophysiology. Understanding shock is very important. And you need to be current in cardiac pharmacology. You need to be able to prioritize your work. And you need to be able to perform a high level nursing assessment.

Was there anything specific that you found difficult about working in the CCU that someone should be prepared for when pursuing this career?

It is important to be assertive. The physicians, who are directing the care of the CCU patient, are not there 24 hours a day. Nurses are. We know what is going on minute by minute with the patient. We see the subtle and dramatic changes that can happen in a second. Get what you need for your patient. Pester the physician if you need to. Ask for help from the charge nurse. Know when you need help. Know what you don’t know.

At what point did you decide to leave the hospital setting and transition your career to a wellness coach?  What exactly was that transition like?

After 18 months in the CCU I saw a job posting for a cardiac rehab nurse. I had been working on the critical side of things. And I wanted to know what the “other side” was like with this patient population. So I took a job in outpatient cardiac rehab working with patients in a hospital gym. We had patients who exercised while wearing a telemetry unit. These folks were recovering from myocardial infarctions or heart surgery. And we had patients who did not have to be on telemetry. They had multiple risk factors for cardiac disease.

I was on a journey to gain my health as well. I had already lost 70 pounds from my highest weight, but had some more to go. My patients knew that I had health goals and that gave many of us a special bond. I co-taught the weight loss groups with our staff nutritionist. And we had great success. Having a nurse who was “walking the walk” along side them was a strong motivator for many.

One of my co-nurses in Cardiac Rehab had recently become certified as a wellness coach through WellCoaches. She actually led group coaching classes with our patients. I was intrigued. It was clear to me that when motivation was internal, there was a much greater chance of long term success for lasting behavior change.

A year later I decided to become certified as a wellness coach.

As a wellness coach how have you been able to help people change their lives?

I left the hospital environment and started my own business, Once and Forever Wellness (www.onceandforeverwellness.com) I have private, one-on-one clients who work with me from between 3 months to over a year. I also do small group coaching and retreats. I run an inspirational Facebook Fan page (www.facebook.com/onceandforeverwellness), a Members Only Facebook group, and make weekly videos where I give tips and tools to my audience and answer their questions (www.onceandforeverwellness.com).

What coaching brings to the table is:

  • A thorough understanding of change theory so that the client makes goals that are appropriate to their stage of change.
  • The knowledge that lasting change comes from the client changing their mind-set – the way they view themselves, their values, their motivations.
  • Helping the client create a vision for themselves in their best wellness that is based upon their primary deep motivators for change and build upon their personal strengths.
  • Translating that vision into more concrete goals for the short term.
  • Ensuring that the client has a high confidence level of being able to achieve the short term goals that they choose and that they have the tools they need to reach those goals.
  • Helping the client break down those goals into weekly baby steps, and working with the client to pull together all the various pieces around what they need to know to succeed and to change their minds and their habits.

My clients have lost anywhere from 10 to over 100 pounds. They have learned to re-prioritize their lives so that they do and get what they need to gain their health. They are finding ways to transform their lives in order to become their health-filled visions of themselves.

Any advice for up and coming students looking to join the world of nursing?

Every single job and type of nursing I have done has been deeply rewarding. Nursing is a marvelous field because you can fill several lifetimes with it and never get bored or run out of new things to learn and discover.

Keep your eyes open as you move through your career. One thing will be right for you in one period of your life and another thing at another.

Be a team player.

Be your patient’s champion and advocate.

Take the time and thought to be in your very best health and wellness.