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Key Responsibilities and Required Skills for Cardiac Care Nurse

💰 $ - $

HealthcareNursingCardiology

🎯 Role Definition

The Cardiac Care Nurse is a registered nurse specialized in the assessment, monitoring, treatment and education of patients with acute and chronic cardiac conditions. This role requires advanced telemetry and ECG interpretation skills, proficiency with hemodynamic monitoring and vasoactive drips, the ability to respond to cardiac emergencies (ACLS), and strong interdisciplinary coordination to optimize outcomes for patients with myocardial infarction, heart failure, arrhythmias, post-operative cardiac surgery and interventional cardiology procedures. Ideal candidates demonstrate critical thinking, patient-focused education, meticulous documentation and adherence to cardiac care protocols and regulatory standards.

📈 Career Progression

Typical Career Path

Entry Point From:

  • Registered Nurse (RN) with basic medical-surgical or telemetry experience
  • Telemetry/Step-down Nurse transitioning from general medicine
  • New graduate RN with a cardiac-focused residency/clinical rotation

Advancement To:

  • Charge Nurse, Cardiac Unit or Telemetry Lead
  • Clinical Nurse Specialist (Cardiology) or Nurse Practitioner (Cardiology APRN)
  • Nurse Manager / Assistant Nurse Manager of Cardiology Services
  • Cardiac Cath Lab/ICU or Heart Failure Program Coordinator

Lateral Moves:

  • Interventional Cardiology (Cath Lab) RN
  • Cardiac Surgery/Mechanical Circulatory Support (MCS) RN
  • Heart Failure or Transplant Program RN Coordinator

Core Responsibilities

Primary Functions

  • Perform comprehensive cardiac assessments for patients including history of present illness, focused cardiovascular physical exam, review of telemetry and 12-lead ECGs, recognition of ischemic changes, arrhythmias, conduction blocks and hemodynamic instability, and escalate per protocol.
  • Monitor and interpret continuous telemetry and rhythm strips, document changes in rhythm or ST-T morphology, and initiate evidence-based interventions or rapid response escalation for acute arrhythmias, ischemic events or decompensation.
  • Safely administer and titrate cardiac-specific intravenous infusions (e.g., vasopressors, inotropes, antiarrhythmics, nitroglycerin, heparin) using unit policy and hemodynamic parameters while monitoring for adverse effects.
  • Provide post-procedural care following cardiac catheterization, PCI, pacemaker/ICD insertion and electrophysiology procedures including vital sign stabilization, groin access site monitoring, vascular assessment, bleeding prevention and activity restrictions.
  • Manage postoperative cardiac surgery patients in collaboration with surgical and critical care teams — perform hemodynamic assessments, chest tube management, ventilator weaning support, pain control and early mobilization protocols.
  • Conduct serial cardiac-specific assessments (vital signs, heart/lung sounds, peripheral perfusion, fluid status, daily weights) and adjust nursing care plans to optimize cardiac output, oxygenation and fluid balance.
  • Interpret 12-lead ECGs, recognize acute coronary syndromes, STEMI patterns, bundle branch blocks and other acute ischemic or conduction abnormalities, and activate STEMI/cath lab pathways or code responses per institutional protocols.
  • Provide patient and family-centered education on cardiac disease processes, medication regimens (antiplatelets, beta blockers, ACE inhibitors, anticoagulants), lifestyle modification, symptom recognition and when to seek emergency care to reduce readmissions and support cardiac rehabilitation.
  • Triage and prioritize care in a fast-paced cardiac environment, recognizing deteriorating patients early, initiating appropriate interventions and coordinating with physicians, advanced practice providers and rapid response teams.
  • Perform and document point-of-care testing and ordering/reconciling diagnostic studies (troponins, electrolytes, BNP, chest x-ray, echocardiogram) to support timely clinical decision-making.
  • Manage vascular access devices commonly used in cardiac care (central lines, PICCs, arterial lines) including dressing changes, line maintenance, troubleshooting waveform and pressure issues and preventing line-related infections.
  • Provide safe blood product administration and monitoring for transfusion reactions in cardiac patients, including pre-transfusion checks, product verification and post-transfusion vital sign surveillance.
  • Deliver specialized care for heart failure patients: medication titration support, diuresis monitoring, daily weight and input/output management, patient teaching for sodium/fluid restriction and coordination with heart failure clinic resources.
  • Participate in emergency response teams for cardiac arrest and codes — perform ACLS interventions, high-quality CPR, defibrillation, airway management and post-resuscitation care following ACLS algorithms and local policies.
  • Accurately document nursing assessments, interventions, medication administration and patient education in the electronic health record (EHR) to ensure continuity of care and meet regulatory and billing requirements.
  • Coordinate multidisciplinary discharge planning with case management, social work, pharmacy and primary cardiology services to ensure safe transitions to home, rehab or skilled nursing facilities, including medication reconciliation and follow-up appointments.
  • Implement infection prevention measures and sterile technique for invasive cardiac procedures and wound care to reduce postoperative complications and device-related infections.
  • Act as a clinical resource for telemetry alarm management, troubleshooting monitoring equipment, and optimizing alarm parameters to balance patient safety and alarm fatigue reduction.
  • Participate in quality improvement initiatives focused on cardiac outcomes such as door-to-balloon time, readmission reduction, medication adherence and adherence to evidence-based bundles (e.g., acute coronary syndrome pathways).
  • Supervise and precept new graduate nurses, orient new staff to cardiac unit workflows, and evaluate competence in cardiac monitoring, ECG interpretation and emergency response.
  • Collaborate with pharmacy and providers to monitor for drug interactions, renal dosing adjustments and adverse cardiac medication effects, and educate patients on proper outpatient medication use and adherence.
  • Maintain readiness to assist in procedural areas (cath lab, EP lab, OR) by preparing patients, reviewing consent, verifying pre-procedure testing, and providing immediate peri-procedural nursing care and handoff.

Secondary Functions

  • Participate in unit-based committees (safety, quality, education) to advance cardiac nursing practice and implement evidence-based policies.
  • Contribute to onboarding, competency assessments, and continuing education sessions focused on cardiac care, telemetry interpretation, ACLS recertification and new device training.
  • Support data collection and documentation for registry reporting (e.g., STEMI, heart failure) and contribute to performance metric tracking and improvement projects.
  • Assist with equipment inventory, maintenance checks of telemetry monitors, defibrillators and emergency supplies to ensure operational readiness.
  • Actively engage in patient satisfaction and service recovery initiatives, responding to feedback and identifying opportunities to improve the patient and family experience.
  • Provide clinical input for the development and revision of cardiac unit protocols, order sets and standing orders to reflect current best practices.
  • Mentor less-experienced nurses in triage and care prioritization, fostering clinical reasoning and professional development within the cardiac team.

Required Skills & Competencies

Hard Skills (Technical)

  • Advanced Cardiac Life Support (ACLS) certification — current and demonstrable application of ACLS algorithms in acute cardiac events.
  • Proficient 12‑lead ECG and telemetry rhythm interpretation including recognition of STEMI, NSTEMI, arrhythmias, conduction delays and ischemic changes.
  • Experience titrating and managing vasoactive and antiarrhythmic infusions (e.g., norepinephrine, dopamine, dobutamine, lidocaine, amiodarone) with knowledge of hemodynamic targets and side effects.
  • Competent with hemodynamic monitoring: arterial lines, central venous pressure (CVP) trends, pulmonary artery catheter basics or equivalent hemodynamic assessment tools.
  • Strong intravenous therapy skills including insertion and maintenance of peripheral IVs, management of central venous lines and care of post-procedure vascular access sites.
  • Familiarity with post-cardiac surgery care including chest tube management, surgical site assessment and basic ventilator weaning principles.
  • Experience with point-of-care testing and rapid interpretation of lab values critical to cardiac care (troponin trends, electrolytes, coagulation studies).
  • Proficiency in electronic health record (EHR) documentation, computerized medication administration (BCMA), and use of clinical decision support tools for cardiac care.
  • Knowledge of cardiac pharmacology: antiplatelets, anticoagulants, beta blockers, ACE inhibitors/ARBs, diuretics, and statin therapy — including indications and monitoring parameters.
  • Certified Telemetry Nurse (optional) or demonstrated advanced telemetry monitoring experience.
  • Familiarity with device therapies: bedside management and troubleshooting for pacemakers, implantable cardioverter-defibrillators (ICDs), temporary pacing and remote device interrogation workflows.
  • Basic familiarity with cardiac imaging orders and interpretation context (echocardiography, chest x-ray, basic coronary anatomy correlations).

Soft Skills

  • Rapid clinical decision-making and critical thinking under pressure in emergent cardiac situations.
  • Clear, empathetic patient and family education tailored to health literacy and cultural needs to support adherence and recovery.
  • Effective interdisciplinary communication and collaboration with physicians, pharmacists, respiratory therapists, case managers and allied health professionals.
  • Strong prioritization and time management skills in high-acuity, variable workload environments.
  • Resilience, stress tolerance and ability to maintain calm during codes, rapid responses and complex patient deterioration.
  • Leadership aptitude for charge responsibilities, precepting, and participating in quality and safety initiatives.
  • Detail-oriented documentation and compliance with regulatory, accreditation and unit policies.
  • Conflict resolution and negotiation skills for handling family concerns, complex discharge planning and interdisciplinary disagreements.
  • Continuous learner mindset with openness to feedback, new protocols and evidence-based cardiac practice updates.
  • Patient advocacy, ethical judgment and confidentiality with a focus on patient safety and dignity.

Education & Experience

Educational Background

Minimum Education:

  • Associate Degree in Nursing (ADN) or Diploma in Nursing with current, active Registered Nurse (RN) license.

Preferred Education:

  • Bachelor of Science in Nursing (BSN) preferred; Master’s or MSN/NP for advanced practice roles.

Relevant Fields of Study:

  • Nursing
  • Cardiac/Coronary Care, Critical Care
  • Clinical/Cardiovascular Nursing Practice

Experience Requirements

Typical Experience Range:

  • 1–5 years of acute care nursing experience; at least 1–2 years in telemetry, cardiac step-down, CCU or comparable cardiac setting preferred.

Preferred:

  • 2+ years of dedicated cardiac telemetry/CCU or post-cardiac surgery nursing experience.
  • Prior experience with STEMI/cath lab pathways, heart failure management programs or post-op cardiac surgical care.
  • Certifications: ACLS (required), BLS (required), CCRN or Certified Cardiac Nurse/Telemetry certification (preferred).
  • Demonstrated experience in ECG interpretation, vasoactive drip management and emergency code response.
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