Clinical Nurse I: Pacemaker & Arrhythmia Ctr

Primary Duties and Responsibilities

The Cardiac Device RN is responsible for providing patient-centered care for ambulatory and inpatient populations with cardiac devices, including pacemakers, defibrillators, loop recorders, and mobile telemetry monitors used in the diagnosis and treatment of cardiac arrhythmias. Coordinates daily device clinic operations in partnership with physicians, manages clinic visits and device-related care, and collaborates with clinic staff to ensure efficient patient flow and timely response to patient needs. Works closely with Electrophysiologists, Cardiologists, Advanced Practice Providers, vendor representatives, and other members of the care team to support optimal patient outcomes. Oversees patients enrolled in remote monitoring programs by triaging alerts, coordinating follow-up care, and communicating with providers and aligned nursing teams regarding plan of care.

• Knowledge of anatomy and physiology of the heart, cardiac electrophysiology and rhythm interpretation.

• Knowledge of indications for implantation of pacemakers, biventricular devices, defibrillators, and loop recorders.

• Knowledge of pacing modes, ICD arrhythmia detection parameters and therapy options.

• Remote and in-person assess, interpret, and report implanted cardiac device functions and recordings; assess patient questions/concerns and refer as appropriate.

• Device system evaluation, testing, and data interpretation.

• Recognize normal vs. abnormal device function.

• Ability to troubleshoot device related issues.

• Cardiac arrhythmia and ECG interpretation–evaluate and appropriately classify, assess effectiveness of prescribed therapy. Address inappropriate detection, therapy or therapy failure with EP physician in timely fashion.

• Accurate document evaluation outcome of visit, including summary of device testing.

• Provide patient and family education regarding device system and plan of care for the short and long-term follow up of their device.

• Triage ICD, pacemaker, implantable loop recorder, and symptomatic patient telephone calls.

• Collaborates in patient end of life scenarios with device management and programming.

• CHF remote and in-person evaluation and monitoring, review trends. 

• Perform and coordinate in-clinic and remote transmission (Latitude, Carelink, Merlin, and Biotronik) visits.

• Maintain device testing equipment and understand use of each.

• Maintain records related to device advisory/recalls/alerts. Assist MD with new advisory information. Identify patient population included and communicate with patients regarding the advisory information.

• Assist with AV Optimization procedure in cooperation with ECHO department and EP physician.

• Wound checks—ability to recognize wound complications and develop plan of care with MD. Performs incisions/wound assessments on new device patients and removes stitches/staples as appropriate.

• Accurately identifies malfunctions, alerts, and sub-optimal device operations and follows appropriate protocols with making programming changes and notifying physicians.

• Follows nursing process in assessing symptomatic patients and providing follow-through as needed such as discussing with physicians, giving instructions to patients, making follow-up appointments, or taking patients to ED. Also triages the patients for remote alert notifications.

• Responds to urgent/emergency clinical situations when interrogating patient in-clinic, using ACLS protocols.

• Provides education to patients and their significant other regarding basic pacemaker function; follow-up care needed; medications; process steps for in-clinic visits and remote device transmissions; and other clinical care needs.

• Documents in pacemaker management system (PaceArt) and electronic medical record (EPIC) regarding testing, changes, and other identified care needs.

• Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.

• Assist in bedside procedures such are Cardioversions, ECHOs and stress tests.

• Update anticoagulation medication lists.

Education and Experience

• Clinical Nurse I’s at Magnet designated facilities only require a BSN or that a BSN program is started within one year of hire date and BSN degree is attained within two years of the starting the BSN program.
• BSN preferred.
• 2+ years RN experience in Telemetry, Critical Care, Stepdown, or Cath lab/Holding nursing preferred.
• Advanced ECG Rhythm interpretation required.
• Outpatient clinic experience preferred.
• Epic and PaceArt experience preferred.

License Required

• Registered Nurse in the State of California - Current and in good standing.

Certifications Required

• All Clinical Nurse I's are required to have current BLS certification prior to clinical rotation.
• Pacemaker & Arrhythmia Ctr: ACLS upon hire

Physical Job Requirements