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Cardiac, or cardiovascular, nurses are often specialized advanced practice registered nurses (APRNs) who work alongside cardiologists and other healthcare providers to provide comprehensive cardiovascular care for patients with acute and chronic heart maladies. Advanced practice registered nurses sub-specializing in cardiology practice under primary specializations as clinical nurse specialists and nurse practitioners, often holding multiple specialty certifications specific to patient population or other sub-specializations such as acute care.
Cardiac nurses possess a high level of education and experience that allows them to diagnose, treat, and manage conditions that affect the complex cardiovascular system. They work to promote optimal cardiovascular health among clients through preventative measures that involve health counseling, screening, and stress tests, as well as disease prevention and management strategies. They also provide care to patients with coronary heart disease, providing post-operative care to those recovering from bypass surgery or heart transplant.
Although cardiac nurses are traditionally employed in hospital cardiology units, cardiovascular interventional units, and cardiothoracic surgical units, the need for cardiac nurses in diagnostic, rehabilitative, and long-term care settings is also on the rise. Cardiac nurses also serve vital roles in a number of cardiology specific medical settings:
- Cardiac Catheterization Labs – Some cardiac nurses may focus their education on cardiac catheterization and hold the designation of a cardiac cath lab (CCL) nurse. Cardiac catheterization labs are most often found in hospital environments, and CCL nurses may therefore work in critical care, emergency care, or acute care. A CCL nurse typically provides short-term, immediate care. Some CCL nurses are responsible for pre-procedure and post-procedure care, as well.
- Telemetry Care – Telemetry care involves monitoring a patient’s vital signs using advanced equipment, such as electrocardiograms. It is common to find telemetry nurses working alongside CCL nurses, as they are responsible for providing follow-up monitoring and assessment.
- Electrophysiology Labs – In electrophysiology labs, cardiac care nurses work in collaboration with cardiologists to diagnose the causes of arrhythmias and offer interventional treatment that may involve pacemakers, ablation, and medications.
Cardiac nurses are qualified to provide cardiac care to patients across the lifespan, which may include newborns with heart defects or elderly patients with advanced stage heart disease. They also provide a wide range of services, which may include:
- Managing hypertension, congestive heart failure, arrhythmias and other heart conditions
- Evaluating and monitoring heart devices, such as pacemakers and defibrillators
- Performing a wide variety of cardiac tests, including stress tests, stress echocardiograms, exercise stress tests, PET/dipyridamole stress tests, and CT coronary angiograms
- Providing physical exams so as to diagnose chronic and acute cardiac diseases
- Interpreting laboratory results or cardiac tests
- Prescribing and managing cardiac medications and other therapies
- Educating patients on health maintenance and disease prevention
Educational Requirements
A cardiac nurse is an advanced practice nurse practitioner or clinical nurse specialist who possesses a graduate-level degree in nursing. Many cardiac nurses possess master’s degrees in nursing and then go on to receive a post-master’s certificate in their cardiovascular specialty. In addition, some cardiac nurses participate in highly competitive fellowship programs once they receive their master’s degree. In general, nurses who want to pursue cardiac nursing possess a master’s of nursing science with a specialization or concentration in cardiac care:
- MS Nursing, Cardiac Care Concentration
- MS Nursing, Acute Care Nurse Practitioner Cardiac Specialty program
- MS Nursing, Cardiovascular Health and Disease Management
- MS Nursing, Acute Care Nurse Practitioner, Cardiovascular Specialization
Some of the courses within a typical cardiac nursing program include:
- Advanced Physiology
- Advanced Pathophysiology
- Advanced Pharmacology
- Nursing Management of Cardiac Patients in Critical Care
- Nursing Management of Cardiac Patients in Acute Care
- Nursing Management of Cardiac Patients in Outpatient Settings and Rehabilitation Programs
- Advanced Scholarship in Research
- Advanced Health Assessment
- Leadership
- Theory in Advanced Practice Nursing
- Project Planning
- Clinical Prevention
- Population Health
Most programs also allow students to further specialize in such areas as: cardiothoracic intensive care, coronary care, interventional cardiology, and heart failure.
Cardiac/Cardiovascular Nursing Certification
Cardiac nurses with graduate-level education are eligible to sit for national certification examinations specific to cardiology.
The American Association of Critical Cares Nurses (AACN) offers two certifications for cardiac nurses: Adult Cardiac Medicine (CMC) and Adult Cardiac Surgery (CSC).
The CMC exam is designed for nurses who are working in the areas of critical care, intensive care, telemetry, progressive care, home care, and interventional cardiology, as well as in heart failure clinics, cardiac catheterization labs, and electrophysiology labs.
The CSC exam is designed for nurses who are working in the areas of cardiovascular surgery, cardiothoracic surgery, or in post-anesthesia care units. Nurses in these settings provide care to post-operative heart surgery patients within the first 48 hours of surgery.
To sit for either the CMC or the CSC examination through the AACN, applicants must meet a number of eligibility requirements:
- Hold a current, unencumbered RN or APRN license in the United States
- Current national certification through either the National Commission for Certifying Agencies (NCCA) or the American Board of Nursing Specialties (ABNS) in a clinical nursing specialty
- Evidence of at least 1,750 hours of care for acutely or critically ill adult patients in the two years prior to application; 875 of those hours must have been accrued in the 12 months prior to application; and 875 of those hours must be in the care of:
- Acutely and/or critically ill patients (for CMC certification)
- Cardiac surgery patients with the first 48 hours post-surgery (for CSC certification)
Applicants may sit for either the CMC or the CSC examinations up to four times in a 12-month period. Certification renewal occurs every two years. To maintain certification, nurses must maintain their national certification in their primary clinical nursing specialty and meet specific continuing competency requirements.
The American Nurses Credentialing Center (ANCC) offers the Cardiac-Vascular Nursing (RN-BC) certification. Note: The Cardiac Rehabilitation Nursing (RN-BC) certification and the Certified Vascular Nurse (RN-BC) certification have been recently retired by the American Nurses Credentialing Center (ANCC).
To be eligible for the Cardiac-Vascular Nursing certification, applicants must meet the following requirements:
- Hold a current, active RN license in a state or U.S. territory (or the recognized equivalent in another country)
- Practiced for at least two years as a full-time registered nurse
- Show evidence of at least 2,000 hours of clinical practice in cardiovascular nursing within the three years prior to application
- Complete at least 30 hours of continuing education in cardiovascular nursing within the three years prior to application
The Cardiac-Vascular Nursing certification is a computer-based test that allows applicants to apply throughout the year and test during a 90-minute window of time at locations throughout the United States. All ANCC certifications are renewed every five years, and specific professional development and practice hour requirements must be met.
The American Association of Heart Failure Nurses, through the Heart Failure Nursing Certification Board, offers certification as a Certified Heart Failure Nurse (CHFN).
To be eligible to take the CHFN examination, the applicant must:
- Hold a current, active RN license in a state or United States territory (or the legally recognized equivalent in another country)
- Work as a RN for at least two years in full-time practice (or the equivalent to two years in part-time practice)
- Have at least 1,200 hours of clinical practice caring for heart failure patients within the two years prior to application
- Have at least 30 hours of completed continuing education within the two years prior to application; 15 hours of which must be related to heart failure care
There is one exam date at a single location each year for the CHFN exam. There are 100 questions on the exam. CHFN certification is good for three years. Nurses may be eligible for renewal by meeting strict practice hours and professional development requirements, or by retaking the CHFN exam and meeting all eligibility requirements.
The American Board of Cardiovascular Medicine (ABCM) certifies cardiac nurses through three levels of certification:
- CVRN Level 1 for Non-Acute Cardiology Care
- CVRN Level 2 for Acute Cardiology Care
- CVRN Level 3 for Catheterization Laboratory Nurses
This certification, although voluntary, may assist cardiac nurse professionals with career advancement. Cardiac nurses must have at least two years experience in their cardiac nursing specialty or have attended a course of study in the cardiac nursing specialty in which they want to become certified. The ABCM exam is for cardiovascular nurse practitioners or non-acute and acute cardiac care and emergency nurses.
Those who achieve a 70 percent or higher score on the exams are offered Awards Certificates. Certification is good for a three-year period and is renewed when the renewal fee is paid and the nurse can provide evidence of at least 50 continuing education hours in cardiovascular nursing in the past three years.
Resources for Cardiac Nurses
The Preventive Cardiovascular Nurses Association is the leading nursing organization that is dedicated to preventing cardiovascular disease through professional and public education and advocacy.
The Northeast Pediatric Cardiology Nurses Association (NPCNA) provides membership that connects professionals from more than 28 northeast regional cardiovascular programs to encourage and promote professional and educational advancement and communication.
The Society of Pediatric Cardiology Nurses is the only international organization that is dedicated to expanding nursing knowledge to children and young adults with heart disease. The SPCN has more than 375 members from around the world.
The American Heart Association, Council on Cardiovascular Nursing accelerates the discovery, translation, and application of knowledge to promote and improve overall cardiovascular health.
The Pediatric Cardiac Intensive Care Society is an international professional society with healthcare professional members that are dedicated to acquiring knowledge and improving practice for patients with congenital and acquired heart disease.
The Cardiovascular Nursing Education Associates provides cardiovascular and critical care nursing courses for continuing education purposes and review courses for a number of cardiac nursing and cardiovascular nursing certifications.
Cardiac/Cardiovascular Nursing Salary Expectations
According to Advance for NPs and PAs National Salary Report 2011, the average salary for a nurse practitioner was $90,583 in 2011, while the average salary for a nurse practitioner in a cardiology clinic or unit was $90,370.
In addition, NPs in emergency departments earned $103,722; NPs in surgery settings earned $91,023; and NPs in hospital settings earned $96,124 as of 2011.