I work for a 10-physician, four advanced registered nurse practitioner (ARNP) cardiology practice owned by a smaller community hospital. My day is filled with cardiac patient care. One day I may be hospital-based, doing inpatient rounds, stress echocardiograms and discharges. The next afternoon, I may be in the clinic, seeing up to 10 patients, after helping out in the hospital in the morning. Or I may be doing devices, overseeing the technicians and nurses who do the interrogations and dealing with all of the arrhythmias, etc., that they discover.

We are a non-teaching hospital so the attending, consultants and the hospitalists take care of all the patients, all the time. We do a lot of heart catheterizations, interventions and devices but not heart surgery or electrophysiology, which is referred out. I manage stable patients independently, with the collaboration of my physician partners. I see a wide range of cardiac events in patients, including chest pain, endocarditis, heart failure (HF), arrhythmias and post-myocardial infarction (MI) and pre/post procedures.

We work in conjunction with the rest of the hospital team, including the hospitalists and other specialists. My day may include writing orders for a skilled nursing facility, describing an angiogram and consenting a 65 year old with a non-ST elevated MI (STEMI), doing post-procedure teaching and discharging a new 80 year old pacemaker patient, managing HF in a 90 year old, stress testing a 40 year old from the emergency department or seeing a 30 year old in the clinic with palpitations. Because of the variety of patients, my great co-workers and the independence I am given, it is a very fun and exciting place to work.

This article was authored by Sandy Perlmutter, MSN, ARNP, AACC, a nurse practitioner at EvergreenHealth Heart and Vascular, in Kirkland, Washington.