The Essential Ingredient: ECMO Nurses

(Meet An Amazing Nurse )

I met Shannon 3 1/2 years ago when doing my first ECMO shift here in Texas.  I was pretty clueless about ECMO, as despite 17 years of experience, I was new to this hospital, and I had only worked in adult perfusion programs throughout my career.

I had gotten a little bit of exposure as a perfusion student doing my pediatric rotation under George Glen and Tom Murphy (two perfusionists I hugely admire) at St. Louis Children’s Hospital back in the day, but that was quite awhile ago, and obviously technology had changed quite a bit.

The first thing that struck me about Shannon was her engaging smile, and always being kind to everyone.  It is rare to meet  someone as genuine and caring as she is, and I was pretty impressed with her sense of humor as well.  Let’s just call it West Texas Humor, but certainly she is sharp as a tack and very clinically aware.

At this institution we are assisted by PICU Nurses when an ECMO is running, and they usually work in an expanded technical role, while perfusionists remain on the unit to be a resource if problems arise.  It’s a great working relationship, and you tend to get to know one another when spending a few midnight ECMO shifts together.

Shannon, Brandy, Midge, Rayla, and of course Marty, were totally instrumental in helping to guide me along with ECMO, and never made me feel like the neophyte I clearly was, and certainly emphasized the fact that my role was to help sort out perfusion related issues or emergencies should they occur.

This was a case where an opportunity was laid out for both sides of the equation (nursing and perfusion) to come together and build on each others strengths, while mending any weaknesses.  Even though in theory I was in charge, their experience provided the  synergy that allowed us to efficiently problem solve together.

It was very constructive and I will always be grateful for their kindness and support.

Anyway, Shannon is now the Director of the PICU and she has agreed to do an interview for CircuitSurfers:

So here we go… (click on images to enlarge)

Question 1:

Can you tell me a bit about the type of clinical setting you work in is, the position or role you play, and without naming the city, the geography or type of area you work in (eg, small town, urban, sprawling metropolis) ?

I am a nurse educator in a PICU at an urban hospital.  In my role as a nurse educator, I am in charge of organizing PICU nursing orientation, managing mentors, identifying educational needs of the staff, educating the staff, teaching needs of an ever-changing healthcare field, while trying to keep up with the latest evidence based research.

Question 2:

What role do you and/or your colleagues play in process of an ECMO run?

My role with ECMO is to take call and work as an ECMO technician.  My colleagues are other ECMO technicians (nurses and respiratory therapist), ECMO coordinators, and perfusionist.

Question 3:

Would you like to see your role expanded?  Do you feel comfortable doing what you do?

In my life right now (expecting a little one soon, VERY busy with work, and trying to obtain the work/life balance), I would not like to see my ECMO role expanded.  I feel comfortable and enjoy my role as an ECMO technician, but I would enjoy helping others expand their role in the vast world of ECMO.

Question 4:

What type of training or classes do you have to take to qualify for the ECMO team?  Do you feel it is adequate?  Would you like more?  Is there a credentialing process in your hospital to accomplish this?

In our institution, you apply for the ECMO technician role through the ECMO coordinator and director.  Together they decide who qualifies for the team, based on experience, skill, knowledge, willingness to learn, etc.

After being chosen as an ECMO technician, you go through a 40 hour training course hosted by physicians, ECMO coordinators, and nurse educators.  After the class, we were able to sit pump with another experienced ECMO technician and a perfusionist/or ECMO coordinator. 

ECMO coordinators discussed your progress with you, and after multiple ECMO runs with another experienced tech, you were able to sit pump. 

I feel like this was adequate training for me.  I do feel like continuous learning with ECMO is necessary for success.

Question 5:

How do you and/or your colleagues view perfusionists- or do you even use them?

We do use perfusionist at our institution.  An ECMO technician is at the pump 24/7 and a perfusionist or ECMO coordinator is in house at all times as well.  I view perfusionist as an amazing resource and have learned so much from them.

Question 6:

Describe the role of the perfusionist at your institution.  What are the dynamics between Intensivist, Surgeon, Anesthesia, Perfusion, and Nursing?

I feel like we have a multidisciplinary approach to care at our institution.  Intensivist round daily with the other disciplines at the bedside.  Rounding helps to incorporate everyone’s opinion and help develop a plan of care for the patient.

Question 7:

Is there anything in particular about ECMO that you either embrace or are afraid of-  basically do you love it ?  If so why?  And what are your greatest fears / concerns?

I embrace how much there is to learn about ECMO and ECMO patients.  Each case is different and offers something new to grow from. 

My greatest fears with it are those true “ECMO emergencies” that are life threatening. 

But then again…it is times like these that bring out the ICU nurse in me and always teach me more and force me to perform at my best.

Question 8:

Can you relate your own personal “greatest ECMO” moment?  As well- what is the scariest thing you have seen (aside from an 8 fingered perfusionist lol) ?

Blood spatter on the ceiling during cannulation always makes others a little fearful of ECMO.  I only wish we could have changed out the ceiling tiles before visitors came…

Well thank you so much.  That was a great interview, and I look forward to dialoging in the future…


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