COVID-19 and the Cath Lab: Creating a Specialty Survey

By Bailey Ann Estes, BSN, RN-BC, RNFA, CNOR, RCIS

The surge of COVID-19 hit our nation and health care system by surprise, rendering us unprepared and lacking in vital equipment and manpower. Hospitals across the nation responded differently depending on state laws, local policies, COVID-19 census and resource availability. Throughout the progression of the pandemic, a majority of research and media attention has focused on physicians, extreme frontline workers and health care systems as a whole. Yet, this left many nurses feeling sidelined without an outlet to speak about the true personal and professional impact of the pandemic.

Invisible Struggles

The ramifications of the pandemic ran far below the surface, affecting nurses and allied health in areas that have historically been immune to infectious disease threats and health care crises, such as the cardiac catheterization lab. This had provided a sense of stability and protection that did not hold during COVID-19.

I saw my coworkers face uncertainty through relocations and decreased work hours. I also saw that the nursing perspective, especially in these highly specialized areas was grossly overlooked. Having experienced a decrease in work hours, I wanted to do something with my time to help and contribute meaningfully by providing the nursing perspective of the systemic impact of COVID-19 and its reach into specialty or procedural areas, like our lab.

Enlightening Study

I joined forces with a fellow cardiovascular tech and interventional cardiologists. Together, we developed a 45-question survey looking at demographics, logistical changes, preparedness, personal protective equipment and mental health. We chose SurveyMonkey due to the ease of access, distribution and compilation of data. The length of a survey was a challenge as we wanted to get a comprehensive analysis yet not make it so long and cumbersome that it would deter respondents from completing all of the questions.

Due to a limited time frame and self-funding, we distributed the survey primarily using social media such as Twitter, Facebook and LinkedIn. Forums specific to cardiac cath lab nurses were integral in sharing the information on a broader scale and reaching a lot of nurses in a short amount of time. We received 450 completed responses with a wide distribution of geographical location and metropolitan, suburban and rural regions, which helps to determine generalizable results on a national scale.

The primary findings of this study revealed some surprising information and validated issues that we were already aware of but only had evidence on an anecdotal level. We were able to uncover the issues that are most important to nurses such as adequate PPE and administrative support. Eighty percent expressed worry about exposing their families to COVID-19.

The more concerning results were the reported decrease in morale of 96 percent and an increase in depression and anxiety. Despite being in a highly specialized area, there was a high amount of nurses relocated and directly caring for COVID-19 patients. Around 65 percent experienced a decrease in work hours with 12 percent laid off, which had a direct impact on finances. Further, 68 percent indicated that they were the primary financial provider for their family. Overall administrative and leadership support and preparedness were perceived as poor.

Future Impact

Our full manuscript was published online ahead of print in December and in the January issue of Journal of Invasive Cardiology. Interviews and highlights with our team were published in cardiovascular news outlets such as TCTMD, Healio-Cardiovascular Interventions and Cardiovascular Business. We hope this data will help leadership and administration to guide decision making with staff as we continue to navigate the pandemic while trying to take care of patients with cardiovascular disease.

We also hope this manuscript serves as a resource for nurses and technicians in specialty areas to share with their colleagues and leadership. Through reviewing the predictors of depression, special attention and resources should focus on nurses who have been relocated, exposed to COVID-19 and are experiencing an increase in mental stress and anxiety. There is a gap in research looking at the personal and professional impact of COVID-19 on nurses, not only in specialty areas, and we do not yet know the long-term impact this will have for nurses to continue to enter and stay in the profession. We hope that future research will investigate interventions with outcomes to support our nurses and improve their wellbeing during these most trying times.