The Registered Cardiovascular Invasive Specialist (RCIS) Credential

Recognition & Support through the Alliance of Cardiovascular Professionals (ACVP)

I have been in and out of a cardiac catheterization laboratory since 1969. I received my start in the Navy by going through their cardiopulmonary technologist program. I was discharged in 1974 and returned to California, only to find that hospitals with cath labs did not recognize my education. California cath labs were looking for RNs only, so I went back to school in a respiratory therapy program at Foothill College in Palo Alto, California. After graduation, I practiced in the field for about two years. At that point, the hospital that I was working for posted a job for a cardiopulmonary tech for the cardiac cath lab. I jumped on it. During the next 20-plus years, I moved around to different cath labs in the San Jose, California area. In 2000, I was asked if I would be interested in working with engineers as their clinical help for the development of devices at a pre-FDA startup company. I did take the job and found the work very rewarding and educational, but after about four years, I could no longer do all the traveling. I decided to go back into a lab. My efforts to do so are what this article is about. In the summer of 2004, I started to look around for a staff job in a cath lab. I started applying to hospitals with openings for an invasive cardiovascular technologist, but once I applied, the interview process came to a halt after they found out that I did not have a fluoro permit. California Code of Regulations, Title 17, dictates that cath labs can only hire a person with a fluoro permit, unless the applicant is an RN. It was like the clock had been turned back 20 years. I was very concerned and thought this was just crazy. I had heard of several other things RCISs could not do because of misunderstandings about the credential, but in my whole career, the subject of a fluoro permit had never before come up. I started to call and write everyone I could think of to get answers. My first thought was, okay, I will just take the exam, receive a fluoro permit, and then everything would work out, but I found out that you first must have a radiology license. I then contacted the Society of Invasive Cardiovascular Professionals (SICP), the Alliance of Cardiovascular Professionals (ACVP), Cardiovascular Credentialing International (CCI), the California American College of Cardiology (ACC) and a cardiovascular school in California, Grossmont College in El Cajon, California. I asked them all, what is going on? The SICP was helpful. I spoke to Tracey Simpson, RCIS, Past President, SICP. She gave me some great ideas as to how to move forward to resolve this problem. I also contacted Elaine Shea, RCS, RCIS, President, CCI. She works at Alta Beta Hospital in Oakland, California, and she shared her thoughts on what I could do to change this situation. One of my last contacts was with the California ACC. Title 17 states that the person delivering the radiation to the patient is the one that needs the permit. The ACC’s interpretation of “delivering” is the person stepping on the fluoro pedal. Under their definition, the person doing stepping on the pedal needs the permit, not the scrub at the table who might be simply moving the table. I also spoke to Jerry Buckley, MA, RCIS, Professor, Cardiovascular Technology Program at Grossmont College. He informed me that he and the school were very aware of the problem and that they were working with the state to have changes made. Finally, I connected with Peggy McElgunn, Executive Director, ACVP, and Jeff Doucette, RN, President, ACVP. Before my first interview at the hospital where I now am employed, I felt that I had to make them understand what my credentials were and what advantages I would bring to the department. I knew if I could effectively convey my experience and knowledge as embodied by my credentials, I might have a chance at obtaining this position. The hospital job description was asking for an RN, but an acceptable alternative may be an RCIS. I contacted the ACVP and was directed to Peggy McElgunn and Jeff Doucette. They were both very supportive; Peggy supplied my prospective employer with a letter explaining just what an RCIS credential meant and what a person with this credential would bring to the department. I also had support from my future direct report, Mike Barber, RN, Director Cardiovascular Services, Community Hospital of the Monterey Peninsula (CHOMP), Monterey, California. He had experience with and understood the significance of the RCIS credential, and was willing to help educate the hospital. With the support from ACVP as to the worth of the credential, Mike’s insistence, the letter from Peggy, support from everyone and my own persistence, I did receive the position, as Assistant Director of Cardiovascular Services. I was placed in charge of helping to open a new service in the hospital, a diagnostic cardiac cath lab. Four years later, we are doing diagnostic cases, elective PCIs and STEMIs. In January of 2009, we will be opening two more rooms and will be adding EP and peripheral cases. Also, I am happy to say I have support from Mike and the hospital administration to require all employees to obtain the RCIS credential within two years of employment; the hospital helps with reimbursement for education and the exam. All my staff, including RNs, radiology techs, respiratory therapists and CVTs that are qualified to take the RCIS have taken and passed it. We have only two nurses that have not taken it but are now studying to sit for the exam next year. It took me about three months of persistence and help from the ACVP to obtain my current position. I am a member of the ACVP and still communicate with Peggy as to any situations where I feel I need support, which she has always provided. Today, I continue to talk and write about Title 17, and try to change the understanding of this regulation. California Code of Regulations, Title 17, section 30450, can searched for online at: https://government.westlaw.com/linkedslice/search/default.asp?tempinfo=find&RS=GVT1.0&VR=2.0&SP=CCR-1000 The author can be contacted at chuck.gibaut@chomp.org

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