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The Ten-Minute Interview with: Debbie Charlton, RN
I have been in the healthcare industry since May of 1983. I started my nursing career in the critical care unit (CCU) while working in the Army Nurse Corps. Once I left the Army Nurse Corps, I was a flight nurse with the Air National Guard for 7 years. My last 17 years of nursing have been in the cardiac cath lab. I started out as a nurse at Vanderbilt University Medical Center in Nashville, Tennessee, and worked my way up to management, which included electrophysiology (EP), pediatric and adult patients. We started with 2 labs and progressed to 5 inpatient labs. We also built a 12-bed holding area and an outpatient swing lab. From there, I went to Shands AGH in Gainesville, Florida, where I was the director of cardiovascular services. I have now been working at the Mobile Infirmary Medical Center in Mobile, Alabama, for almost 3 years.
Why did you choose to work in the invasive cardiology field?
While working as a nurse in CCU, I was always the one who received the cath lab patients. I thought it was fascinating and exciting to hear what could be done for these patients and I wanted to be a part of that process. Opportunity opened the door for me with an opening in a cath lab and I took it. It has been the best decision I have ever made.
My current role is Director of Cardiovascular Services at the Mobile Infirmary Medical Center, which includes 4 cath labs, 1 EP lab, a 21-bed holding room, a congestive heart failure clinic, and the Electrocardiogram (EKG) and Echo departments. I see my role as a multi-faceted servant-leader. It is my role to serve the patient/family, the staff and the physician. My role means being part cheerleader, part servant, part teacher, part counselor, part clinician, part risk-taker, part advocate (staff as well as patient), and part listener…all rolled into one.
What is the biggest challenge you see regarding your role in the lab?
I would have to say the biggest challenge is balancing a budget with all the influencing factors of new technology, new product and reimbursement issues that we constantly face in this environment.
What motivates you to continue working in the cath lab?
I love the constant changes that this environment provides. I love working with the staff and the physicians. They all bring their own unique individuality to the department and they are able to provide wonderful service to our patients, who put their trust and faith in us. Making a difference in that patient’s life is what it’s all about.
Is there an unusual case you have been involved with?
I really can’t think of any unusual cases that I have been involved with. When I worked in the pediatric cath lab, I found some of the heart defects challenging but rewarding and a learning experience.
When work gets stressful and you experience low moments (as we all do), what do you do to keep your morale high?
I know that all areas experience these moments. I think you have to find what motivates each individual and get creative whenever possible. I think you have to support them as much as possible and get them through each difficult situation. We try to do ‘kudos’ moments, pizza lunches, and/or meal cards to recognize those who have worked hard at making a difference. You have to allow people to vent their frustrations and work with their ideas on how to improve your labs or moments that are difficult to get through. I can honestly say that I now have the best staff I have ever worked with in my career. They are very intelligent and they ‘own’ their area. They are supportive and initiate change in our labs. They are my motivation on days that are low for me as a director. I am very proud to be working with such a great team!
Are you involved with the Society of Invasive Cardiovascular Professionals (SICP) or other cardiovascular societies?
Yes, I have been elected co-chairperson of the Jubilee Chapter here in the Mobile area. I am excited to be working with a new chapter as well as Ernie Livingston, RN, BSN, who is the elected chairperson. Although our chapter is new, we have a lot of support and attendance from all of the local hospitals.
Are there websites or texts that you would recommend to other cath labs?
I would recommend that any organization get involved in the Cardiovascular Roundtable (The Advisory Board Company, Washington, D.C.), TCT (Transcatheter Cardiovascular Therapeutics), and Peripheral Angioplasty and All that Jazz conferences.
Do you remember participating in your first invasive procedure?
I remember when we deployed our first stent in a coronary artery at Vanderbilt. It was exciting for everyone involved in the case. I was so proud to be on the leading edge of technology. It was almost as if you could hear a pen drop in the room. We all were so quiet and trying to keep our excitement down without disturbing the physician. It seemed like everyone was in the room…nurses, cardiovascular surgeons, technologists and administration in the control room. Wow…what an experience!
If you could send a message back to yourself at the beginning of your cardiovascular lab career, what advice would you give?
I would tell myself to learn the details of each procedure. I would focus more on the cellular level and understand why and how the physician makes the decision he/she makes. It is so overwhelming when you start, so I would tell myself to slow down and take the time to learn it all. It is not something you are going to learn overnight. Experience comes with time. Don’t be afraid to ask questions.
Where do you hope to be in your career when it is time to retire?
I see myself in an administrative role, hopefully at a point where I have developed relationships and skills that as a leader, I have fostered growth and development of that organization so that it is recognized as a center of excellence. I look forward to the challenges and opportunities that any job may provide. I hope to leave a legacy of being a great leader with a winning team. I know that I can accomplish this because the philosophy of and commitment to excellence is what I believe in.
Has anyone in particular been helpful to you in your growth as a cardiovascular professional?
I would have to say that there have been two people in my career for whom I have the utmost respect and admiration. Robin Steaban, the cardiology administrator at Vanderbilt University Hospital in Nashville, Tennessee, was instrumental in developing my management and computer skills early on in my career as a new manager. She always strived for excellence and had the ability to motivate you to a higher level. She was a mentor and a friend. The second individual would be my current administrator, Alan Holley, at the Mobile Infirmary Medical Center. He supports you when needed but does not micro-manage any area that is under his direction. He is well-respected by his peers and all the directors under his leadership. He gives positive feedback and has the talent to motivate you when needed. He is a very visible leader and knows all of the staff and supports them as well. I have been very blessed to have had two different leaders influencing my career in cardiology.
Where is the invasive cardiology field headed in the future?
We are going to have some really exciting times in the world of cardiology. The invasive side of cardiology will continue to explode with new and improved technology. I can also see less invasive procedures, and hopefully, new and improved drugs that will help with heart disease. I think the dynamics of the business will change based on future elections, mergers and industry changes. Reimbursement will also be a driving factor for cardiology. All we can do is sit back and ride the wave of new technology. I am looking forward to seeing how the industry changes and how we will manage these changes.
