The Ten-Minute Interview with: Deborah James, RCIS

Why did you choose to work in the invasive cardiology field? The first time I saw a cardiac catheterization performed I was hooked, totally fascinated. Over the last 30 years I have rarely been bored. There is always new technology, always a new challenge, and I love the instant gratification of helping someone immediately. Can you describe your role in the cath lab? I have been in my current position for 24 years. I still scrub, monitor, and sometimes circulate in the lab. As a CVT, even with the RCIS credential, my scope of practice in the state of California has been limited. I have always enjoyed training new staff members, whether they were registered nurses (RNs), radiologic technologists (RTs) or CVTs. I now find myself in the position of having trained people for tasks I can no longer perform myself. What is the biggest challenge you see regarding your role in the lab? My biggest challenge is to accept that I can no longer perform my job as I was trained to. In the state of California you must have a fluoro license. It is frustrating not to be able to do things I know I can do very well. I am more limited now. For example, I can no longer do point-of-care testing, which in our lab is running simple O2 sats and ACTs. I can no longer pull sheaths hold pressure, yes, but pull the sheath, no. Of course I can no longer pan the table. What motivates you to continue working in the cath lab? I still love working in the cath lab, even after 30 years. It is still the most rewarding and fulfilling place in which I have ever worked. Is there an unusual case you have been involved with? My most bizarre case was several years ago. We got called back to the lab one night for a middle-aged man who had collapsed while waiting to pick up his wife, who worked at the hospital. He had closed down his left anterior descending artery (LAD) very proximally. We were able to get a wire and balloon across, but were never able to keep it open. He then proceeded to clot everything in his left system. There was nothing we could do. The most bizarre thing was that we could not identify any fixed lesions anywhere. When work gets stressful and you experience low moments (as we all do), what do you do to keep your morale high? When things get really stressful, I turn to my family. I have three great children, two little ones at home and one grown. I keep pictures of them with me at work. They remind me of what is truly important. Are you involved with the Society of Invasive Cardiovascular Professionals (SICP) or other cardiovascular societies? I have been involved with several organizations over the years. The SICP has been the most active and helpful. We are trying to start a Bay Area Chapter of the SICP. Are there websites or texts that you would recommend to other CV labs? We keep a copy of Dr. Morton Kern’s book, The Cardiac Catheterization Handbook, in the lab. I use the Cath Lab Digest website as well as some other links I have found through them. Do you remember participating in your first invasive procedure? I remember my first percutaneous transluminal coronary angioplasty (PTCA). We used huge catheters and monitored pressures on each side of the lesion before and after ballooning. I was scared, excited and really nervous because the physician who mentored our lab director was there from Atlanta. His name was Andreas Gruentzig! If you could send a message back to yourself at the beginning of your cardiovascular lab career, what advice would you give? Go back to school. Get a license. I had a small child then, and as a single parent, I just felt it was too hard. Where do you hope to be in your career when it is time to retire? I am so close to retirement now that I can smell it. However, before I retire, I would like to see a national license for CVTs. We are an invaluable resource in the cath lab that is being underused and pushed out in some places. Has anyone in particular been helpful to you in your growth as a cardiovascular professional? There have been so many people who have helped me along the way that it is hard to name them all. Dr. Joel Schrank in Jacksonville, Florida, was the one who made me believe in myself and my abilities. I have worked with many fine physicians in San Francisco over the years who have taught me a great deal. Dr. Bob Lundstrom, Dr. Craig Goard, Dr. Ian Benham and Dr. Michael Petru are just a few. I was also privileged to work with one of the best charge nurses you could ever have. Sunny Holland was my boss for twenty-some years and is still a good friend. All these people helped me immensely and I can never thank them enough. Where do you think the invasive cardiology field is headed in the future? We seem to be doing more and more with interventional radiology. I think that trend will continue. Who knows where the next big advance will take us? I, for one, can’t wait to find out. Deborah James can be contacted at djmama51@hotmail.com

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