The Ten-Minute Interview with...James Dockery, RCIS

Why did you choose to work in the invasive cardiology field? I’ve always had a passion for studying the healthcare field, although initially I wasn’t quite certain what area I wanted to venture into. I knew I wanted to specialize in a certain area and was researching what degree opportunities were available in my area regarding healthcare. I found out that I could receive a degree in Cardiovascular Technology from an accredited program at Northeast State Technical Community College, the only accredited program in Tennessee. This seemed very interesting to me, so I applied, was accepted, and graduated in May of 2003. We were trained both in invasive and non-invasive fields, but had to choose a specialty area to focus in for our clinical time. I was really impressed by the invasive side of cardiology: the adrenaline rush, the atmosphere, and knowing I could help in changing someone’s life from the time they were on the table with a 90% LAD to leaving the hospital with an artery that had been opened completely. This is truly what I like best about invasive cardiology. Can you describe your role in the CV Lab? Our facility employs 3 RCISs, 3 RNs, 1 EMT, and 1 RT(R). The role of the RCIS is to function primarily as scrub assistant to the cardiologist or vascular surgeon and monitor cases on the hemodynamic system. Occasionally, if there is an extra RCIS in the room, we also help in the circulating role. Currently only RNs are allowed to give drugs during cases. Our cath lab staff are also cross-trained in peripheral angiography and stenting. We have 3 wonderful vascular surgeons who perform these procedures in our mobile cardiac and vascular lab. It’s been a great experience learning to scrub and assist the surgeons in these peripheral cases. One additional role we have acquired is educator to the RCIS, RN, and LPN students that routinely rotate through our facility. This has also been a great experience for the staff and myself as we get to help educate tomorrow’s nurses and cardiovascular techs. What is the biggest challenge you see regarding your role in the CV lab? The biggest challenge I have faced is trying to juggle family time with work. I assume everyone knows and understands the time restraints you are faced with when you work in an invasive lab. I have a lovely wife and 3-year-old daughter, and it’s difficult sometimes when I can’t spend as much time with them as I would like due to taking call. However, my wife and I both realized that this type of career would require certain limitations on our family life. We both have realized that planning ahead seems to aid in planning events for our family. It’s very rewarding to help someone in a desperate time, such as when they’re having an acute MI. The satisfaction of helping that patient helps everything come into perspective. What motivates you to continue working in the CV lab? My biggest motivation for working in the cath lab is that things are always changing. It’s great to see the newest drugs and medical technology that aid in preventing and treating heart disease. Learning about new tools for fighting heart disease offers an ongoing educational opportunity, aiding my growth as a healthcare professional. Why did you choose to get involved with the SICP? How did it happen? I chose to get involved with SICP because of the awareness the society brings to people regarding invasive cardiology. I wanted to get more involved with educating people about the field I love. After I graduated and began working, I wanted to know specifics about my scope of practice and policies regarding the cath lab. I reviewed the material and information provided by the SICP on their website (www.sicp.org). It seemed only natural to be a part of such an important society involved in the field in which I work. I joined immediately. Can you describe your role with SICP? I am a relatively new member and I am striving to gain fellowship status with the SICP. I hope to be involved in numerous committees so I can have a voice in the policies that affect the cardiac cath lab. Your work for the SICP is volunteer. What motivates you to continue? The fact that it’s all volunteer makes it more meaningful. Only individuals who have a passion and desire to make a difference in their field of expertise would take the time to be involved with SICP. People who have this desire are eager to help advance their field, even if it is all volunteer. What is the biggest challenge you see regarding your role with the SICP? I have numerous challenges ahead of me. I would love to see a local chapter assembled for my area. I am not aware of any chapter within a 100-mile radius. My area has such a numerous number of hospitals with cath labs, that it would be wonderful to have a chapter representing our area. I look forward to trying to organize this along with a fellow member of the SICP who also works in my hospital. What is the most bizarre case you have ever been involved in? I can truly say I have had the opportunity to witness a lot of bizarre things in my cath lab. We have had numerous patients with anomalous circumflex arteries arising from the proximal RCA. One case always sticks out in my mind. One of our cardiologists was searching for the left coronary system for diagnostic visualization with no luck. He had tried multiple attempts to view the left main to no success, when finally it showed up originating from the right sinus of valsalva. This was truly an unusual and rare case for the staff to experience. When work gets stressful and you experience low moments (as we all do), what do you do to help keep your morale high? On those days when the stress level rises for whatever reason, I find that laughing really helps to relieve stress and tension. If I can find the opportunity to find something funny or amusing to laugh at, trust me, I will. If you were to ask the staff and physicians I work with, they would probably tell you that I cause them some consternation in having to put up with me and my prankster ways. However, that’s just my personality, and I enjoy laughing at myself and with others. It’s amazing when you get someone to do something that takes so much energy and effort I’m speaking of the human smile. Try smiling or laughing, it just melts the stress away. If you could send a message back to yourself at the beginning of your cath lab career, what advice would you give? I would tell myself to never miss the opportunity to learn. You can never know everything there is to know about the cath lab. There are numerous things I learn on a daily basis. Each individual working in the cath lab brings a background of knowledge to the working area. From EMTs to RNs, each person has something to add to the learning experience in the cath lab. Our cardiologists are always eager to teach, so I am always prepared to absorb their knowledge. In addition to learning, never miss the opportunity to teach other people the things you’ve learned from your experiences. Are there any websites or texts you would recommend to other labs? The Cardiac Catheterization Handbook, by Morton J. Kern. The texts and CD by Wes Todd were extremely helpful to me (www.westodd.com). Grossman’s Cardiac Catheterization, Angiography, and Intervention. It’s also informative to visit CCI’s website (www.cci-online.org). It lists many organizations where you can search for information regarding the cardiac cath lab. Do you remember your first invasive procedure? My first invasive procedure occurred during my second semester of cardiovascular school. I can’t remember the patient’s name or the vessel that was stented, but I do remember being extremely excited and nervous to finally get my hands on the manifold and indeflator. In the end, the vessel was stented and had a good result. That was a memorable moment which confirmed my ambition to become an RCIS. Has anyone in particular been helpful to you in your growth as a cardiac professional? Several people have contributed to my growth as a cardiac professional. The cardiologist and vascular surgeons I work with on a daily basis contribute greatly by asking for my opinion during cases or answering any questions that I may have. I think when physicians ask for your opinion or thoughts on a case you’re involved in, it encourages you to continue to educate yourself to be prepared for situations that may arise throughout any procedure. Secondly, the staff I work with every day has become my second family. The closeness we share as a team really contributes to morale and makes it a good environment in which to work. Finally, without the support of my wife, it would be difficult to grow in this profession. She fully understands and supports me on those days and nights when I get called in to do a case. Where do you see yourself professionally when it is time to retire? Hopefully, by the time I retire I can say I’ve had the opportunity to serve the cath lab from regular staff to management. I enjoy the relationships I have formed with the staff and doctors I work with on a daily basis. I desire that by retirement I can say I have made an impact on someone’s life and they can say, he really enjoyed the work he did. What changes do you think will occur in the field of cardiology in the coming decades? I believe the biggest changes will occur with MRI and CT imaging of coronaries for diagnostic use. The advancement of stent design and drug-eluting therapy will always be a part of further advancement in cath labs. I also feel that peripheral angiography and stent placement will be more of the normal routine for cath labs across the country. I’m always surprised to see the latest and greatest technologies arising every year.

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