10-Minute Interview: Sue Deck, BS, RN, RCES

Why did you choose to work in the field of electrophysiology? It was more or less a natural progression from the cath lab. As a nurse, I was often asked to sedate patients for EP studies. When EP separated from the cath lab, I followed. Describe your role in the EP lab. What is a typical day like for you? There is no typical day. My official job description is EP Educational Coordinator. My duties include planning and implementing staff education (on and off site) and ensuring that staff competencies are up to date. I also revised our EP tech clinical ladder and the sedation nurse orientation process, and I assist with scheduling clinical time for our EP internship. I help out in the lab from time to time, and also go to the OR to assist with atrial fibrillation (AF) mapping cases there. In addition, I have some administrative duties such as maintaining and updating the departmental Policy & Procedure manual, scheduling and running staff meetings, and doing performance improvement projects. Every day is different. What is the most bizarre or unusual case you have ever been involved with? I really can t think of one particular case, but I will never forget seeing DC His ablations. Back in 1992 or 1993, before RF ablation was commonly performed here, it was the only option for refractory AF (followed by a PPG of course!). They put the catheter in the patient, connected it to the generator box, and poof! It was almost like sticking the catheter in a light socket. You could hear the pop from the steam bubble and sometimes the patient actually lifted off the table a little bit. It was really something. Not a discrete lesion, but usually very effective. What aspects of your work do you find most rewarding and/or challenging? As a nurse, I get a great deal of satisfaction out of improving the health of our patients, whether as a clinician, or by improving a process. I coordinated EP research studies for several years, and during study follow-up I had the opportunity to see how greatly peoples lives were impacted by what we do in the lab. We were involved in the CONTAK-CD and InSync ICD trials, and some of our patients improved dramatically with CRT. It was neat to see that and know we were involved is something that made such a difference in peoples lives. Now, as an educator, it is always great to see the lightbulb come on when someone grasps a new concept. The most challenging parts of my job are trying to find the time to do everything, and trying to keep abreast of all the new technology. Are you currently involved in any other EP- or cardiology-related projects or groups (i.e., research or writing projects, etc.)? I recently had the honor of being selected as a member of the Cardiovascular Credentialing International (CCI) task force that developed the new Registered Cardiovascular EP Specialist (RCES) credential. We are in the process of implementing a new data management system and changing our in-room documentation process, and I am working with our IS department and the EP staff to get it up and running. We are fortunate to have two team members who have made the project their own, and due to their hard work we are making progress; we plan to go live in early February. Probably the hardest thing about the project is getting the staff engaged in the process. We have used the same system for many years, and change can be difficult. What advancements do you hope to see in the field of cardiac electrophysiology in the next five years? What specific areas of EP and/or patient care need more attention? I hope to see more formal training programs for EP techs. At this point, the internship we have here at Lancaster General is for training our own new employees. It is a great program and it turns out good techs, but at this point, its focus is keeping our lab staffed. EP techs are in scarce supply everywhere, and industry draws many of the best and brightest out of the lab. So I think we need to have formal programs that teach a standard EP curriculum. We are working on that here, but it is a long process. Patient care wise, atrial fibrillation will continue to be a priority, especially as the baby boomers age. Hopefully, ablative techniques will continue to evolve to the point where we have good success rates across the board. Heart failure will continue to be an important issue as well; CRT has made a huge difference for those who respond to it, but therapy for non-responders is still limited at this point. Are there any particular Web sites or texts you would recommend to others in the field of EP? The Heart Rhythm Society s Web site is good, and the industry sites offer lots of information for both medical professionals and patients. For those just starting in EP, Electrophysiologic Testing by Richard Fogoros is great. The Hayes and Ellenbogen pacing/ICD texts are also very good. Once you have a good grasp of the basics, there are many good texts to choose from. Journals are a good source for new techniques and technology as well. What advice would you give to EP allied professionals who are currently at the start of their career? Keep your eyes and ears open, read everything you can, and ask a lot of questions. Also, be prepared for change. Has anyone in particular been helpful to you in your growth as an EP professional? Without a doubt, Dr. Seth Worley has had the most impact on my career in EP. He started the EP program at Lancaster General, and in the beginning, back in the early 1990s, we all learned as we went along. It was exciting and challenging. He has always been very involved in clinical research, and when EP started to explode in the late 1990s, he gave me the opportunity to coordinate EP trials. I probably learned more about device therapy doing that job than anywhere else. In my opinion, he is the reason we have the EP program we have here at LGH.