Since ECMO is used on the sickest of the sick, your work can change at a moment’s notice if there’s an emergency, if the patient is being weaned off ECMO or if the patient or their family decides to withdraw life-saving measures.
Baher walked us through what a typical shift looks like as an ECMO nurse specialist. First, Baher says she gets the report from the previous shift’s ECMO specialist about the patients under their care. During this time, she’ll find out information like:
- What type of ECMO the patient is on (venoarterial or venovenous)
- The patient’s most recent arterial blood gas results
- What medications the patient is receiving
- The current ECMO settings
- Any significant events that occurred
After she receives this shift change report, Bahr reviews the ECMO circuit and ensures she doesn’t see any new problems like clots or kinked lines.
Over the course of her shift, a provider will come by to assess the patient. That usually includes a conversation about where the ECMO treatment is heading. If the patient’s labs are trending in the right direction, they’ll attempt to wean the patient off ECMO to see how they’re healing.
Throughout her shift, Bahr performs and charts assessments. If the patient has been on ECMO for more than 24 hours, Bahr will perform hourly assessments. If they’ve been recently started on ECMO, she’ll perform assessments more frequently. Throughout the whole shift, she keeps a close eye on their vitals to make sure they aren’t decompensating.
At the end of her shift, she passes on the report to the next ECMO specialist where the process starts over again.
How to become an ECMO specialist nurse
The first step on the road to becoming an ECMO nurse specialist is to become a registered nurse (RN). To become an RN, you’ll need a degree—either an Associate Degree in Nursing (ADN) or a Bachelor of Science in Nursing (BSN)—and meet all other requirements for state licensure. Once licensed, you’ll be qualified to apply to a variety of nursing positions.
When choosing your degree path, you should keep in mind that a BSN may be beneficial when going into critical care. Though ADN nurses complete just as many clinical hours as BSN nurses, BSN nursing students do additional coursework in leadership, understanding research and practice critical thinking on another level, which can be especially beneficial in ICU settings. ADN nurses can earn their BSN through RN to BSN programs.
Most ECMO specialist nurses are experienced ICU or CVICU nurses, so getting a job in an ICU or step-down unit is a great place to start. Remember, not every hospital can offer ECMO, so make sure you’re applying to those that do if this is a long-term goal. Those hospitals generally offer their own trainings guided by the Extracorporeal Life Support Organization (ELSO) where the ECMO specialists undergo initial training, continuing education and competency checks. You can also find initial training about ECMO through the American Association of Critical-Care Nurses (AACN).
Take the first step
Working as an ECMO nurse specialist is a unique way to apply yourself in a critical care role. Every day, these nurses use medical technology that almost sounds like science fiction to give very seriously ill patients another chance to fight back. Could this be the critical care nursing niche for you?