Love the idea of working in critical care nursing? The complex care, participation in intense procedures and narrow focus that comes with lower patient ratios can all have an allure. While the patients these nurses tend to are often too sick or sedated to carry on a conversation or say thank you, critical care nurses don’t mind—they just want to see their patients get better.
These units are unsurprisingly filled with specialized equipment and tools to help do just that. One tool you may have heard about is the extracorporeal membrane oxygenation (ECMO) machine. Whether you’ve ever worked with an ECMO patient or not, you may be intrigued by this machine and the trained staff who know how to use it.
Furthering the intrigue is that working with this specialized equipment isn’t just for respiratory therapists or cardiovascular perfusionists. Experienced ICU nurses who fulfill certain requirements can also be called on to help. Read on, and we’ll walk through what ECMO is, what ECMO nurse specialists do and how to become one.
What is ECMO?
Extracorporeal membrane oxygenation (ECMO) is a last resort therapy for some of the sickest patients in the hospital. It allows the heart and lungs to rest by pumping the patient’s blood into the machine, which oxygenates and warms the blood before pumping it back into the body through plastic tubes.
It can be used to help very sick patients with heart or lung conditions get the rest they need. It’s often used as a “bridge treatment” to help patients with cardiac or respiratory failure before and after cardiothoracic surgery. Often, ECMO patients are treated with mechanical ventilators as well. During this treatment, patients are sedated and given pain medications to make them more comfortable.
It’s important to note that ECMO is only a “life-sustaining treatment.” It does not cure or treat the disease or injury that led to heart or lung failure. This means that if the original condition is not improving, it may be very hard for the patient to get off ECMO support. This can make for difficult decisions about the patient’s quality of life going forward. It’s also important to note that this specialized treatment option isn’t universally available. Typically, only large medical centers have the resources to support ECMO care, so this can compound some of the challenging care decisions made during times of great demand.
Seeing a patient on an ECMO machine and ventilator can be a lot to take in—both mentally and emotionally. While you’ll start to understand more about the machine and process as you gain more experience, it can still be difficult to watch. “I will never forget the first patient I personally took care of who was on ECMO,” says Nakisa Baher, RN-BSN and ECMO nurse specialist at Bryan Health Medical Center. “You never really get used to seeing ECMO in action.”
What is an ECMO specialist nurse?
ECMO specialist nurses are registered nurses trained to manage the ECMO circuit for critically ill patients. While these nurses have backgrounds as staff critical care nurses, their focus as the ECMO specialist is the machine and knowing how to troubleshoot it in an emergency.
Many ECMO specialist nurses have backgrounds in the cardiovascular intensive care unit (CVICU) and often work separate shifts as a staff nurse in addition to their shifts as an ECMO specialist. The staff nurse caring for an ECMO patient must think about all of the patient’s needs while the ECMO specialist is hyper-focused on the patient’s vitals and how they are responding to the ECMO treatment.
Aside from ECMO nurse specialists, ECMO specialists can also include respiratory therapists, cardiovascular perfusionists and physicians who have undergone ECMO training.