Cardiovascular Nurse Navigator: Interview with Shannon Hernandez, RN, ADN, CCRN

My Specialty

Cardiovascular Nurse Navigator: Interview with Shannon Hernandez, RN, ADN, CCRN

Helping patients and families through the frightening experience of heart surgery

By Working Nurse
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WORKING NURSE: Tell us the name of your nursing specialty and where you work.

SHANNON HERNANDEZ, RN, ADN, CCRN: I am currently working as the cardiovascular nurse navigator at San Antonio Community Hospital in Upland, California.

How did you get into this specialty and did it require any special training?

I am a CCU nurse and worked full time in CCU for six years before applying for this position a year and a half ago. I hold a Critical Care Registered Nurse (CCRN) certification through the American Association of Critical Care Nurses and have completed a training series that focuses on post-open heart surgery recovery, which was provided by critical care educators here at San Antonio Community Hospital. After completing the series, I worked with experienced OHS nurses to orient myself to receive the post-open heart surgery patients and eventually began to care for these patients on my own.

I was a “heart” nurse for over five years and became very familiar with the process the patient and the family go through before and after surgery. When an opening came up for a cardiovascular nurse navigator, I applied. This position requires a BSN, so I am attending school as well as working. I continue to work occasional days as a bedside nurse in CCU to keep my skills current.

How long have you worked at San Antonio, and how did you choose to begin working there?

I accepted a position with San Antonio Community Hospital in July of 2000, right out of nursing school. I was attracted to San Antonio because of their new graduate critical care float pool position and interested in critical care because of the intensity and need to apply critical thinking skills, so I applied and was hired.

I participated in an intense series of critical care classes and then became part of the float pool, which covered ICU, CCU and three separate DOU units. Each morning I would call staffing upon arrival at the hospital and would then receive my assignment. I enjoyed the challenge of working in a different unit and had to develop good assessment and organizational skills to meet the challenges of floating. Eventually I transferred to CCU so to increase my knowledge and skills and learn to receive post-open heart surgery patients.

What does a typical day involve for you?

As the cardiovascular nurse navigator (CVNN) I help the patients and families “navigate” through the often frightening experience of open heart surgery. I act as a liaison between the cardiac surgeons and their patients and families. In the morning I print out a list of patients in-house who are being followed by the cardiac surgeons. I make early rounds, collaborate with floor nurses, review labs, write information for the surgeon on the progress notes, check on patients and report my findings to the surgeons.

When a patient is in surgery, I am in contact with the OR and update the family and loved ones throughout the procedure, keeping them abreast of progress and the estimated time of completion. I am also in contact with the cardiac catheterization lab and notify the surgeons and surgical team if there is a critical patient in the cath lab who requires stand-by preparation for open heart surgery.

I am responsible for reconciling medications and preparing all discharge instructions. I make sure that all disciplines (dietary, cardiac rehab, diabetic education) have completed their instructions and, in collaboration with the floor nurse, make sure the patient is ready to go. On or near the day of discharge, I meet with the patient and family members to give them specialized instructions for home. I talk to them about scheduled follow-up appointments, lab requisitions and prescriptions.

In between all this, I return any phone calls from patients and families who have questions about care or progress. I contact and inform the surgeons as necessary. Patients who have had surgery that requires monitored medications, like Coumadin, are also followed by the CVNN with orders from the cardiac surgeons. I also do chart review and collection of data required by the state and other entities regarding cardiac
surgery outcomes.

What are your favorite aspects of the job?

I enjoy working with the patients and seeing them get better and go home. It is a lot of work to coordinate all that needs to fall into place in order for them to be safely discharged, and I take great satisfaction in seeing patients and families do well. I also enjoy putting the minds of the families at ease when a patient is in surgery by updating them during the surgical progress so they don’t have to worry and wonder what is happening.

Any challenges or least favorite aspects of the job?

Like any job in nursing, every day is unpredictable. It is part of being a nurse. I like a day that is organized and, at times, that is impossible.

What advice would you give to a nurse looking to enter your field of nursing?

Critical care is an exciting field. Take the time to become efficient in the basic care of patients before jumping into it because it requires quick decision-making and lots of organization. The critical care float pool here at San Antonio Community Hospital prepared me for this opportunity to be a cardiovascular nurse navigator.


American Association of Critical Care Nurses

Cariothoracic Surgical Nursing, by Betsy A. Finkelmeier

Core Curriculum of Critical Care Nursing, by American Association of Critical Care Nurses

American Journal of Critical Care

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