All You Need To Know About Cardiothoracic Nursing In Nigeria

Do you know that most people, even healthcare professionals (nurses, surgeons, doctors), do not know what cardiothoracic nursing is all about?

Cardiothoracic nurses are critical care nurses who specialise in caring for patients with cardiac, vascular, thoracic, and related pathologies.

In this article, we are going to divide our discussion into the following major sections:

• What Is A Cardiothoracic Nurse?
• How To Become A Cardiothoracic Nurse In Nigeria
• What Do Cardiothoracic Nurses Do?
• Cardiothoracic Nurses Salaries
• Where Do Cardiothoracic Nurses Work?
• Which Schools In Nigeria Have The Best C Cardiothoracic Programs?   
• Top Tips On Becoming A Cardiothoracic Nurse
• What Is The Career Outlook For Cardiothoracic Nurses?

This article is a comprehensive guide for registered nurses in Nigeria who are considering a rewarding and promising career path as a cardiothoracic nurse.

This article is designed to provide you with practical and detailed information that will assist you in making an informed decision about your career path in cardiothoracic nursing.

You can also share it with colleagues considering pursuing a career in critical care or cardiothoracic nursing.

What Is A Cardiothoracic Nurse?

Cardiothoracic nurses care for patients with cardiac, vascular, thoracic and related pathologies.

They work very closely with cardiologists, cardiothoracic surgeons, cardiac specialists and other healthcare professionals in cardiac care.

Cardiothoracic nurses can care for patients of all ages but can also decide to focus on specific groups. For example, a paediatric cardiothoracic nurse focuses on providing care for infants and children with cardiothoracic problems in a surgical or medical setting.

How To Become A Cardiothoracic Nurse In Nigeria

The journey begins with a first degree in nursing or a diploma.

After your nursing degree or diploma, you must have about two years of working experience before applying to start your training and education.

As of this writing, only one institution has trained and educated cardiothoracic nurses in Nigeria. The University of Nigeria Teaching Hospital, Enugu, is the only training institution in Nigeria with a post-basic cardiothoracic nursing programme.

To gain admission, you must complete your general nursing education, have about two years of post-qualification clinical experience, and possess a valid practising licence.

Admission is very competitive. The institution admits only 30 nurses annually (may have been reviewed or is being reviewed), and the program lasts 12 months.

Once you gain admission, it’s studies and training from day one.

You’ll be exposed to a lot of clinical training in the cardiothoracic surgical departments, cardiac catheterisation lab, non-invasive cardiac unit, intensive care unit, cardiac ICU, and other critical care areas in the hospital. You’ll also have the opportunity to gain some experience in different critical care aspects, like the renal department, neuro ICUs, physiotherapy, and medical/surgical departments.

The experience is well-rounded and balanced.

However, most of your time will be spent in the cardiothoracic critical care environment, where you will be busy taking care of post-operative open heart surgery patients, patients needing coronary catheterisation, and patients needing care after different kinds of advanced cardiothoracic procedures.

What Do Cardiothoracic Nurses Do?

Cardiothoracic nurses primarily work in critical care areas within hospitals, such as general intensive care units, cardiothoracic intensive care units, neuro-ICUs, and renal units.

These areas require close patient monitoring and the administration of critical care medications, such as inotropes, opioids, anaesthetic agents, electrolytes, and other delicate medications.

In the cardiac surgical departments, cardiothoracic nurses can be found in the post-anaesthesia units, caring for patients recovering from the effects of anaesthesia, or in the cardiac ICU, taking care of immediate post-operative cardiothoracic surgery patients and in high dependency units.  

They can also work closely with interventional cardiologists in the cath lab as first assistants or scrub nurses for coronary or other cases in the cath lab.

Cardiothoracic nurses have specific duties, which include the following (but not limited):

• Administration of anaesthetic medications in cardiothoracic intensive care units: Most immediate post-operative cardiothoracic patients brought into the cardiac ICUs are almost always sedated. The cardiothoracic nurse works closely with the critical care physician (the intensivist) to ensure that the patient receives the required dose of sedation to keep the patient calm. Cardiothoracic nurses have a broad knowledge of how these medications work and are experienced enough to know when to keep a patient sedated or initiate the weaning-off protocol.

• As discussed above, cardiothoracic nurses assess patient response to anaesthesia and adjust doses according to to sedation protocols. Critical care physicians (who have extensive experience in anaesthesia) work closely with cardiothoracic nurses to ensure that patients receive safe doses of anaesthesia as required.  

• Management of patient airways in the cardiothoracic critical care unit: Most sedated patients are always assisted in breathing via a mechanical ventilator. Cardiothoracic nurses are responsible for ensuring patient safety while invasively or non-invasively ventilated. They monitor blood gases, care for the airways, and ensure the patient is comfortable throughout the ventilatory therapy.

• Drug administration: The drugs used in critical care nursing/medicine are special drugs that require very close monitoring during administration. The cardiothoracic nurse ensures patient safety while administering critical care medications. These medications are administered via special venous accesses, like central lines, PICC, etc. The cardiothoracic nurse knows how to manage and maintain these special vascular accesses to prevent infection and prolong their lifespans.

• Cardiothoracic nurses can carry out certain advanced bedside procedures, like urinary catheterisation, inserting IV lines (central and peripheral), inserting arterial lines (for invasive blood pressure monitoring), and other advanced bedside procedures, depending on their experience and privileges where they practice. They can also assist the critical care physician in intubating, passing chest tubes, and other critical care bedside procedures.

• Advanced patient monitoring: In critical care, patient monitoring goes far beyond checking vital signs three times a day. Patients needing critical care are monitored every second! Apart from blood pressure, temperature, and pulse, other parameters like invasive blood pressure monitoring, levels of CO2 in the blood (for ventilated patients), urine output ( checked hourly, sometimes every 30 or even 15 minutes), and neuro-vital signs for patients under sedation are some of the advanced monitoring cardiothoracic nurses are responsible for in the critical care unit.

Cardiothoracic nurses are also required to render basic nursing care, such as monitoring vital signs, ensuring patient comfort and adequate nutrition (via NG tubes or gastro-tubes), and other forms of nursing care, in addition to specialised care.

Cardiothoracic Nurses Salaries

Critical care nurses are among the highest-paid nurses in Nigeria.

Lagos, Abuja, and Port Harcourt are some of the big cities in Nigeria where critical care nurses are well paid.

Experience is the single factor determining the pay of cardiothoracic nurses in Nigeria. It is not just your academic qualifications that determine your pay but your skill and experience.

Cardiothoracic nurses in Nigeria can earn between 200,000 and 500,000 (naira) and even more, mostly in private institutions with advanced cardiovascular, thoracic, and critical care services. These include hospitals with standard intensive care units, operating theatres, advanced radiological services, and other advanced healthcare professionals, like physiotherapists and medical laboratory scientists.

Where Do Cardiothoracic Nurses Work?

Here are some places where cardiothoracic nurses can work.

• Cardiothoracic ICUs.
• Cardiac Catheterization Laboratories.
• Medical/Surgical Departments.
• Renal Units.
• Neuro ICUs.
• Cardiac Rehabilitation Centers.
• Cardiac Research Centers.
• Administrative Centers.

While cardiothoracic nursing may seem like a core clinical speciality, that does not mean there aren’t opportunities beyond the bedside or ICU.

Cardiothoracic nurses can further their careers by seeking higher education and training that can place them in leadership positions or as research specialists in cardiothoracic nursing.

They can also pursue administrative positions and effectively work with NGOs that support populations suffering from cardiac problems.

Which Schools In Nigeria Have The Best Cardiothoracic Programs?   

Unfortunately, in Nigeria, as of writing, there is only one training programme for cardiothoracic nurses, and that is at the University of Nigeria Teaching Hospital, Enugu.

It’s a one-year training programme focused mainly on clinical postings, class work, and research.  

Several institutions offer training for critical care nurses.

Cardiothoracic nursing and critical care nursing have much in common. The main distinction is that cardiothoracic nursing primarily deals with cardiothoracic critical care, while critical care nursing (ICU nursing) has a broader focus.

Read more about the differences and similarities here.

Top Tips On Becoming A Cardiothoracic Nurse

Critical care nursing/medicine is challenging.

In the ICUs, you can be on your feet the whole shift and wouldn’t even know what a chair feels like.

It’s in the ICU that you will see more deaths that can cause you a lot of emotional stress, and you must be ready to face it!

You need to be sure of what you want to do.

There’s the challenge of learning fast and staying on top of the learning curve so that you are equipped with the right knowledge needed to save lives and work with your colleagues.  

Here are some tips to help you:

• Get used to thinking independently: Critical care nursing provides a degree of autonomy for nurses. Many protocols and guidelines guide critical care nurses in clinical decision-making. You don’t have to wait for anyone to tell you anything before you do it (and before you do anything for a patient, you must deeply understand what you’re doing for them). The time you wait could be fatal for the patient. For example, if a patient goes into cardiac arrest suddenly, would you stand by and wait to be told what to do before you act? No, you swing into action immediately and let the team join you. Most nurses are used to being told what to do before they act. Well, in critical care, it’s a bit different. The aim is to preserve life or prevent the progression of damage caused by pathology or physiological imbalance.

• Get used to advocacy: advocating for your patients and, most importantly, advocating for your speciality. One of the reasons nurse anaesthetists have survived worldwide for nearly 100 years is rigorous advocacy. We need the same energy in critical care nursing (all aspects of critical care nursing). So, if you’re coming into critical care nursing, you must be ready to let everyone know that you’re capable of looking after a patient without having a physician look over your shoulder all the time.

• Run far from ego and pride: There are many humbling moments in critical care. It’s a vast place, and no one can ever boast to know it all. Why? Simple. It’s a cocktail of different specialities. There’s cardiac, renal, haematology, endocrinology, physiotherapy, nutrition, neuro, you name it, so one man can never boast of knowing it all! You need to have an open heart to learning, accept your mistakes, and keep growing as a critical care nursing professional.

• Focus on leadership: I mentioned earlier that though critical care nursing might seem like a core bedside nursing speciality, there are still numerous opportunities beyond the bedside. We need more healthcare leaders who champion courses that improve healthcare delivery and practice. You can be one of them.

• Get a good mentor: In leadership, the subject of mentorship is famous because to become great in anything, you need someone who has gone ahead of you to assist you. Becoming a good critical care nursing professional will be smooth if you get a mentor. Someone who has gone ahead of you and has more experience and, most importantly, has more connections and a more extensive network.

What Is The Career Outlook For Cardiothoracic Nurses In Nigeria?

The job prospects for cardiothoracic nurses are excellent.

There is a continuous need for cardiothoracic nurses worldwide!

If you decide to pursue a career in cardiothoracic nursing, you should travel out of the country to do so.

Nigeria isn’t ready for healthcare yet.

There are very few advanced-level degrees for nurses in Nigeria (Master’s and Doctorate). The only place where you can enjoy advanced education is in developed countries.

However, you can get foundational training and education in critical care or cardiothoracic nursing here, which will help you when you decide to travel.

We heard that there were plans to convert post-basic nursing speciality programs in Nigeria to Master’s, however, we haven’t confirmed this news yet, and if it’s true, we will be very excited about it.

What makes nursing and medicine very interesting is that they are the same thing worldwide.

The physiology or anatomy of an African is the same as that of an Asian or American.

The differences are very tiny (maybe genetics).

So, your experience in nursing and medicine in any part of the world is valuable and valid if you decide to go somewhere else.

After Thoughts

Critical care nursing is wide; it’s not just about ICUs and theatres.

It’s made up of a cluster of other nursing specialities like:

• Critical care nursing (general ICU nursing).
• Cardiothoracic nursing.
• Operating Theatre Care.
• Nurse Anaesthetist.
• Renal Care.
• Neuro Care.
• Orthopaedic Care.
• Mental Health Care. Etc.

Critical care is a form of care beyond the normal, basic or general.

It’s close, delicate, and constant care, where small mistakes can be fatal and small actions can save lives.

This article will be updated regularly to include the latest information on Cardiothoracic nursing in Nigeria.

For more professional ideas and advice like this, follow Care City on Instagram, Twitter, Facebook, and LinkedIn.

You can also find us on Substack.