How to Become a Cardiac Nurse (Steps, Education, and Salary)

Cardiovascular nurses care for, treat, and rehabilitate patients with heart disease, one of the leading causes of death in the United States. You will work with everyone from patients recovering from surgery to the critically ill.

Career Overview

Where you'll work: Hospital cardiac intensive care and post-operative units, cardiovascular centers, physicians' offices, and home health agencies.

What you'll do: Under a cardiologist's direction, you treat patients with heart disease, stroke, heart failure, and related conditions, help them recover from surgery, and teach lifestyle changes that protect heart health.

Minimum degree required: ADN or BSN, though many employers prefer or require a BSN.

Who it fits: Nurses who think fast and work well under pressure, since cardiac patients can deteriorate quickly, and who are detail oriented enough to manage complex treatment plans.

Median annual salary: $93,600 for registered nurses (BLS, May 2024).

How to Become a Cardiovascular Nurse

Decide if the specialty is right for you. Talk with cardiovascular nurses through professional associations, social media, or your local hospital, and shadow one if you can. It is an intense specialty, so confirm it fits before you commit.

Determine the education you need. You can enter with an ADN (about two years) or a BSN (about four years). Find out what local employers prefer and weigh the time and cost against your goals.

Graduate from an accredited program. An accredited degree qualifies you for licensure, specialty certifications, and advanced degrees, and lets you apply for federal financial aid.

Get licensed as an RN. Meet your state's requirements, which typically include passing the NCLEX-RN and a background check.

Consider a cardiovascular certification. After gaining experience, a certification demonstrates specialized knowledge and can open doors and raise pay.

What a Cardiovascular Nurse Does

Cardiovascular nurses care for patients with heart disease and work with their families to improve and maintain their health.

"Cardiovascular nursing is woven into every aspect of nursing because all our patients have hearts, and therefore they all have the potential to develop complications like cardiovascular diseases," says Joanna Dagenais, MSN, RN, CCRN-K, clinical education director for the Preventive Cardiovascular Nurses Association (PCNA).

Common conditions include:

• Coronary artery disease, when plaque builds up in the coronary arteries, slowing blood flow and raising the risk of heart attack, stroke, or sudden death.
• Stroke, when blocked blood flow deprives the brain of oxygen.
• Heart failure, when the heart cannot pump efficiently, causing fatigue and shortness of breath.
• Arrhythmia, when the heart beats abnormally and cannot pump efficiently.
• Heart valve disease, when damaged valves cannot open or close correctly.

Cardiovascular nurses educate patients on their condition and the lifestyle changes central to recovery, and they serve as a point person, updating physicians, patients, and families during long hospital stays.

Responsibilities

Your role varies by setting, but common responsibilities include health assessments (medical history, current condition, symptoms), medications and treatments (including inserting and removing IVs and chest tubes), postoperative care to prevent infection, heart attack, and blood clots, rehabilitation through exercise and lifestyle change, and patient and family education.

Is It a Good Fit?

Strong candidates work well under stress, since a cardiac patient's condition can change quickly and demand immediate lifesaving care. They are detail oriented: "It's important to be able to do a thorough assessment so you can build on that and see when changes are occurring," says Dagenais. And they communicate well, since even the smallest change can require a change in care, and families often need updates at difficult moments.

Where You'll Work

Most cardiovascular nurses work in hospitals. "Within the hospital, you could work in general care, progressive care, or critical care and specialize in cardiology," says Dagenais. "Other areas, such as a cardiac catheterization lab, can let you work with both inpatients and outpatients."

• Cardiovascular department: Care for patients with acute and chronic heart conditions, monitoring them or focusing on rehabilitation.
• Cardiothoracic surgical unit: Care for patients recovering from procedures like open-heart surgery.
• ICU/CCU/CVICU: Care for seriously ill patients recovering from life-threatening events like heart attack or heart failure.

A Day in the Life

A cardiovascular nurse usually starts with an update on their patients, then checks vital signs and lab work to flag anyone needing urgent care. Through the day, they monitor patients, relay changes to the care team, and carry out any treatment changes a physician orders.

"The cardiovascular specialty nurse sees a patient holistically and treats every part of a patient's condition," says Dagenais. "While cardiovascular is a specialty, you will have patients with other conditions like renal function disorders, endocrine disorders like diabetes, and the need for many tests and procedures." Managing your time well lets you give every patient quality care, from administering medication to inserting or removing chest tubes to changing dressings.

Education

Weigh your goals when choosing between an associate degree and a BSN. "BSN programs offer more training and practice in critical thinking, which is crucial in cardiovascular nursing," says Dagenais. "A BSN program may give you the foundation to hit the ground running in your first position."

Associate Degree in Nursing

Prerequisites vary but may include a high school diploma or GED, coursework in biology and algebra, recommendations, an interview, SAT or ACT scores, and a passing score on the HESI A2 exam. Core curriculum covers microbiology and immunology, an introduction to the profession, pediatric and geriatric nursing, and health assessments. Programs generally require 700 to 800 clinical hours, often more by state rule, completed in skills and simulation labs and rotations at hospitals or clinics. Time to complete: two years full time.

Bachelor of Science in Nursing

Prerequisites are similar, with more advanced biology and math coursework. Core curriculum adds professional nursing, leadership, and nursing management. Clinical requirements again run 700 to 800 hours or more, completed in hospitals, clinics, simulation labs, and sometimes community service. Time to complete: four years full time, or two years if you already hold an ADN.

Online Programs

Online ADN and BSN programs offer flexibility for family or work commitments, and some let you complete coursework at your own pace outside traditional semesters. You will still complete clinical hours in person.

What to Look For in a School

Beyond location, cost, student-to-faculty ratio, and curriculum, weigh accreditation (required for licensure, certification, and federal aid), job placement and career counseling, and the program's first-time NCLEX pass rate, which signals the strength of its education.

Licensure

After graduating, obtain an RN license from your state board of nursing by passing the National Council Licensure Examination (NCLEX-RN), administered by the National Council of State Boards of Nursing (NCSBN).

The NCLEX-RN is mostly multiple choice, with some fill-in-the-blank, multiple-response, and drag-and-drop questions. It is computer adaptive: answer correctly and questions get harder; answer incorrectly and the next is slightly easier. It tests four areas: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiological integrity. You will face a minimum of 75 and a maximum of 265 questions over up to five hours. The NCSBN offers a practice exam, flashcards, review courses, and study groups. After passing, apply to your state board, which often also requires a background check, fingerprinting, and references.

Gain Experience

"From the time they're in nursing school, nurses look at the cardiovascular system in every assessment they do, so we all have experience with cardiovascular systems even fresh out of the gate," says Dagenais.

New nurses are typically encouraged to gain general experience before specializing, but demand has changed that in some places. "The inpatient hospital setting has never needed nurses more at every level," says Dagenais. "A lot of hospitals that previously wanted experience before moving nurses to progressive or critical care are now open to taking people in and training them on the front end." That flexibility generally does not extend to outpatient roles: "Nurses in clinics and medical offices usually need experience to get those positions."

Certification

Certification is optional for cardiovascular nurses but worthwhile. "A hiring manager is typically impressed if a candidate is certified," says Dagenais. Several options exist, so you can pick one that fits your goals.

Cardiac Vascular Nurse, Board Certified (CV-BC)

Granted by the American Nurses Credentialing Center (ANCC), this certifies entry-level clinical knowledge for registered nurses. Requirements: an active RN license, two years of experience, at least 2,000 hours of cardiovascular clinical practice in the last three years, and 30 hours of cardiovascular continuing education in the last three years. The exam runs three hours and 150 questions. Free practice questions and paid test prep are on the ANCC website.

Cardiovascular Nurse Level I and Level II (CVRN-BC)

Granted by the American Board of Cardiovascular Medicine (ABCM). Level I covers non-acute cardiovascular nursing (telemetry, PCU, post-procedure, cardiac rehab, office-based roles); Level II covers acute care (CCU/CVICU, cath labs, interventional cardiology). ABCM recommends one year of non-acute practice before Level I and two years of acute practice before Level II. Each exam is 150 questions, taken online with a webcam. On-demand courses and review manuals are available for a fee.

Cardiac Medicine (CMC) and Cardiac Surgery (CSC)

Granted by the American Association of Critical-Care Nurses (AACN), these are critical-care subspecialty certifications. CMC is for RNs caring for acutely or critically ill adult cardiac patients; CSC is for RNs caring for cardiac surgery patients in the 48 hours after surgery. Requirements: an active RN license, a separate clinical nursing certification, and either 1,750 hours caring for acutely or critically ill adults in the previous two years, or five years as an RN with at least 2,000 hours in direct care of such patients. Each exam is 90 multiple-choice questions focused on clinical judgment, taken at a testing center or by remote proctoring.

Certified Cardiac Rehabilitation Professional (CCRP)

Granted by the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), this proves competency in cardiac rehabilitation. Requirements: 1,200 clinical hours in cardiac rehab or secondary prevention and a bachelor's degree from an accredited program or current RN licensure. The exam is three hours and 140 multiple-choice questions, taken at a testing center or by remote proctoring.

Salary and Job Outlook

The median annual salary for all RNs is $93,600 (BLS, May 2024). The BLS does not report RN salaries by specialty, but earning a BSN and a professional certification can raise your earning potential, as can your employer, location, and experience.

RN employment is projected to grow about 5% from 2024 to 2034, slightly above the average for all occupations. Demand will rise as current nurses retire and the older population grows, and that older population is exactly who cardiovascular nurses tend to treat. "Nurses at every level and in every setting are in extreme need right now," says Dagenais. "General care cardiovascular floors are always in need of nurses."