By Deborah Jeanne Sergeant
Many people experiencing heart surgery likely assume that the nurse operates the “heart-lung machine” responsible for keeping them alive while the surgeon stops their heart to repair it.
But that is incorrect. Perfusionists do this work.
These operating room specialists monitor equipment that pumps and oxygenates their blood and also help when ventilating sick patients is not enough, such as those very sick with COVID-19.
SUNY Upstate is the only school in the region and one of about 20 nationwide that offers a degree in clinical perfusion.
The school requires a few bachelor’s level prerequisites in the sciences. Student perfusionists complete 75 cases. To become certified, graduates must pass the board exam of the American Board of Cardiovascular Perfusion. To remain certified, the perfusionist must take 40 cases a year, minimum and over three years, complete 40 hours of continuing education credits.
In general, candidates should have strong math and science aptitude.
“You have to handle stress well,” said Bruce Searles, chairman of cardiovascular perfusion at SUNY Upstate. “You will work in a stressful environment. When someone’s head is on fire, you can stay calm and not feel the need to get into arguments. You need a thick skin as you may get yelled at when it’s not your fault. Works well independently. There’s no one in the room who knows the technology that we use. The surgeon says, ‘This is what I need to have happen’ and they could not do that. There’s no one else there to do that.”
The remuneration is pretty good. According to Salaryexpert.com, an entry-level perfusionist in the Central New York area earns an average salary of $92,987.
“It’s a great job for people who work well under stress and also people who like to work behind the scenes,” Searles said. “The patient never knows you. You never get Christmas cards from them. It’s not like high touch like respiratory care or physical therapy. We’re very behind-the-scenes. I love how the heart and lungs work and I get to do that — I replace them. I get to practice at a very advanced level intensive care. People say, ‘you monitor a machine’ but that’s like saying, ‘You monitor your car’ when you drive it.”
The demand for perfusionists remains keen, even as the pandemic has wound down. In addition to practicing, perfusionists can work in equipment sales, training and academia.
Searles said that Upstate currently has 12 students enrolled in the perfusionist program currently and the school received 284 applications. The lack of opportunities to receive the education has created a bottleneck for minting new perfusionists.
“There are only 4,500 of us nationwide and we need more as we’re in a serious shortage,” said Carla Maul, perfusionist and director of perfusion.com, a site boasting 12,000 members worldwide. The Fort Myers, Florida-based company provides temporary and permanent perfusion staffing.
She likes how the career has progressed in technology in the past 20 years, noting that people who want to become a perfusionist should be comfortable with technology.
“I enjoy seeing really sick patients recover and have a healthy, wonderful life,” she said. “We are the ones that patients never ever know are there. People don’t know what we do. Kids in college don’t think of this as a profession because they’ve never heard of it.”
That represents one of the reasons that perfusion needs more workers. The small number of educational opportunities available is another reason. Maul compared getting into a perfusion program as difficult as getting into Harvard because of the limited number of spots open. As a result, patients sometimes must delay vital surgery.
Sometimes, perfusionists are on stand-by for patients who may need their help during surgery.
In addition to the operating room, perfusionists also work bedside with extra corporeal membrane oxygenation (ECMO), supporting the lungs or the heart and lungs.
“Some COVID patients couldn’t oxygenate even on full ventilator settings,” Maul said. “ECMOs are in ICU.”
Perfusionists may also work on the go, as patients receiving ECMO sometimes need transportation to a larger medical center for more specialized care.
“I have never once regretted choosing this as my profession,” Maul said. “My profession chose me. I would encourage all the young people thinking about what profession they’d go into to think about this. If they’re interested with patient care and surgery and interested in technology, this would be a perfect profession to consider.