"I have been in my present role since June 2000, one of the first cardiology nurse consultant posts in the country. My job is predominately clinical and I have a variety of areas of responsibility. The role has changed considerably since I started as the needs of the service have altered. I now manage a team of 16 staff.
"I was responsible for setting up the nurse-led follow-up service for patients who have undergone percutaneous coronary intervention (PCI). Harefield Hospital was one of the first hospitals to set up such a service. Patients are reviewed either in the outpatient clinic or via the telephone. This service is now run by the clinical nurse specialists (CNS) in cardiology.
"The rapid access chest pain clinic is also nurse-led and runs twice a week. I run one of the clinics each week and the other is run by a CNS. This service enables GPs to refer patients who have chest pain which they think may be due to a cardiac problem.
"All patients are offered an appointment within two weeks of referral.
"I have also set up the lipoprotein apheresis unit. This is a dialysis-type treatment for patients who have exceptionally elevated levels of cholesterol. Ours is the largest unit in England, currently treating 35 patients from as far afield as Leicester, Kent and Suffolk, and we always have additional patients being assessed for treatment. I work closely with HEART UK, the cholesterol charity to help promote the treatment of high cholesterol levels in the UK.
"In 2009 I set up pre-admission clinics for patients being admitted for elective PCI and we have now extended this service to almost all elective cardiology patients. We opened the Woodlands pre-admission unit in June 2013 and now all pre-admission appointments for patients coming into Harefield Hospital are carried out in this unit.
"We have produced a video about the PCI pre-admission clinic for patients who are being admitted to Harefield Hospital.
"I also now carry out a ward round every day on the cardiology unit with one of the specialist pharmacists to help improve the patient pathway for patients who undergo PCI. We are both non-medical prescribers and are therefore able to ensure that patients are prescribed appropriate medication.
"In 2015 we set up an inherited cardiac conditions clinic so there is now a service at both Trust sites. Two of the CNSs in cardiology assist with the running of this clinic.
"In addition, I am actively involved in audit projects within the Trust and present at a variety of meetings in the UK and abroad. I have also published several articles on the work I do at Harefield Hospital."
- Sally Deane
- Nichola Dent
- Nicky Mackay
- Julie Bellchambers
- Fiona Eggenton
Harefield Hospital's cardiology team developed the role of clinical nurse specialist in cardiology to help reduce previously long waits for cardiology outpatient appointments, to address the reduced availability of medical staff due to the reduction in junior doctor's hours and the enable experienced nurses to develop new roles and skills.
We have all worked within the Trust for a number of years and have gained our experience working in different areas of cardiology, cardiothoracic surgery, intensive care, clinical research and management. As a prerequisite to our job we are all educated to degree level and have all completed a clinical examination module.
A varied role
The role has changed significantly since its inception in 2002. Our roles are varied and include:
- The assessment of patients in the Rapid Access Chest Pain Clinic (RACPC)
- Pre-admission clinics for patients undergoing elective cardiology procedures
- Follow-up clinic for patients who have undergone primary, emergency or elective PCI both in clinic and over the telephone
- Inherited cardiac conditions clinic
- Collating and inputting data into local and national databases
- Audit of PCI outcome, patient experience, compliance of antiplatelet therapy to name but a few
- Collating/analysis of data for annual reports and presentation at conferences
- Teaching pre- and post-registration nurses
Appointments take place Monday to Friday, 8 am to 5 pm and between us, we work a combination of part- and full-time hours.
In the near future, the team will also review patients who have been assessed in the pre-admission unit on the day case unit. This will enable greater continuity of care for the patients.
Our main responsibilities
The nurse-led PCI outpatient follow-up clinics aim to see all patients who have undergone PCI at Harefield Hospital. Primary and emergency PCI patients are reviewed at one month and six months. Elective PCI patients are seen at three months. Additional appointments are made as clinically indicated.
An appointment consists of:
- Clinical assessment
- Medication review
- Risk factor assessment
- Referral for further investigation / cardiac rehabilitation/support as required
- Discussion with the relevant consultant as appropriate
All information obtained from appointments is entered into a local/national database and a GP letter is generated, a copy of which is sent to the patient and any other relevant healthcare professionals involved in the patient’s care.
Trust protocols have been ratified to allow us to increase or reduce and stop various cardiac medications and we are in the process of being assessed to use these.