Fitness for surgery (cardiac pre-operative)

The team

  • Hannah Ashpole, advanced practitioner
  • Hillary Schrauwers, clinical nurse specialist 
  • Heather Bennett, clinical nurse specialist 
  • Rudi Keshwara, staff nurse
  • Nancy Browne, clinical coordinator/administrator support

A growing team of clinical nurse specialists (CNSs) and an advanced practitioner run the cardiac fitness for surgery service at Harefield Hospital. This very successful service began in 2002 and has grown rapidly, particularly since 2009. The specialist nursing team now sees more than 550 patients each year.

The team ensures that cardiac surgery patients, mostly those needing coronary artery bypass grafts or valve surgery, are fit and well enough to have their operations.

The nurses’ role in the clinic

A member of the specialist nursing team sees the patient in a fitness for surgery clinic where, following a thorough review of a patient’s notes, the patient undergoes a series of investigations according to their individual clinical needs. This includes, among others, blood tests, chest X-ray, ECG, lung function tests and echocardiogram. The nurse also examines the patient and discusses their medical history with them. Most often the patient will also see a pharmacist, and occasionally an anaesthetist, both of whom work closely with the CNS team to ensure that the patient is in optimal health before being scheduled to have their surgery.

It can take up to four hours for a patient to have all tests and administration procedures completed.

As soon as all the test results are available, they are reviewed by a nurse specialist. If there are no abnormalities, the notes are passed to the theatre scheduling department to be put on the waiting list for a date for surgery. If tests come back with abnormal results, the specialist nurse follows an agreed protocol for referring patients for further investigations, if appropriate to the patient’s individual needs or forward the patient’s file for review by a registrar and discussion in a multidisciplinary team meeting. In some cases, the nurses will discuss alternative treatment options with the patient.

The nursing team works closely with the surgical scheduling team as well as all specialists from the multidisciplinary team including the consultant, intensivist, senior pharmacist for cardiothoracic surgery and anaesthetist.


Cardiac pre-operative team:

Availability: Mon-Fri 8am-4pm 

Contact details

Telephone: 01895 828 542 (out of hours, please leave a message)
Fax: 01895 282 958
Email: preoppatients@rbht.nhs.uk

Useful documents

Fitness for surgery clinic at Harefield Hospital (pdf, 503KB)

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