Surgery at Royal Brompton Hospital


Mary Madigan


Princess Alexandra ward has 35 beds. Patients needing cardiac surgery or investigations before their surgery are cared for here.

The high dependency unit (HDU) / Elizabeth ward has 14 HDU beds and four beds in the recovery unit. Patients are admitted to HDU for emergency care as a result of an acute illness or recovery after a routine admission for surgery or a medical procedure.

Information for nurses

The surgical unit offers excellent experience in the field of cardiothoracic nursing. The HDU provides the opportunity to gain experience in caring for patients in the more acute post-operative phase, in addition to the important area of rehabilitation and education prior to discharge home.

The wards are managed by ward sisters, who are supported by a team of senior staff nurses, who act as team leaders to ensure that the rest of the team members are supported and developed. The surgical unit and the private patients' ward have a clinical practice educator who works with all members of the nursing team in order to ensure professional development is encouraged and supported in the clinical environment. Each member of staff is allocated a mentor, who in partnership with the nurse helps devise a personal development plan. There are regular teaching sessions. In addition to ward-based teaching, there are numerous in-house study days available in our training and development department plus a wide variety of courses, such as the cardio-respiratory specialist course and critical care modules. We also run an MSc course in cardiorespiratory nursing, in conjunction with Imperial College London.

Other nursing roles in the unit, include a cardiac liaison sister, a cardiac pre-admission clinic nurse and home care nurses who support patients at home as part of our early discharge programme (the nurses visit the patients at home, and have the facility to carry out tests such as ECG and phlebotomy, and can administer medication according to defined protocols and guidelines). The home care team also assess patients on the waiting list for cardiac surgery, as part of our fit-for-surgery programme, providing information to the patients and families about lifestyle changes.  They also identify any clinical problems which could lead to cancellation of the surgery if not dealt with. These roles combined, ensure that we provide excellent support to patients prior to admission to hospital, during their hospital stay and following discharge.

In addition, we also have a lung cancer and palliative care nurse specialist who sees patients having thoracic surgery in the outpatients clinic with the consultant prior to admission. He or she provides support and information to the patient and their relatives during their hospital stay. The role is also a valuable educational support for the rest of the nursing team.

The peri-operative specialist practitioner (PSP) is a nursing post as part of the surgical team carrying out some of the roles traditionally undertaken by the surgical SHO. This includes routine pre-operative assessment and management of the surgical patient. They undertake practical procedures in which they are competent.

Information for doctors

Being a specialist centre for the research into and the treatment of heart and lung disease means we are fortunate to have a very highly skilled workforce, with all the support services that such a vital area of medicine requires. We have modern and well-equipped operating theatres with the latest equipment used by surgeons to undertake the latest surgical techniques, such as ‘octopus’ (allowing beating heart coronary artery bypass grafting). We also have a well-equipped cardiac catheter suite, consisting of four laboratories, used by our cardiologists.

The intensive care unit is staffed by a highly skilled workforce who care for patients with a wide variety of cardiothoracic conditions, who require care post-surgery. They also manage patients who are admitted directly to the unit from other hospitals in the country or from abroad who need the specialist knowledge and skills of a tertiary referral centre.

Information for patients on Royal Brompton Princess Alexandra ward

Information for patients on Royal Brompton high dependency unit (HDU)