My role in the Cardiac Surgery Outpatients Clinic
Cardiac outpatients is a multidisciplinary department open between Monday and Friday at St Thomas’ Hospital, in which staff assess possible patients requiring interventional cardiology or cardiac surgery.
My role as Lead Advanced Nurse Practitioner is to manage the care and treatment of patients with heart valve disease. I deal in particular with the surgical potentials, who, after referral for a surgical opinion, are given an appointment in one of the ‘new patient pre-assessment’ clinics.
It is an action-packed morning in Cardiac Outpatients with appointments starting at 9am, where receptionists, nursing assistants and nursing staff, meet patients. They receive an information pack containing the itinerary for the morning and the St Thomas’ ‘Having Heart Surgery’ leaflet. Observations are conducted, noting the height, weight, BMI, temperature, heart rate, blood pressure, respiratory rate and oxygen saturation of the patient. Personal contact details and next of kin are checked and recorded. A breathing test known as Spirometry will be performed, followed by routine swabs for MRSA. Then an electrocardiogram (ECG) is done by a cardiac physiologist to look at heart rate and rhythm, followed by an echocardiogram (specialist ultrasound) to study the heart function and valves. The next step is to meet the Consultant Cardiac Surgeon who will review the echocardiogram and explain why surgery for their heart valve disease is necessary. The surgeon will take them through the procedure advised, discussing its advantages, and any potential risks.
Once accepted for surgery, I see the patient. Part of my role is to undertake a full past medical history, construct a list of current medicines and perform a clinical examination. This includes using a stethoscope to detect any valvular abnormalities. The detailed history is recorded clearly in their notes to further assess surgical compatibility. During this time, I take the opportunity to explain in more detail to both patient and partner/family, the expected patient journey before and after surgery, and the recovery time frame after going home. I will answer any questions they may have, giving them my contact details if they have further enquiries, and reassure them that I aim to see my patients daily post-surgery.
All pre-operative patients then have a chest x-ray and blood tests. Some may require additional tests such as specialist CT or MRI scans, formal lung function tests and carotid Doppler tests (ultrasound scan of the neck). Following this, I collate all the results from the investigations and discuss these with the Consultant. When ready for surgery, I notify the admissions coordinator.
In the next blog I will talk about one of my patients and their journey (confidentially of course).
You can find out more information about heart valve disease on the Heart Valve Voice website (www.heartvalvevoice.org) which I support in various projects.
Have you got a health question?
We've teamed up with AXA PPP healthcare to bring you articles, information and tips from their clinical teams on a wide range of health topics. And if you have a health related question of your own - about your or your family's health, medication or upcoming procedures, for example - you can also access their, "Ask the Expert" service. Available around the clock, 365 days a year this free resource allows you to ask the team of friendly and experienced nurses, midwives and pharmacists about any health concerns you may have - whenever you need them, 24 hours a day, every day. Please get in touch now.
Click below to submit your question online.
Leave a Comment!
Community Terms & Conditions
These content standards apply to any and all material which you contribute to our site (contributions), and to any interactive services associated with it.
You must comply with the spirit of the following standards as well as the letter. The standards apply to each part of any contribution as well as to its whole.
be accurate (where they state facts); be genuinely held (where they state opinions); and comply with applicable law in the UK and in any country from which they are posted.
Contributions must not:
contain any material which is defamatory of any person; or contain any material which is obscene, offensive, hateful or inflammatory; or promote sexually explicit material; or promote violence; promote discrimination based on race, sex, religion, nationality, disability, sexual orientation or age; or infringe any copyright, database right or trade mark of any other person; or be likely to deceive any person; or be made in breach of any legal duty owed to a third party, such as a contractual duty or a duty of confidence; or promote any illegal activity; or be threatening, abuse or invade another’s privacy, or cause annoyance, inconvenience or needless anxiety; or be likely to harass, upset, embarrass, alarm or annoy any other person; or be used to impersonate any person, or to misrepresent your identity or affiliation with any person; or give the impression that they emanate from us, if this is not the case; or advocate, promote or assist any unlawful act such as (by way of example only) copyright infringement or computer misuse.
Nurturing a safe environment
Our Silversurfers community is designed to foster friendships, based on trust, honesty, integrity and loyalty and is underpinned by these values.
We don't tolerate swearing, and reserve the right to remove any posts which we feel may offend others... let's keep it friendly!