My experience with Specialist Community Heart Failure Nurses

Earlier this year I had a placement with Specialist Community Heart Nurses. They were a small close-knit team who welcomed me without hesitation into the wonderful world of Cardiac Community Nursing.

Despite being intimidated at first, I was in awe of their expertise and confidence as independent practitioners, and developed my own confidence and independence massively by the end of the placement!

This experience not only developed my confidence in communication and clinical skills but also taught me the language of kindness.

I’m a Final year Student Nurse on a Community Circuit Pathway; this means that the majority of my placements are in community settings. So far, I’ve had placements with District Nursing Teams, Patient Safety Team, Stroke Rehabilitation Ward, etc. I admire the holistic nursing that comes with the Community setting; we are able to develop long term therapeutic relationships with many patients and provide high quality person-centred care.

I knew Community Nursing was for me before I started the nursing degree. In my personal life, I am very close to my Grandparents. When my Granddad’s illness progressed, I saw first hand how being able to receive palliative care at home improved his comfort and the well-being of our family. I wanted to be able to provide that comfort to patients too in the privilege of their home.

The placement involved working with the nurses to run clinics, perform telephone consultations, visit their patients at home, monitor symptoms, undertake physical assessments e.g., chest percussion and auscultation, triage, perform venepuncture, assess peripheral oedema, adjust medications according to symptoms and clinical presentation and so much more!

Besides developing these clinical skills, I really admired the important therapeutic role the nurses had; many patients struggled with self-managing and felt in low moods, but by having the support of the nurse we all had smiles on our faces by the end of the visit (often laughter too!).

In particular, I was blessed to have an amazing Practice Assessor. Many of her patients sang her praises to me and encouraged me to listen to all her advice – I absolutely did! I really admired how she had such a person-centred approach to every single one of her patients, and she would go above and beyond to help them in any way she could. Any time I had a question, she would always give me a clear answer and signpost me to any resources she knew of.

She also encouraged and supported me to do independent telephone consultations and to coordinate care, this could involve ringing up GP Surgeries and Pharmacies to chase medication prescriptions or doing physical assessments on home visits, e.g., chest auscultation to assess whether there was fluid in the lungs. I was outside my comfort zone every day but with my Practice Assessor’s advice I felt so supported and excited. She had truly taught me the value of a great mentor but most importantly the language of kindness.

During this placement, I had a wobble. I became unsure if the community is where I should start working when I qualify. I had great experiences from my last ward placement and began doubting my pathway. I spoke with many different staff, nurses, my personal tutor, family and friends. I received different advice from everyone and was unsure myself what to do. However, I know Community Nursing is where my heart is and after much reflection, I regained my passion. My advice to any unsure students would be to reach out to anyone who inspires you, read the QNI mythbusters amongst other helpful resources and follow your heart!

Don’t let anyone else’s negative outdated ideas of the community affect your passion.

Outcomes

My knowledge of cardiac conditions improved massively during the placement; I now understood the difference between an electrocardiogram and an echocardiogram! As well as what on earth Ejection Fraction percentages meant! I now understand that Heart Failure is when the heart begins to eject blood insufficiently. It can be caused by cardiac arrest, hypertension, cardiomyopathy, arrhythmia, amyloidosis and many other factors. Leading to symptoms such as breathlessness, fatigue, weight gain etc. It is diagnosed by a series of tests including electrocardiograms, echocardiograms, chest x-rays and blood tests.

Heart Failure is not immediately a palliative condition and can be managed by medications, surgeries such as coronary bypass and pacemakers, as well as lifestyle factors – exercise and diet. The role of the Specialist Heart Failure Nurse is so crucial in providing much needed holistic support to patients, improving quality of life and reducing hospital admissions. As Heart Disease is a leading cause of death, there is even more need for more Specialist Heart Failure Nurses, yet financial pressures on CCGs can challenge this need.

I would strongly recommend students to contact the Heart Failure team for a placement/bespoke, whether this be inpatient or community. These Specialist Nurses are passionate leaders and I have no doubt they will positively impact your nursing journey like they did mine.

Conclusion

Don’t be afraid to put yourself out there, volunteer for every opportunity and offer help at every turn. Your team will appreciate you and your confidence will soar. Your Nursing Journey will challenge your comfort zone every day and you will grow into the best version of yourself.

Thank you!

Resources:

https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm https://www.bhf.org.uk/for-professionals/healthcare-professionals/innovation-in-care/heart-fai lure-specialist-nurses

https://www.bhf.org.uk/informationsupport/conditions/heart-failure

https://www.qni.org.uk/students/more-information-and-links/

My twitter: hannahmary_c