Clinical Nurse Specialists (CNSs) are nurses who are certified in a specialty of choice. This certification means that they have an advanced level of knowledge, as well as advanced clinical skills in that specialty. CNSs use their skills and expertise to provide physical and emotional support to patients, coordinate patient care and inform and advise patients on clinical and practical issues.
CNSs play a pivotal role in patient care and at HCA UK, we have teams of specialist CNSs across medical specialities such as cancer, cardiac and gynaecology.
Cardiac surgery and rehabilitation CNS Suzanne O’ Connor has worked as a Cardiac CNS since 2015. Here she shares how she help patients before, during and after cardiac surgery, and the long-lasting bonds she often forms with patients.
Understanding the role a CNS plays in patient care
I’ve worked in cardiac nursing for as long as I can remember – and even after 25 years, it’s still as rewarding as when I first started. It’s the type of nursing where you can physically see an improvement in a patient’s health – from seeing them before surgery to after they’ve recovered and are getting back to what they love doing. Sometimes, patients stay in touch years after their procedure – it's amazing to be able to build that relationship and have an impact on someone’s life.
My first interaction with a patient, and where my work begins, is at the point where they are referred for heart surgery at London Bridge Hospital. I will contact the patient and arrange for them to have their pre-assessment. This involves me speaking to patients about their overall health, talking through their medical history and asking them about what their home environment will be like after surgery. I also give advice on what they’re allowed to eat and drink before surgery, what they need to bring with them on the day and overall, what to expect from their time in hospital and their recovery and rehabilitation.
After surgery, I will check and see how they’re doing, and later on, ask how their recovery is going. I am also responsible for referring them to a rehabilitation team. My work doesn’t stop there though, as even after they begin their rehabilitation, I check in with patients once a week to answer any questions about their recovery.
Adapting the care to meet each patient’s needs
The patients who come for heart surgery at London Bridge Hospital vary so much in terms of age, how active they are and their expectations after surgery – so it’s important from a nursing perspective to not have a ‘one size fits all approach’ to the care I provide to patients and understand what each individual patient’s goal is following treatment.
For example, one of my 82-year-old patients might want to return to gardening once a week, whereas I may have a 45-year-old patient who enjoys marathon running and wishes to get back to running long distance. Both of these patients could have exactly the same condition and could be having the same procedure, but they will have different expectations of what they want to achieve following surgery.
Helping patients with their recovery and beyond
After my patients have undergone surgery and are recovering, I refer them to specialists who will support them further with their recovery - for example physiotherapists, dietitians and pharmacists. I call every patient once a week after discharge to see how they’re progressing – after a couple of weeks some patients don’t need me call anymore, but for others they like to keep checking in – it’s a personal choice and one which I honour.
Once they have been referred back by their surgeon to their cardiologist, that is when any final conversations between me and the patient can be had. By then, it ends up being more a chat about their lives in general than their rehabilitation – but that is great as it means that my job has been done!
What Suzanne’s patients said about her care
We asked a couple of Suzanne’s patients to tell us how the care she provided impacted them. Here are quotes from Raymond and Jack.
“Coming to London for the first time for major heart surgery was initially daunting to me, but after speaking to Suzanne for the first time that all changed. At a time where so many things were unfamiliar – travelling overseas during COVID, having to organise and take COVID tests before being admitted into hospital and having no hospitals visitors – Suzanne knew so much about what was going on – she acted as a motherly figure, guiding me through each of the steps and coordinating my care in such an efficient way. I honestly couldn’t be more grateful for her support and guidance.”
Raymond, Cardiac patient at London Bridge Hospital in September 2020
“Suzanne was great – she helped with so many of my concerns and questions, especially after surgery when I was back at home recovering. Whenever we spoke, she was able to provide her expert advice and had a great manner. I always felt she was more than willing to listen and chat with me about how I was doing without me feeling I was taking up her time. She really made me feel like I was the only patient she had. Her advice and help has made me feel more confident again following my surgery and six months on, I’m continuing to build on that confidence and getting stronger every day.”
Jack, Cardiac patient at London Bridge Hospital in July 2021