April 1 2008 marked the start of Catherine Renwick’s appointment as Ben’s Nurse at the Royal Brompton Hospital. The new post of Paediatric Cardiac Electrophysiology Nurse Specialist allowed children and their families to benefit from Catherine’s knowledge and skills of working with children with abnormally fast or slow heart beats (arrhythmias) and inherited conditions, which predispose them to sudden and sometimes life threatening collapse. Whilst based at the Brompton, Catherine provided support to families across the wide geographic area covered by the hospital, visiting homes and liaising with schools, GPs, and other care workers and interested parties. Funding for the post for the first three years was provided by the Ben Williams Trust, after which time it had proved so successful that it was absorbed into mainstream NHS funding.
How the Post and Service have Developed
Since Catherine’s appointment to the post of Ben’s Nurse in April 2008, the paediatric arrhythmia and inherited cardiovascular conditions service at Royal Brompton Hospital has seen substantial developments. This includes many nurse-led initiatives to improve the patient experience and access to the arrhythmia service. The success of the specialist nursing post has demonstrated the value of such services and driven a substantial increase in demand.
Catherine developed the nurse-led SVT (supraventricular tachycardia) service, providing continuity for the 100 patients each year attending the paediatric arrhythmia clinic. Patients are seen and assessed in the same way as they would be by a doctor, with a full medical history taken and physical assessment performed. The child’s treatment is then planned, with further investigation initiayed where necessary.
In support of this, Catherine completed an independent prescribing course, enabling her to prescribe medication. It also allowed her to change prescriptions between clinics in response to side effects or worsening symptoms. Details of the implementation of this independent prescribing service have been published by Catherine in the Journal of Cardiac Nursing.
Outside the clinic, Catherine spends significant amounts of time providing information to professionals in primary and secondary healthcare, the social care and education systems.
Educating healthcare professionals has seen Catherine present at a number of national and international conferences in the last five years. She has also developed the UK’s only study day on arrhythmias for paediatric nurses, which attract attendees from across the country.
Catherine visits schools with the aim of enabling any child with an arrhythmia to live as normal a life as possible. She provides direct teaching to staff to ensure they understand the child’s condition, symptoms and medications. Those schools that do not receive a visit are provided with a care plan.
An audit of the patients seen in the nurse led SVT service has shown very positive results. Patients reported that Ben’s Nurse had a positive impact on their experience of the arrhythmia service through continuity at clinic appointments, reduced waiting times, clinic efficiency, diagnostic clarity and symptom recognition and management. This all helped to allay the child’s anxiety.
Catherine continues to develop the role, studying for an advanced nurse practitioner masters degree. She also plans to research the exercise habits of children affected by arrhythmias with the intention of publishing the results in the future and using the results to provide individual safe exercise programmes.
Catherine is now the lead nurse in family care for paediatric electrophysiology and inherited cardiac conditions. As a direct result of Catherine’s success in her role, the specialist nursing team at the Brompton has expanded rapidly and her team includes a number of new nurse specialists whose posts have been created to build on the model we helped to establish. Catherine’s guidance and supervision, drawn from her experience as Ben’s Nurse, have been key to the shaping and implementation of these roles.
The Burdett Trust for Nursing
A major contribution to the funding of Ben’s Nurse was received from the Burdett Trust for Nursing. The grant covered almost half of the cost of the post for first three years, offering real security for its establishment and development. The Burdett Trust for Nursing makes grants to support the nursing contribution to healthcare, and aims to encourage nurses and other healthcare professionals in a wide range of innovative projects.