The Nurse Specialist Post
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. After three years of funding by the Ben Williams Trust, the post 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. Of particular note is the inherited cardiovascular disease clinic, at which adults and children are seen together as family groups.
Catherine also 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 initiated 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 spent significant amounts of time providing information to professionals in primary and secondary healthcare, the social care and education systems.
Catherine also visited schools with the aim of enabling any child with an arrhythmia to live as normal a life as possible. She provided direct teaching to staff to ensure they understood the child’s condition, symptoms and medications. Schools that did not receive a visit were provided with a care plan.
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.
The success of the specialist nursing post demonstrated the value of such services and has driven a substantial increase in demand. 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.