‘Cardiac assessment needs to be one of the core nursing skills’

This was not because Monsieur Poirot’s fan base had grown, but because at 9.17pm, when Hercule took a break, the latest advertisement by the British Heart Foundation highlighted UK’s biggest serial killer.

It was really a two-minute documentary. The star, representing the viewer, spent the whole two minutes being subjected to the symptoms of a heart attack. One was left in no doubt that, as well as presenting with chest pains, heart disease can manifest itself a little more discreetly.

For me, the advert is a godsend, for most of my previous working days had been filled with correcting patients’ assumptions that unless someone is in absolute agony, they can’t be having a myocardial infarction.

Ironically, a previous BHF campaign exacerbated this assumption with a poster depicting a chest being squeezed by a steel band. Patients delayed seeking treatment because they compared their slight ache with the poster man’s agony and decided they were not experiencing a heart attack.

Most cardiac patients rarely mention ‘pain’ but refer to ‘discomfort’ or ‘indigestion’. As a result of such dithering, their heart muscle has been irreparably damaged. So hats off to the BHF for getting it near perfect.

Is this ignorance confined to the public, or does it extend to those who should know better – us, for example?

Patients do not always develop chest discomfort at home or on a critical care unit – it may be during admission for a totally unrelated condition. Cardiac patients often end up on general wards because of bed shortages on specialist units.

It is we as nurses who are best placed to perform cardiac assessments and, in essence, save lives – yet most of
us haven’t a clue about how to do this, let alone interpret an ECG or identify even the most basic of rhythms on a cardiac monitor.

The acquisition of such skills should be part of the mandatory assessed training for every nurse and HCA, regardless of speciality.

Ignorance about heart attack symptoms from the public is understandable. From us, it’s unforgivable.

Watch the ad at www.bhf.org.uk.

Rob Harteveldt is a cardiac liaison nurse specialist at Stoke Mandeville Hospital

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