Mina recently visited her GP and was prescribed increased diuretics for her breathlessness and oedema. The Heart Failure Nurse comes to do a follow-up visit to assess whether the drugs have been effective. He has visited several times in the past and knows the family well.
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The Heart Failure Nurse visits Mina
Scene 1
HF NURSE: Hi Mina, how are you feeling?
HF Nurse thinks: She’s not as well as the last time I saw her…
MINA: I’m fine, just a wee bit out of breath.
Scene 2
HF NURSE: What’s making you out of puff?
HF Nurse thinks: She looks breathless.
MINA: I get breathless even from making a cup of tea.
Scene 3
HF NURSE: How are you sleeping?
HF Nurse thinks: She looks very tired.
Scene 4
MINA: Not very well. I’m really tired but I keep getting breathless and having to go to the window to get some air – even in the middle of the night!
I haven’t had a good night’s sleep in ages.
Scene 5
HF NURSE: Is it okay if I have a look at you?
MINA: Yes.
Scene 6–18
Q. Which Healthcare professionals might be involved in Mina’s care at this stage in her heart failure trajectory?
- Heart Failure Nurse? Yes, the heart failure nurse coordinates overall care, carry out on-going reviews and monitor & titrates medical conditions.
- Cardiologist? Yes, the cardiologist considers surgical options, where appropriate, and is responsible for optimisation of medical therapy.
- Respiratory Consultant? Yes, the respiratory consultant reviews COPD and is responsible for optimising medical therapy.
- Community Nurse? Yes, the community nurse carries out home visits to meet Mina’s healthcare needs.
- General Practitioner? Yes, the general practitioner has an umbrella overview and ensures that Mina receives optimum care.
- Pharmacist? Yes, the pharmacist is responsible for ensuring medication is safely managed.
- Occupational Therapist? Yes, the occupational therapist offers advice and information on energy conservation and organises appropriate adaptations/aids.
- Physiotherapist? Yes, The physiotherapist offers advice and information on breathing/relaxation/strength and balance exercises.
- Dietician? Yes, the dietician offers advice and information on diet.
- Social Worker? Yes, the social worker co-ordinates the team to meet Mina’s social needs.
- Community Psychiatric Nurse? No, although Mina is at an increased risk of anxiety and depression, provision of appropriate other health and social services might decrease this risk. At this stage, there is no need to involve the CPN but Mina’s wellbeing status should be closely monitored.
- Cardiac Psychologist? No, although Mina is at an increased risk of anxiety and depression, provision of appropriate other health and social services might decrease this risk. At this stage, there is no need to involve the CP but Mina’s wellbeing status should be closely monitored.
- Palliative Care Specialist? No, although palliative care should be considered at an early stage, Mina does not require specialist palliative care input at the moment.
Scene 19
The Heart Failure Nurse puts in place some immediate interventions to help Mina.
Page last reviewed: 28 Sep 2020
