Nurse specialists help patient and family through heart surgery and recovery.

Story and photos by KEN MOSIER
For Health Care Today

Heart surgery can be traumatic — anyone who has experienced it or had a close family member go through it can tell you that. The worst part is the unknown. What is going to happen? What will I do after surgery? How can I get back to a normal life?

Increasingly, hospitals today are helping patients navigate the rocks and shoals of heart surgery by assigning a nurse specialist to the patient. These "Nurse Navigators" go by different names at each hospital but their primary duty is easing the fears and trying to guide the patient — and their families — through the ordeal of the surgery. Many draw on specialized expertise as cardiac nurses to help the patient along.

Sherry Brown has been an R.N. at Good Samaritan Hospital for 44 years. Her official title is Cardiac Care Specialist Patient Advocate. Recently she hosted Candace Kitchen, an R.N. from Atrium Medical Center. Kitchen explained that cardio-surgery is a new program at Atrium (which opened in December) and she was appointed Cardiovascular Care Coordinator to assist patients and families. At Grandview Medical Center, Lisa Rostad handles the duties with the title Cardiovascular Case Manager.

Brown has had personal experience, having had triple-bypass surgery herself. But it was another surgery that led to her accepting the job when it was offered.

"My mom had open-heart surgery at another hospital and I sat for six hours and didn't know what the heck was going on up there," she said. "Your head starts pounding. What is going on with Mom? Is everything OK?

"I said that will never happen here."

Brown frequently visits the family during the surgery and gives them any information that she might get from the O.R. "Sometimes the surgeons say, 'Sherry, leave us something to say,'" she said with a laugh.

The amount of information coming from the OR to the nurse navigator varies from hospital to hospital, but all three said they are informed — and so inform the families — when the patient goes on and comes off the heart pump during the operation.

The navigators make their appearances to patients at varying times. "I will actually meet them when they come for their preadmission testing," Kitchen said. "I will actually sit down and go through their education process and go over everything — all of what they need to do in the days prior to and what they need to do the night before as far as their preparation, their medications and things they need to do."

"I go greet them in the preadmission area," Rostad said. "I introduce myself and take a history on them. Once I get all that, I go through the whole process of what the surgery is about, explaining to them in a lot of detail what they are to expect — even if it is a little scary."

Brown usually calls during patient preadmission while the testing nurses fill in the patient on what to expect. Brown then meets the patient at the hospital the day of the surgery. "I like to walk with my patients to the surgery and I like to bring the families in and explain everything before they get into that room and then I escort them to the room and explain everything to them as I am standing at the bedside," she said. "I stay involved all day."

After the surgery, the education continues. "I try to give them some insight on how long (recovery) will be and I talk to them about how to manage themselves when they get home," Rostad said.

"My goal is to visit with them every day (after surgery)," Kitchen said. "It depends on how busy we get with the teaching and the whole process."

Rostad also makes an effort to get back to the patient after the surgery.

Brown also makes rounds on the patients each day and gives the family and patient her pager number so she can be contacted with any question 24/7. Kitchen said that the staff has her pager number so she can be contacted in an emergency and Rostad gives patients/families her business card and will return calls if not at her desk.

The presence of a trained professional answering any question from the families and from the patients is often a great comfort.

Brown summed it up best. "They know that I am here not just as a nurse but as someone who is going to watch over their care. An advocate is someone who cares about you — really cares about you — and worries about you.

"That is the way it is with all of us — not just me," she said.

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