The specialist nurse was on Edgecombe 1, my placement area, to assess Mr RC, one of the patients I was looking after. Mr RC is a 88 years old not for resuscitation. He was admitted fallowing unwitnessed fall with a past medical history of Atrial fibrillation, chronic kidney disease, congestive heart failure, dementia, Hypotension, Hyperparathyroidism,. He has a pacemaker, a stoma and a catheter. He has reduced mobility and need assistance of one to transfer from bed to chair and vice versa . When I saw the nurse that I recognise by the uniform, I went to her to introduce myself and ask her if I could watch her doing the assessment. She was happy to let me observe her and afterward she took time to explain to me the symptoms of heart failure and nursing interventions.

The nurse started by introducing herself and explaining why she was there and gained consent for the assessment. She started by asking questions such how he was doing and went on specific questions related to breathing, pain and anxiety. she checked the skin also. After the assessment, she explained to me why she was assessing patient ‘s breathing and skin’s condition. She explained that in heart failure, symptoms to look out for are mainly, breathlessness after activity or at rest, feeling tired most of the time and finding any activity exhausting , swollen ankles and legs, fast heart rate and dizziness. She explained that some people may also experience a persistent cough , wheezing, a bloated tummy, loss of appetite, weight gain or weight loss, confusion and a pounding , fluttering heart beat. Depression and anxiety is also among the symptoms. She continued by explaining the type of medication are used to treat pain, agitation, sickness. In a short period of time, she gave me an insight into heart failure and nursing interventions . she has to leave quickly though as she was called elsewhere

Understanding the symptoms of my patient was very beneficial to me and how I relate to the patient. It has helped me to understand how he was feeling. I understood why he wanted to stay in bed day and night and needed lots of encouragement to get out the bed for meals. I used to think he was being lazy. Somehow I fell ashamed about myself for being judgemental without taking the time to really know the patient.

After that brief learning session, I went on to read more about what heart failure is , its symptoms and nursing interventions. Heart failure is a long term condition that usually get worse over time. it is characterized by the inability for the heart to pump enough blood to meet tissues and organ’s metabolic needs. It can be the result of high blood pressure , valve disorder.. ..Its symptoms vary depending on heart failure presentation and treatment include reducing cardiac output or Systematic vascular resistance with medication such as Angiotensin -Converting enzyme (ACE) and Angiotensin -2 receptor blockers that relax the blood vessels making it easier for the heart to pump the blood, Beta blockers.. Going through heart failure and gaining a bit of understanding of blood pressure medication has helped me to make sense of the care plan and nursing interventions. I understood why my patient was on Furosimide, a loop dieuric medication used to treat fluid built up. The fluid loss can result in urea and electrolyte ( U&E) imbalance , hence those chemicals are daily checked. The weight is also checked daily to ensure the medication is having the desired effect . The patient is also on fluid restriction which require to update the fluid balance, ensuring all his intake and output are documented. Salt intake need to be reduced as excessive salt led to water retention and high blood pressure which are risk factors for heart failure or complications of existing heart failure such as in case of Mr RC. The Patient was also on other blood pressure medication.

Mr RC is fitted with a pacemaker which is a pulse generator that send electrical impulses to the heart in order to keep the heart beating regularly as he has Atrial fibrillation, a condition that cause an irregular and often fast heart beat.

What I take from meeting with the specialist nurse is that it is important to understand the medical conditions that our patient have so that we can monitor better their symptoms and the effect of their medications. I feel that now I understand better heart failure and how this condition can interfere with his normal function and activities of daily living.