Shercock Nurse driving innovative cardiac care in Donegal

By Sean McMahon

Twenty five years after qualifying from Kings College Hospital in London Shercock nurse Cathy Farrell is taking on a challenge that aims to save lives by increasing awareness about cardiac health.

Since completing her studies in the prestigious London training hospital Cathy has worked in coronary care, having attained her primary degree in critical care nursing, with a focus on cardiology.

Cathy, the daughter of Brendan and Jody Farrell from Cootehill Road in Shercock, spent nine years in London before returning to work in Donegal in 2002. Her recently appointment sees her taking up the position of registered advanced nurse practitioner (RANP) in heart failure for the county.

Registered advanced nurse practitioners are the highest level of clinical experts in the nursing profession in Ireland. They provide diagnosis, treatment and discharge for specified groups of patients.

This new initiative is rolled out under the HSE's enhanced community care programme by Letterkenny University Hospital and Community Healthcare Organisation (CHO1). CHO1 covers Donegal, Cavan and Monaghan.

Cathy will work in the hospital and across Donegal in her new role. The service will facilitate GP's to refer patients that may have heart failure: “The patient will have a heart scan performed by a cardiac physiologist in the community clinic and I will do a history and physical examination and report back to the GP if there is a diagnosis of heart failure or not,” Cathy explained.

“If a patient has heart failure then we start appropriate medication and enrolled them in the specialist nurse led clinic for education and support,” she tells.

They clinics are current based in the community hospital setting in Dungloe, Carndonagh and Donegal Town, all of which are over 40km from Letterkenny. Prior to this service, patients would have travelled an average of 100 kilometres round trip to clinics. Now that trip is reduced to about 30 kilometres per visit, explained Nurse Farrell.

Cathy says the aim is to increase awareness of the symptoms of heart failure, such as shortness of breath, swollen ankles and tiredness: “Patients should inform their GP if they have any suspicions. They will be assessed early. Their GP can undertake a blood test which help in the diagnosis and refer for further assessment if needed. This will help people receive an earlier diagnosis and start treatment which in turn can result in improved symptoms and quality of life.”

Nurse Farrell says awareness is a key component of treatment: “The words heart failure can be very scary. People think there is no hope for them and they will die soon, but heart failure is now considered a chronic disease like asthma or diabetes. While we do not say we can fix it, you can live with it. The symptoms often comes on slowly and sometimes people put their symptoms down to getting older or being unfit. There is a blood test that can give a fairly good indication, whether it is likely due to heart failure or not,” said Cathy.

Cathy says the new role will present many challenges: “We also follow up people in our community clinics. People recently discharged from hospital with heart failure. This has reduced their need to come back to hospital clinics and they report great satisfaction with this. When we need to discuss patient care with the cardiologist or their GPs we can do this over the phone, reducing their need to attend them in person,” Nurse Farrell concluded.