Expanding the scope of nursing with echocardiography

Six months after her BHF Alliance award for pioneering work on a mobile heart clinic, heart failure specialist nurse Viki Jenkins discusses her bid to gain a first-of-a-kind echocardiography accreditation and training nurses in Africa.


18 January 2018, by Siobhan Chan

Viki Jenkins

Viki Jenkins, a Masters level advanced nurse practitioner, runs mobile heart clinics in North Wales

Trailblazing heart failure specialist nurse Viki Jenkins won our Rising Star accolade in the BHF Alliance Awards in June 2017 for her dedication to patient-centred care.

The award acknowledged her ambition to become the first Masters Level Advanced Nurse Practitioner in the UK to be accredited by the British Society of Echocardiography (BSE).

Viki treats patients in North Wales: attending medical appointments can mean a three-hour drive on rural roads for patients. With the echocardiography (echo) training, she will be able to lead patients through the entire process from investigation to diagnosis and treatment – so they may only need to visit the clinic once.

“I hope to have completed the course and be BSE accredited in 18 months’ time,” she says. “It involves a lot of algebra and physics, so I’m out of my comfort zone.

“It’s incredibly hard work, but an excellent opportunity.”

Innovative heart clinic

Roles like mine could be the norm in decades to come

Viki Jenkins, a heart failure specialist nurse training in echocardiography

The award also recognised Viki’s pioneering work within the innovative mobile heart scanning clinic in rural Gwynedd, north-west Wales, for patients with undiagnosed heart conditions such as valve disease and heart failure.

Before the clinics were set up, patients would have to attend several appointments: first seeing their GP; then being referred to a consultant; undergoing scans and tests; receiving their results and then being treated.

Run by Betsi Cadwaladr University Health Board, the mobile clinics – operating in community hospitals, local GP practices and even patients’ houses – use portable echocardiography machines to offer assessment, diagnosis and treatment closer to home1.

Building connections

The extended role will allow Viki to be the main point of contact for managing the patients and build relationships over time, leading to better understanding of their conditions and developing more effective treatment plans.

“Consistency is really important to patients – when they see multiple people, they are told the same thing in a slightly different way each time,” she explains. “When they’re seen and followed through by the same person, you can manage how you’re explaining everything and assess their understanding.

“Sometimes you see them have a lightbulb moment and they say, ‘nobody explained that to me before!’”

Training in southern Africa

Last year, Viki visited Lesotho, southern Africa, as part of the Betsi-Quthing health partnership scheme, set up by North West Wales NHS Trust and Quthing Ministry of Health.

The scheme has sent out medics, researchers, lecturers, and nurses from north Wales to train nurses in Lesotho – and learn from them.

“The nurses there do an incredible job,” says Viki. “They’re very isolated and don’t have a lot to work with – sometimes there isn’t even running water.”

Viki and her colleague Dr Pauline Cutting, an emergency department consultant, taught clinical examination skills and trained the nurses in respiratory medicine and cardiology and HIV dermatology, while learning more about tuberculosis and working in isolated areas.

Screen showing echocardiogram of heart

Viki is expanding her role by training in echocardiography

The future of nursing

“The recognition through the BHF award is vital to help me promote what the community heart failure team are doing in rural north-west Wales, and also how the scope of nursing is being challenged,” Viki says. “On a personal level, it is also lovely to receive this positive recognition.”

Meanwhile, other clinical teams in Wales are now reaching out to Viki and her colleagues, GP Dr Graham Thomas and senior echophysiologists Liana Shirley and Rachel Bee, about how to implement a similar community clinic model for diagnostic echo and heart failure management in their area.

Viki’s work is developing at a time of increasing attention on community-based cardiology: last year, the Welsh Government’s Heart Disease Implementation Group pledged £1m towards providing diagnostics and assessment closer to people’s homes.

“Nursing has always been an innovative profession, and it’s always changing,” Viki says. “By working towards the echo accreditation, I’m extending the scope of nursing practice – roles like mine could be the norm in decades to come.”


 

The 2018 BHF Alliance Awards are now open for nominations. Find out more about the awards and enter today.

References

1 Pioneering mobile heart clinic to help cut waiting times for North Wales patients, Betsi Cadwaladr University Health Board http://www.wales.nhs.uk/sitesplus/861/news/40593