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James Cripps and CAN

I qualified as a nurse in 2009 and spent the next 6 years working in Cardiology at Leighton hospital. I started working at the University of North Midlands (UHNM) in August 2015. Since I have completed a Post graduate diploma with a special interest in cardiology and finished my master’s degree with a dissertation which focused on a service improvement to enhance the care received by heart failure patients.  I have completed my non-medical prescribing qualification and I am currently learning how to perform echocardiograms and to place PICC lines (peripherally inserted central catheters) to help improve patient care.

I currently work within a team of cardiac advanced nurse practitioners where our role can vary from day to day. This can include seeing any acute admissions coming through the emergency portals 24 hours a day, nurse led clinics, reviewing in-patient cardiology referrals, and looking after our patients within the cardiology wards. I feel privileged to be a part of cardiology at UHNM as every single member of staff works together to provide the best care possible for our patients.

I really enjoy my job at UHNM as no two days are the same.

I feel extremely supported and encouraged within my role at the UHNM, not just from the consultants in cardiology but from the senior A&E doctors who we also work very closely with.

When I am not in work, I spend most of my time being a father to my 3 children. But when I get a rare day to myself, I like to enjoy one of my many hobbies which includes trail running, climbing, skydiving and snowboarding.

The Cardiac Assessment Nursing team at Royal Stoke University Hospital provides 24-hour cardiac support to the hospital's A&E department, providing a cardiology opinion to around 500 patients a month, the majority of which are seen within 30 minutes of referral, and facilitates the management of a further 400 referrals a month from ambulance crews, wards  and other hospitals.

This team of experienced and specially trained, advanced cardiac practitioners deliver a prompt decision-making service to patients presenting to either the emergency portals or to outpatients clinics with a wide array of cardiac symptoms. In the past, patients attending A&E with suspected cardiac problems used to remain in hospital waiting to be seen by a specialist, via admission to the medical assessment unit or referred to a rapid access clinic if further investigation was required.

At Royal Stoke, patients presenting with a cardiac problem are referred to the team, who undertake a thorough clinical assessment and formulate a management plan including diagnosis, initiation of appropriate treatment and/or arrange further cardiac investigations either as an outpatient or through direct admission to the cardiology bed base. The 24 hour / 7 day a week service allows prompt access to a specialist cardiology opinion, reducing patient admissions and reducing outpatient waiting lists. It is estimated this saves the equivalent of six bed days every day for the Trust.

As well as undertaking vital rapid assessment and management decisions about acutely ill patients, the team of ten nurses can talk to patients who aren't admitted about their symptoms, offer reassurance, discuss lifestyle advice where necessary, refer patients for outpatient tests, arrange follow up and inform their GP of the plan directly via letter.

Team lead Dot Morgan-Smith said: "Our senior cardiac nurses have an average of 15 years' experience. To prepare for this role we also trained for a minimum of three years, including general health assessments, independent prescribing, and studying for a postgraduate diploma/MSc in cardiology."

As well as being on-hand to assess in Royal Stoke's busy A&E department, the team also run the rapid access chest pain service, and several arrhythmia and general cardiology clinics providing prompt outpatient assessment and investigation, to diagnose and manage a range of Cardiological presentations. The team also provide a Monday to Friday Advanced Cardiac Practitioner service to the cardiology wards, supporting the junior medical staff to facilitate inpatient diagnostics and making autonomous decisions on patient discharge to facilitate patient flow across the bed base. The on call 'twilight shift' across the 68 beds after 1600 is supported by a junior doctor and a practitioner.

The Cardiac Assessment Nursing team won the British Heart Foundation Alliance Team of the Year in 2017 and also scooped the British Medical Journal Cardiology Team of the Year in the same year.