Provision of cardiac rehabilitation for all those that

Transcription

1 Celebrating 25 years: the Milton Keynes community cardiac group Kate Olson, Visiting Lecturer of Adult Nursing at City University and Editorial Board Member of the British Journal of Cardiac Nursing, interviews members and a volunteer from Milton Keynes community cardiac group where she works part time, to find out their views of the service in celebration of their recent 25th anniversary Provision of cardiac rehabilitation for all those that would benefit continues to be an area for improvement. There is much published about those groups that commonly do not attend such as those with more complex cardiac conditions. In 2014, Milton Keynes community cardiac group (MKCCG) celebrated its 25th anniversary. MKCCG is a charitable organisation that provides a phase 4 programme to the local community, as well as long-term maintenance programmes for those with any cardiovascular condition, including dedicated sessions for those with heart failure or chronic obstructive pulmonary disease (COPD). Evidence-based, suitable exercise is provided to all. Recently, the group also started Singing for Breathing sessions for members with either COPD or heart failure. The group was set up by Gill Robinson in 1989 with a donation of 50 and an exercise bike it now has over 400 members. Members range in age from 29 to 91, with a good mix of male and females. Many members have been attending for a long while, some even more than 20 years. Although all sessions have an exercise instructor and two health professionals to manage them, volunteers (known as blue shirts ) are a key part of the success of the programme. A description of the service has been published in a previous edition of the British Journal of Cardiac Nursing (Olson, 2012). For this issue, I (KO) recently spoke to some of the members and one of the volunteers to find out their views of the service. Lisa Hilton Lisa was diagnosed with an atrial septal defect and pulmonary hypertension in Prior to her diagnosis, she had no knowledge of having a heart condition and had been fit and well. She has been a member of MKCCG since September 2007 after being told about the group by a friend who was a nurse. Lisa completed the phase 4 programme and now attends one of the maintenance sessions each week. KO: Why did you come to the group? LH: I felt that I had to do something, obviously no gym would touch me and I was always quite active. It was the best thing I ever did. My consultant swears by it and every time I see him and my London consultant, they are impressed that I exercise. It s got me through. KO: When you come to rehab, what exercises do you prefer to do? LH: I like the gym work. I have a bike at home as well that I try and do 2 3 times a week, just 20 minutes at a time. Obviously I can t run. There s a lot I can t do. I can t swim anymore so I just try and do a bit on the bike and I walk as much as I can on the flat [surface] and do this once a week as well. 290 British Journal of Cardiac Nursing June 2015 Vol 10 No 6 BJCA_2015_10_6_290_Interviews.indd /05/ :23

2 KO: What do you feel is the main benefit of this group for you? LH: When I have times when I haven t been for a few weeks, I really do feel it sort of mentally as well. I really do feel it s a social thing. I love coming and just meeting up with the same people every week. They look after me because I m younger than them. They care, it s very caring, and you always know there is somebody to talk to so I ve been very, very lucky. istockphoto/kupicoo KO: If there was somebody who was unsure about attending cardiac rehab, what would you say would be the main benefits generally? LH: The fact you can exercise. I have quite a few friends around the country with the same condition as me and none of them have got anything like this at all. They can t go to the gym, some of them do the odd bit of swimming but generally they can t do anything at all. So it s just the fact of being able to exercise with people knowing that if you don t feel right on the day or at any time, that there are professional people there. Evidence-based exercise can benefit those with cardiovascular conditions Angela Empitage Angela came to the group after suffering a cardiac arrest in In total, she spent almost 3 months in hospital. She has a history of sleep apnoea and asthma. She attended a 6-week induction programme for those with COPD or heart failure and now attends the weekly class for those with long-term conditions. KO: What led up to you going to group? AE: Straight after the cardiac arrest, I couldn t sit up, stand or walk I felt I couldn t do anything. The physiotherapists were brilliant and once I started being able to walk, I got on. When I came out of hospital, I had to sleep downstairs because although I d done the stairs at the hospital, when I tried doing our stairs, the tread is about twice as deep, but I was determined I was going to get back upstairs so I could have my own bed properly upstairs. The physiotherapist came here and said she thought there ought to be some follow-up exercises and I went to group after that. KO: In yourself, health-wise, do you feel like you did before you had all these problems? AE: I feel much better than I ve done for several years. What s good about group is that you don t stress yourself out; they keep an eye on you. There s more motivation to go there than if you are a member of a gym. KO: What sort of things do you do at group? AE: Most of the time, I either go on the treadmill or one of the cycles. KO: Do you see yourself attending the group for a lot longer? AE: As long as they ll have me. It s nice to be able to talk to people who have been in perhaps not exactly the same position but very similar, hear their experiences and all that. We re all very well looked after. KO: If you came across somebody with a heart condition and they weren t doing rehab, what would you say would be the general benefits of going? AE: That you do feel much better. At the end of the session, I usually feel energised and I ll go and do the shopping before I come home that might not have happened in the past. British Journal of Cardiac Nursing June 2015 Vol 10 No BJCA_2015_10_6_290_Interviews.indd /05/ :23

3 Inset: Sue Neville discharge from ITU Sue Neville today Sue Neville Sue became a member of the cardiac rehabilitation group in September 2013 after a mitral valve replacement and tricuspid valve repair for endocarditis. Before her diagnosis, she had been fit and well but had a 6-week history of a flu-like illness and shortness of breath. Eventually, she was taken to A&E and was in ITU with a diagnosis of sepsis, respiratory failure, liver and kidney failure, pneumonia and anaemia. KO: Had you had valve problems before that you had been aware of? SN: Never. I wasn t feeling well, thought I d picked up something from work, I d never felt as ill as that. I d always been so active and never had a heart problem. KO: That must have been a shock as most people either know they ve had something so they know they re at risk of endocarditis or if they re going to have surgery, they know in advance, so they ve had time to prepare for it. SN: I think that s why I can t get my head round it because I was the last person I thought would have a heart problem. I ve always been so active, eating healthy. I m not one to sit down. I just find it really hard to cope with, even now. KO: Although it s nice to be discharged, were you nervous about coming home? SN: I was really scared. I remember the first time I came home I thought I d just go upstairs and get my slippers, I got up two stairs and I started crying. I hated bed time when I came home. The dreams, the hallucinations. I d wake up all of a sudden. I still needed help out of bed in the morning; if I needed to go to the toilet at night, my husband would help me up out of bed and back in bed. KO: So how did you get to go to the group? SN: I had a lady come to visit me in hospital. I went to a presentation evening Gill was doing for new people with my husband. I was really nervous and I thought why did I say I would do this? Gill was lovely and made me feel very welcome, talked to me and put my mind at rest so I started my first 6 weeks. I was allocated a keyworker who kept a close eye on me, helped me with the exercises; I really had difficulty getting down on the floor so I used to exercise in a chair. They gave me lots of encouragement, helping build up my confidence which was virtually nil. I was achieving a fitness level that I never dreamed of. It was really tough, but with encouragement, I was building up my confidence and thought if I actually put my mind to it, I could achieve it. After I d done my 6-week course, I signed up for 6 months. We start with a warm-up, then cardio. We work on muscles, strength, and endurance. We have a little tea break, then we have an active cool-down and relaxation class to finish off. Fitness level and confidence and overall wellbeing has improved tremendously. KO: What was the thing that made you think, right, I ve got to keep going with that? SN: All my family noticed a difference. It made me feel better about myself. Six weeks is not long and sometimes it was a struggle for me to go in. When I started the 6 months, I just got a buzz out of every time. Some weeks I didn t want to go, but when I got there and started exercising, I d come out and after group, my husband or my kids would come round and say how did you get on? I d be down on the floor showing them how I d done a press-up on my knees. Can you believe that? Doing press-ups? I ve never been able to do press-ups. Day-to-day chores are getting easier. Without group, I d still be shuffling along and struggling with everyday activities just trying to get up in the mornings, let alone trying to get dressed. It was a black hole but it s a lot easier with the help and dedication from the group. Now I look forward to my group and push myself each time. I m more confident and have more stamina. I still have a way to go but life looks better than I ever thought possible. KO: If you were talking to somebody who was thinking about going to group but wasn t sure, what would you say to them? SN: When people offer you the chance of going to group, having been through open heart surgery, it is scary you ve got low self-esteem and you don t feel confident about doing anything. You don t think you will have the strength or stamina. Just picking up a cup uses all your energy, how on earth are you going to do rehab? It just gets easier; you don t have to do the exercises, just being there mixing with other people, just moving your legs. It s a big boost and I would encourage anybody to go. It has benefited me tremendously. I owe getting my life back to the group, Gill, the staff and volunteers who believed in me. 292 British Journal of Cardiac Nursing June 2015 Vol 10 No 6 BJCA_2015_10_6_290_Interviews.indd /05/ :23

4 Joe James Joe was one of the first members of the cardiac group and has been attending since having a myocardial infarction in Joe has seen the group move from a number of different places as the number of attendees kept increasing. KO: How did you come to be at group? JJ: When I was in hospital, Gill came to see me and told me she was starting a cardiac rehabilitation group and asked if I wanted to go along. After I finished the 6-week exercise programme at the hospital, I went along. It was just a small group at first. As the group got larger, we moved to different places. KO: What sort of things did you do at group? JJ: We started basic exercises, floor exercises and standing up exercises. We all found this a bit daunting because we thought, would we have another heart attack? But Gill had so much confidence and that confidence shone on us and we were able to take from her something that was going forward that was a good thing. Some of us then did a 26-mile marathon across the North York Moors Gill had given us the confidence and ability to do this. We did two more. A lot of new members came along who had never done anything like this before and it was a bit trying for some of them. But with Gill s help they got through it. The social side was wonderful. Because that s what rehab is all about sometimes: socialising, getting back into the fold, meeting people and coming back to what you used to do. We also did a lot of fundraising from the start, forming a social committee that was our main objective fundraising. It s truly wonderful what Gill has done for me and everyone else. She s given me back my family and new friends. I ve been to wonderful places and had wonderful walking weekends away. The social part of it is just all part of rehabilitation. KO: If you were talking to somebody who just had a heart attack and they re not sure what to do next, what would you say about the benefits of doing something like the group? Why is it such an important thing to do? JJ: I always find when I meet new members that have just started the group, they can be very afraid, keeping themselves to themselves. They don t know what to expect. They think they can t really do the exercises, it will be too much for their heart. Those I talk to, I reassure them that they are being watched, the professionals are looking out for them, and [tell them to] take things easier, only do what you think you can do, don t go over the top. If you feel you are going over the top tell somebody. I also encourage them to get into the social side. KO: How do you feel your health has been over the years? Do you feel rehab has helped improve it? JJ: I do things I didn t think I was able to do. I still think I m 21 like everyone else. I ve been okay for 25 years so that s saying something for Gill s regime. Lyn Dick Lyn has been working at MKCCG as a volunteer for the last 10 years. Volunteers are known as blue shirts and as well as supporting the exercise instructor with the exercise component, they are also trained to check pulses and blood pressure, perform basic life support and use an AED. They are vital to running the group and provide support for the members that attend. Lyn became a volunteer after her husband died suddenly of a heart attack. She had been a nurse previously, and met a friend who volunteered and suggested that it may be something she would enjoy. KO: Do you always volunteer on the same day at the cardiac group? LD: I started on a Wednesday (long-term maintenance group) but I had enjoyed the phase 4 so much with different patients coming through that I ve stayed with phase 4 ever since. I really enjoy seeing them come in from being very vulnerable and very frightened to seeing them join the parent group and to see them start to blossom and relax and just be themselves, getting over their incident, no matter what it was. British Journal of Cardiac Nursing June 2015 Vol 10 No BJCA_2015_10_6_290_Interviews.indd /05/ :23

5 KO: Tell me a little bit about what you do at cardiac group. LD: I usually get the job of doing the Thera trainer. This is for those people that are slightly incapacitated, in as much that they could have had a stroke or they could have problems with their legs or even upper arm problems. The Thera is quite unique because it s been built by people that have disabilities so, therefore, their understanding of this machine is well founded. I was given several extra training sessions to do this and I ve been doing that job ever since. KO: What do you enjoy about going to group? LD: I like seeing the people start to blossom, start to recover and get their confidence back, get their lives back on track really, from being very scared and worried that they can t do things, and I think the cardiac group gives them the reassurance that they are now a person again who happens to have or had a cardiac problem. I feel quite good when I leave on a Wednesday. You see people and you think, gosh what am I grumbling about, and it kind of puts it all in order really. Acknowledgement The author would like to thank all those that agreed to be interviewed for this article. References Olson K (2012) The Milton Keynes Community Cardiac Group. British Journal of Cardiac Nursing 7(1) 44 5 Come and visit us at our website. Meet the team, subscribe and find out about writing for us British Journal of Cardiac Nursing June 2015 Vol 10 No 6 BJCA_2015_10_6_290_Interviews.indd /05/ :23