A day in the Life of Clinical Nurse Specialist, Ciara Cahill

My name is Ciara Cahill. I am a Clinical Nurse Specialist in the Heart Failure Clinic at University Hospital Limerick (UHL). I’ve worked in various roles in the Cardiology Department at UHL since 2008. I have three small boys so life outside of work is very busy, with most of my evenings spent on the sidelines of Under-8 training and matches!

The Heart Failure Clinic is an outpatient-based service and we manage more than 450 active patients. The heart failure service is led by the Clinical Nurse Specialist, supported by cardiology registrars and consultants as required. We provide telephone support to patients and GPs. For GPS, our support enables them to provide a high level of care for the patient in the community.

What I enjoy most about my work

The part of my job I enjoy most is seeing the difference I make to the lives of patients and their families every day. I have patients attending the clinic for many years and I get to know them and their families so well. We aim to prevent hospital admission and in most cases, this is achieved by educating the patient to recognise early signs and symptoms of deterioration.

As heart failure is a chronic disease, many of our patients will unfortunately reach end of life while still attending our services. I liaise with cardiac physiology colleagues, palliative home care team and GPs to provide symptom management for patients when end of life is approaching. When death is inevitable, it gives some satisfaction to know that these patients have reached the end of their lives peacefully and comfortably in their own homes surrounded by those who loved them dearly.

My favourite part of the day

My favourite part of my day is without doubt meeting the patients, especially elderly people who love to share stories about the many adventures of their home, work and love lives! They always have words of wisdom to impart. I had one patient attend, with his wife, for his first visit to the clinic recently on the eve of their 67th wedding anniversary. That made for an interesting consultation listening to their stories of meeting, getting married and the various stages of family life together.

A key focus for our team

We are currently looking towards expanding our service to see patients in hospital prior to discharge. This is a crucial time for providing education on the diagnosis and management of their condition which will be further built upon when they come back to the outpatient clinic. In the meantime, we provide education and support to nurses working in the wards across UHL to enable them provide evidenced-based care to patients in their care.

The newly established community integrated care teams provide a huge opportunity for the heart failure service. We will be working closely together to provide care at the most appropriate and convenient location for patients.

Our cohort of patients varies hugely. We accommodate some with early morning appointments so they can attend before going to work. Our more elderly patients find it difficult getting up and out in the mornings and in those cases, we arrange late morning or afternoon appointment times.

Opportunity for nurses

Cardiology as a speciality is a very acute, progressive, research-based area of medicine that’s constantly changing and evolving. If given the opportunity, we would encourage nurses to embrace Cardiology and help shape the care provided to the patients who require our expertise.

A Day in the Life of Cardiac Physiologist - William Neylon

My name is William Neylon and I’m from Corofin, Co. Clare. I work as a Cardiac Physiologist in the Cardiac Diagnostics Department at University Hospital Limerick (UHL). This is an outpatient department where we perform diagnostics tests on the heart. I have been working in this department since 2017. I completed a Bachelor of Science in Clinical Measurement in Technological University Dublin in 2015. When I’m not at work, I enjoy farming and GAA.

My job is very varied. We organise a rota at the end of the week so we perform different tests every day. It’s this variety that makes the job interesting. I might be working in Echo, where we perform Echocardiograms. This is an ultrasound of the heart where we look at the structure of the heart, assessing the valves, chambers, and muscle function. A wide range of inpatients and outpatients have this test each day.

In the Pacemaker clinic, we interrogate pacemakers and defibrillators. We also perform exercise stress tests on people, or fit Holter and blood pressure monitors on people and analyse the results.

In the Cath Lab, I work as part of a team performing angiograms, a diagnostic procedure that uses X-Ray images to detect blockages in the blood vessels. This team includes consultant cardiologists, cardiology registrars, nurses and radiographers. This team also works as the 24-hour STEMI team where we carry out emergency procedures on people who are having a suspected heart attack.

I’m proud to work in a setting where we have really successful outcomes for patients.

I really enjoy meeting all the patients every day. Most of the time we are with patients for up to 20 minutes and so you get the chance to meet many people every day. It’s very rewarding to meet patients who have recovered several months after having first come into the unit as a STEMI emergency.

I enjoy the variety of the different tests we perform. I enjoy working as part of the team in cardiac diagnostics and cath lab. It’s very important that people can work well as part of a team, especially for the STEMI service, so that patients will receive the best possible outcome. However, it’s just as important to work individually, performing each test to the best of our ability. I really enjoy working with other medical and healthcare professionals including nurses, medical doctors, and allied health professionals such as radiographers.

I’ve been working in UHL since 2017. For me, one of the best parts of the job is when new staff come into the department, bringing with them a fresh perspective as well as an eagerness and enthusiasm for learning. It’s very rewarding to work with these new staff as they develop their skills. We have taken students from the Clinical Measurement Science course in Technological University Dublin and recently from the new course in Clinical Measurement Physiology in Atlantic Technological University in Sligo.

What I would like to see happen in the department

I would like to see the department grow more, and provide our service to more patients and expand the range of tests that we carry out. As the department grows, staff members will have more opportunities for professional development, which will further enhance our service; an important development.

What I would like to see happen or change.

Over the last number of years there has been a small team working in the Cardiac Diagnostic department with a very good bond and team ethic. As the department and team expands, I would like to see this team ethic remain and grow stronger. A happy working environment improves quality and the patient experience

My most memorable moment

I sat the International Board of Heart Rhythm Examiners (IBHRE) exam in 2019. This is a professional certificate to examine a person’s competency with pacemaker and defibrillators. I was lucky enough to be able to sit this exam. I put a lot of work into studying for the exam and I was really pleased when I passed. I could not have done it without the knowledge of and support from my colleagues.