CCU nurse Bep Sonneveld has been working within cardiology for 35 years. She experienced the emergence of thrombolysis and the first catheterisation and angioplasty treatments. She has recently began assisting patients remotely through the Luscii app. Bep was initially sceptical, but that soon gave way to enthusiasm.
Why so much love for cardiology?
‘Thirty-five years ago, I began my training as an in-service nurse. I had to do an internship at every department in the hospital and simply lost my heart to cardiology. This was partly due to the technical aspect, but especially to the focus on guidance. I see anxious people regularly. Giving them reassurance and advice is a great thing to be able to do. It continues to amaze me that such a small organ as the heart has so much impact’.
What exactly do you do now in the hospital?
‘I have a combi-role. Within coronary care, I nurse people who have been catheterized a few hours earlier. Others suffer from acute heart failure or have trouble with arrhythmia. I delve into their backgrounds and monitor them throughout the day. Setting medication, observing, reassuring, doing the rounds with the doctor. The turnover is high. When I transfer a patient to a regular ward, the next one is already waiting for me. At the outpatient clinic, I see the same category of patients, but then in a different phase. The relationship there is also very different. I monitor some of them for years and then you really do build a bond’.
A combi-role; does that give added value?
‘Absolutely! Sometimes, I nurse people at the CCU who know me from the outpatient clinic. They are always so happy to see a familiar face. That can happen the other way around, too. And even if I receive people at the outpatient clinic that I haven’t seen before, I know what they went through at the CCU. That all contributes to the continuity of care’.
You recently started assisting people with chronic heart failure remotely. How does that feel?
‘Very good actually. We receive the weight, blood pressure and heart rate through the app from patients at home. And we can see people through a video connection. That gives so much added value. We can now detect deterioration much earlier. For example, you see weight increase before serious complaints arise. We have already prevented an acute admission three times. Eventually, they did become admissions, but not those delivered with wailing sirens. If patients are still well enough to provide notifications themselves, it really makes a world of difference’.
But you weren’t immediately enthusiastic about remote supervision?
‘I thought, now we are only going to offer “computer treatment”. But that is not the case at all. With video calling, you not only get to speak to your patients, but also see them sitting in their own homes. Therefore, you can observe everything: how they talk, how they sit, the colour of their skin. Basically, everything you would normally make note of when someone is sitting opposite you. It just feels very natural’.
And are patients happy with it, too?
‘For patients, it is an accessible system. They all pick it up quickly. As they measure their own blood pressure and weight, they also learn what their normal values are. Insight into their illness increases as a result. I have noticed that remote monitoring is particularly reassuring for those who are still getting used to their heart failure. The fear diminishes. They feel they are under close supervision’.
Do you see room for expansion?
‘The length of stay in hospitals is getting shorter and shorter. Sometimes, I think it’s best to keep people in a day longer, just to be sure. I would prefer to keep an eye over people with heart failure who, for example, have not been away from the furosemide pump for very long. At the moment, we call them after three days. It would give me more peace of mind if we could monitor them instantly at home, as soon as they are discharged’.