I'm Sarah Hubball, I'm cardiac nurse specialist working for the cardiac
rehab team, so cardiac rehabilitation
is a treatment option
to help people to understand about their heart condition
in order for them to learn about what steps they need to take
to look after their health condition in the longer term.
It basically empowers them to become involved in future health
care discussions so that they can make a decision about their health care.
I joined the service back in last year,
right in the middle of the first lockdown,
and which my colleagues stated it was quite a difficult time
and a transition from face to face clinics
and classes to a virtual class.
I'm quite new. So I had my interview,
I think, at the end of March, beginning of April.
I was fortunate enough to get the job, but I didn't start until July.
So when I arrived, we were already up and running with the virtual classes.
So I kind of hopped in with.
That was a new experience because I've been in university.
We did the face to face exercise classes. So it was it was quite new.
But I had two good colleagues that were able support me.
Plus I had the nursing staff as well.
So that was good, too,.
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We will see anybody
who had an acute heart event, so they might have had a heart attack
or heart surgery., might have had angina, had stents put in for example,
and they're referred to us from our local hospitals across the borough.
So Kings, St. Thomas's, as well
as the local hospitals, such as Queen Elizabeth, Pru and Darenth Valley.
But we also see people with heart failure, which not many services
see people who have heart failure because of the number of staff
needed to do the exercise with them.
The class was up and running when I came, and Helga
was at the forefront with the nurses team.
They showed me the ropes because virtual class was quite daunting
for somebody that hasn't done anything online beforehand.
And it worked well, very well.
And it's still running to this day.
But now we run both virtual
classes., we do face to face home
visits for the high, high risk individuals.
And also we now do in class environment too.
With the virtual classes, we can only accept really low risk patients, low
risk in terms of the likelihood of them having an event during exercise.
With that, we need to ensure
that they are stable on the medication, they're adhering to the medication.
We've been through a functional test,
so we know that functionally they are quite good
and they're able to do the exercise itself.
And then when they're exercising at home, they always have somebody there.
So in case something were to happen that they're there in the morning
before we even start exercise it's
the case that we make sure that they are wearing the appropriate footwear.
They've taken the medications because it's so early in the morning as well,
and then through their way, they're able to go through.
The important thing to say is that cardiac exercise is really, really safe.
And I think a lot of people worry
about doing exercise, especially after the heart event.
The number of instances with which people
taken unwell, during an exercise class is really low.
And that's because
we do a lot of risk assessments prior to them coming along to the class.
The live classes, it's a bit more easier because we're able to interact
and you're able to see
when patients are maybe beginning to kind of fall off a little bit.
So you're able to intervene quite quickly and either reduce the intensity
at which they're exercising until their heart rate kind of recovers
and they're feeling a bit better and then being able take them back up.
So usually just before they refer to us, they would have been on some kind
of a walking program.
So they were to start to begin
to get used to some form of exercise when they come to us, how we
just like to suppress their fears
it's just to sort of say that it's a slow build up.
So you start off
nice and gentle with the warm up itself and we take things through.
And what this is, this is individualised to you as an individual.
So it's not the group.
It's not who is exercising with, it's you.
So we offer a education program,
and that is mainly done at the moment via Microsoft Teams.
It's a virtual program.
So one of our nurses, an exercise specialist, along with other members
of the multidisciplinary team, will do a short education
session with them, different sessions for about eight weeks.
So we have dieticians
talking about eating healthily with living with a heart condition.
We have our clinical psychologist talking about coping mechanisms,
also managing stress and what they can do.
We got a cardiac exercise specialists
to talk about long term maintenance for exercise as well.
With the variety of patients We have to make sure that
the information we give them is tailor made for them.
So it's not a one size fits all, especially when it comes to education.
And that's why we do such a varied education kind of service.
So it's not just based around heart disease.
It covers heart surgery, heart failure, helps younger people as well.
So after they finish with our cardiac rehabilitation, after the eight weeks,
they have an option of joining the phase four in the community,
that phase four is run by exercise specialists.
If they don't feel the gym environment's for them or the group environment's
for them, they will continue
doing their home exercise programmes, walking programme, or
if they've done a little bit of exercise at home with with myself,
Helga or Jay then they can do that for themselves going forward.
Physical activity is really important for heart patients.
It does help prevent against future heart disease and have strength and heart,
especially when people have had heart surgery or do have heart failure and helps
improve the heart muscle function.
So we want them to be as physically active as they can.
And when it's done with health care professionals like we have in our team,
our exercise specialists, our cardiac nurses, we can do it
safely and, you know, keep it safe for the patients.
I do feel optimistic about the future.
It's been a very difficult year for the cardiac rehabilitation team
because we've had to change.
But we have adapted and we have made great strides in doing virtual class
and going forward I feel it's a good team and we work together.
So, yes, I feel that
we will strive, especially now going back to face to face.
So we have a lot more to to play with going forward.