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\"As a teenager, Molly Case underwent an operation that saved her life. Nearly a decade later, she finds herself in the operating room again--this time as a trainee nurse. She learns to care for her patients, sharing not only their pain, but also life-affirming moments of hope. In doing so, she offers a compelling account of the processes that keep them alive, from respiratory examinations to surgical prep, and of the extraordinary moments of human connection that sustain both nurse and patient. In rich, lyrical prose, Case illustrates the intricacies of the human condition through the hand of a stranger offered in solace, a gentle word in response to fear and anger, or the witnessing of a person's last breaths. It is these moments of empathy, in the extremis of human experience, that define us as people. But when Molly's father is admitted to the cardiac unit where she works, the professional and the personal suddenly collide. Weaving together medical history, art, memoir, and science, How to Treat People beautifully explores the oscillating rhythms of life and death in a tender reminder that we can all find meaning in being, even for a moment, part of the lives of others.\"--Publisher's description.

Cardiothoracic nursing has undergone great change over the last decade. With the continuing improvement of surgical techniques, pharmacology and pre- and post-operative care, there have been many new initiatives and innovations in the nature and practice of this specialised sector of nursing. Rehabilitation and patient education are to name but a few of the areas where exciting new challenges and opportunities for cardiothoracic nurses have opened up.

A succinct yet comprehensive reference tool for cardiac surgery nurses, this new addition to the Fast Facts series provides quick access to frequently used information regarding the care of cardiac surgery patients. It encompasses the timeline from pre-op to recovery period, with a special focus on the prevention and management of commonly seen post-op complications. The book addresses surgical treatments for coronary artery disease, valve disease, descending aortic aneurysms, and congenital heart disease in adults, and covers patient presentation and diagnostic tests, immediate and extended post-operative period care, cardiac rehabilitation programs, and patient education. Intended for daily use, this reference not only contains important guidelines for all nurses caring for cardiac surgery patients, but reinforces highly specialized skills and supports the development of new skills. It will be highly valuable to new graduates and nurses who are considering a switch to cardiac care, as well as seasoned practitioners.

Cardiothoracic nursing has undergone great change over the last decade. With the continuing improvement of surgical techniques, pharmacology and pre- and post-operative care, there have been many new initiatives and innovations in the nature and practice of this specialised sector of nursing. Rehabilitation and patient education are to name but a few of the areas where exciting new challenges and opportunities for cardiothoracic nurses have opened up. This book is a definitive and accessible text for cardiothoracic nurses. Written for nurses from a nursing perspective, it offers practical advice and information on all aspects of cardiothoracic surgical nursing and pays particular attention to the continuing developments cardiothoracic nurses must face.

Abstract Objective To explore the impact of a patient-centered nursing management model on the psychological state of inpatients in the thoracic and cardiovascular surgery. Methods Seventy patients who underwent thoracic and cardiovascular surgeries in our hospital from December 2023 to June 2025 were selected. They were randomly and double-blindly divided into the observation group and the control group, with 35 cases in each group. Both groups of patients were given conventional drug treatment. The control group received routine care, while the observation group received patient-centered nursing management model on the basis of the control group. The Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Scale (HAMD) were used to compare the psychological states (anxiety and depression) of the two groups before and after the nursing intervention. The nursing satisfaction levels were also compared between the two groups. Results The comparison of HAMA and HAMD scores between the two groups before nursing showed no statistically significant difference (p>.05). The HAMA and HAMD scores of the two groups after nursing were lower than before nursing, and the HAMA and HAMD scores of the observation group after nursing were lower than those of the control group (p<.05). The satisfaction score of the observation group patients with nursing services was significantly higher than that of the control group (p<.05). Conclusion patient-centered psychological care can alleviate the adverse psychological state of hospitalized patients in thoracic and cardiovascular surgery, ultimately improving their quality of life.

IntroductionEvidence-based early rehabilitation intervention after heart valve surgery has been proven to have many benefits, but the experience of implementing nurse-led early rehabilitation combining exercise and psychology is still lacking. It is urgent to find a more acceptable and cost-effective method to provide exercise intervention and psychological support. The aim of this study is to design a nurse-led cardiac rehabilitation programme to increase the physical capacity and mental health for heart valve patient based on broaden-and-build theory.Methods and analysisA non-blinded randomised controlled trial will be conducted. A total of 86 adults diagnosed with heart valve disease will be recruited and randomly assigned to the control group and intervention group. The recovery for valvular heart disease intervention, based on the broaden-and-build theory, will be guided one-on-one by a multidisciplinary team and will consist of two main components: physical intervention and psychological intervention. The baseline assessment will be conducted 1 to 2 days after admission, and sequent evaluations will be implemented at post-intervention, 3 months after intervention and 6 months after intervention. The primary outcome is the finding of six-min walk test and mental state. Other outcomes include quality of life, 36-item short-form health survey, Short Physical Performance Battery, stress, coping modes and social support.Ethics and disseminationThis study was conducted following the Helsinki Declaration and was approved by the ethics committee of the Zhong Da Hospital, Southeast University (2024ZDSYLL098-P01). The results of this study are scheduled to be published in relevant peer-reviewed journals.Trial registration numberRegistered at the Chinese Clinical Trials.gov (ChiCTR2400090853).

Objective To investigate whether an internet based, nurse led vascular risk factor management programme promoting self management on top of usual care is more effective than usual care alone in reducing vascular risk factors in patients with clinically manifest vascular disease.Design Prospective randomised controlled trial.Setting Multicentre trial in secondary and tertiary healthcare setting.Participants 330 patients with a recent clinical manifestation of atherosclerosis in the coronary, cerebral, or peripheral arteries and with at least two treatable risk factors not at goal.Intervention Personalised website with an overview and actual status of patients’ risk factors and mail communication via the website with a nurse practitioner for 12 months; the intervention combined self management support, monitoring of disease control, and drug treatment.Main outcome measures The primary endpoint was the relative change in Framingham heart risk score after 1 year. Secondary endpoints were absolute changes in the levels of risk factors and the differences between groups in the change in proportion of patients reaching treatment goals for each risk factor.Results Participants’ mean age was 59.9 (SD 8.4) years, and most patients (n=246; 75%) were male. After 1 year, the relative change in Framingham heart risk score of the intervention group compared with the usual care group was −14% (95% confidence interval −25% to −2%). At baseline, the Framingham heart risk score was higher in the intervention group than in the usual care group (16.1 (SD 10.6) v 14.0 (10.5)), so the outcome was adjusted for the separate variables of the Framingham heart risk score and for the baseline Framingham heart risk score. This produced a relative change of −12% (−22% to −3%) in Framingham heart risk score for the intervention group compared with the usual care group adjusted for the separate variables of the score and −8% (−18% to 2%) adjusted for the baseline score. Of the individual risk factors, a difference between groups was observed in low density lipoprotein cholesterol (−0.3, −0.5 to −0.1, mmol/L) and smoking (−7.7%, −14.9% to −0.4%). Some other risk factors tended to improve (body mass index, triglycerides, systolic blood pressure, renal function) or tended to worsen (glucose concentration, albuminuria).Conclusion An internet based, nurse led treatment programme on top of usual care for vascular risk factors had a small effect on lowering vascular risk and on lowering of some vascular risk factors in patients with vascular disease.Trial registration Clinical trials NCT00785031.

Abstract Objective To assess whether a nurse led, flow monitored protocol for optimising circulatory status in patients after cardiac surgery reduces complications and shortens stay in intensive care and hospital. Design Randomised controlled trial. Setting Intensive care unit and cardiothoracic unit of a university teaching hospital. Participants 174 patients who underwent cardiac surgery between April 2000 and January 2003. Interventions Patients were allocated to conventional haemodynamic management or to an algorithm guided by oesophageal Doppler flowmetry to maintain a stroke index above 35 ml/m2. Results 26 control patients had postoperative complications (two deaths) compared with 17 (four deaths) protocol patients (P = 0.08). Duration of hospital stay in the protocol group was significantly reduced from a median of nine (interquartile range 7-12) days to seven (7-10) days (P = 0.02). The mean duration of hospital stay was reduced from 13.9 to 11.4 days, a saving in hospital bed days of 18% (95% confidence interval −12% to 47%). Usage of intensive care beds was reduced by 23% (−8% to 59%). Conclusion A nurse delivered protocol for optimising circulatory status in the early postoperative period after cardiac surgery may significantly shorten hospital stay.

AimTo explore the acceptability and feasibility of a parental early warning tool, called the Congenital Heart Assessment Tool (CHAT), for parents going home with their infant between first and second stage of surgery for complex congenital heart disease.BackgroundHome monitoring programmes were developed to aid early recognition of deterioration in fragile infants between first and second surgical stage. However, this necessitates good discharge preparation to enable parents to develop appropriate knowledge and understanding of signs of deterioration to look for and who to contact.DesignThis was a longitudinal qualitative feasibility study, within a constructivist paradigm. Parents were taught how to use the CHAT before taking their infant home and asked to participate in semistructured interviews at four time points: before discharge (T0), 2 weeks after discharge (T1), 8 weeks after discharge (T2) and after stage 2 surgery (T3). Interviews were transcribed verbatim and thematically analysed.SettingOne tertiary children’s cardiac centre in the UK.SubjectsTwelve parents of eight infants who were discharged following first stage cardiac surgery for complex congenital heart disease, between August 2013 and February 2015.ResultsFour main themes emerged: (1) parental preparation and vigilance, (2) usability, (3) mastery, and (4) reassurance and support.ConclusionsThe study highlighted the benefit of appropriately preparing parents before discharge, using the CHAT, to enable identification of normal infant behaviour and to detect signs of clinical deterioration. The study also demonstrated the importance of providing parents with information about when and who to call for management advice and support.