Meet Cardiac Nurse Educator Matthew Derbyshire! Matthew has worked in the field of cardiac nursing for the past 17 years in both the UK and Australia. Matthew currently works as a nurse educator in the Cardiac Centre at Townsville University Hospital in QLD, where he is passionate about improving the knowledge and skills of all his staff to allow them to best meet the needs of the cardiac patient.

You will learn about what makes cardiac nursing so interesting, reflective practice, leadership, advice for those considering nurse education, advice for junior nurses managing a deteriorating patient and so much more!

Follow these links for more great articles on cardiac nursing and nurse education by The Nurse Break.

Can you tell us about the ‘behind the scenes’ of your role as a cardiac nurse educator?

At the start of my shift, I endeavour to receive a handover to allow me to know what is going on in the shift. This way I can be aware of who may require assistance and what educational opportunities I can take advantage of.

Following this, I will then plan to work with staff that I identified the previous day who require assessment with a competency or education to complete a competency. One of the challenges of the Nurse Educator role would be the availability of staff. Sometimes there are staff who you really want to work with but workload and time constraints for the staff member can make this challenging.

If working with staff is not possible, other activities in my day include providing scheduled education for other departments on subjects like ECG reading. It also involves preparing training days for my staff for the Transition to Specialty Practice Program (TSP) Cardiac which I aim for all my staff to have completed as well as Mandatory Training days for my staff to ensure ongoing competence. 

At 12:30 we have a lunchtime relief member of staff start which provides me more time to provide focused education to certain members of staff. Although as this time is limited and on busy shifts, I really need to prioritise who I educate or assess during this time.

At 14:30 I will usually have staff education session scheduled, either delivered by myself or another member of staff. For these education sessions, I try to keep things topical. For instance, this month one of the Cardiology Registrars is currently delivering a number of talks for me on Takotsubo Cardiomyopathy as we recently had a patient who went into cardiogenic shock as a result of this condition. I also try to provide education sessions on skills such as temporary pacing on a regular basis as my staff feel they need to be refreshed on this skill regularly. 

At the end of the shift, I will try to look at who is working the next day and which staff will require education or assessment. I will also look at what patients will be on the unit as well as what procedures are occurring the next day. In this way, I can maximise educational opportunities for staff by allocating more complex patient’s to more junior staff during a time where I can provide them with support.

Do you have any advice or great resources for reading ECG’s?

For ECG education I would recommend ECG’s Made Incredibly Easy. I enjoyed the simple format of the book and what I learned I was able to put into practice on a daily basis in the workplace.

What is your advice to a junior nurse when they experience thier first medical emergency?

For junior nurses being involved in MET calls for the first time I would say the best thing you can do is think to yourself “what can I do to stop this situation from becoming any worse”. This can be very hard to do with the noise and the seniority of the staff around you plus the adrenaline running through your system. However, any small role you can play if you can do it competently can be very important.

Things such as scribing, which nobody seems to want to do, can be one of the most important roles in an emergency situation to show what has happened, what is happening now and allowing people to decide what to do next. I would say the worst thing to do is be one of the people who stand around with no role. In these situations, you are not helping and can actually be a hindrance so I would recommend checking on the rest of the patients in your area.

Why should more nurses consider a career as a cardiac nurse?

I have a special interest in Cardiac Nursing so I must admit to being bias towards it. However, learning about the heart and everything that relates to it such as observations, medications, and the ECG allows you to build your knowledge until everything makes sense. Also, patients with cardiac issues can have other comorbidities which allow for exposure from other specialities to keep your practice well rounded.

Could you tell us about some of the talks you have given across the state using TEAMS?

The talks I have done across the state using Microsoft TEAMS have involved a number of subjects including arterial blood gas analysis, complications of myocardial infarction, and lots of ECG talks. It is great fun interacting with other centres and allowing them to also share their experiences.

In the last study day, I was talking about a patient who ruptured his papillary muscles in Mount Isa and one of the nurses in Mount Isa remembered the patient and was able to recount her experience of his initial presentation. By using a microphone, camera and PowerPoint presentation I am able to convey most of the information on TEAMS; however, I look forward to being able to use POLL Everywhere to create more questions at the end of each session to allow even more interaction from all the sites.

What is your leadership style in nursing? How can nurses be effective leaders in the workplace?

My leadership style is very simple. I provide clear plans for where I want my staff to be from an educational and skills point of view and over what time period this should be achieved. If staff are having trouble meeting these goals, then some problem-solving skills and learning plans can be employed to help facilitate learning. However, by being as invested as possible and showing true enthusiasm for learning I am normally able to help staff develop into very competent Cardiac Nurses. Hopefully, this role modelling of enthusiasm for Cardiac Nursing also rubs off on some of the nurses too.

How can readers best raise awareness about cardiac health within the community?  

There are a number of great resources for Cardiac Health including the Heart Foundation website. It not only provides information on risk factors for coronary artery disease but also helpful advice including a number of recipes for healthier meals. In providing advice to patients one of the most important pieces of advice is that changing a patient’s lifestyle, especially ceasing smoking; this is more beneficial than any medication a patient can take. 

Reflective practice is an essential component of career growth, how do you maintain this?

In order to develop as a nurse, especially one who has made as many mistakes as me, reflective practice is an essential tool and can lead to the development of a “treasure trove” of knowledge. It is always important to look at not only your actions but the other factors at play that led to a suboptimal outcome. In this way, not only my knowledge but awareness of how to manage the environment around me can be achieved. This can also be applied to things that have gone favourably in the workplace. At present, I am developing my skills in inserting ultrasound (US) guided peripheral intravenous cannulas. At present, I am still not “hitting the jackpot” every time.

However, with every attempt, I am keeping a journal to document what has gone wrong and what has gone right in order to refine my practice. In this way, I can realise that whilst initially covering the probe with gel may be easier than filling the US probe cover with gel. When the US probe cover is put on the US probe, it tends to wipe off the gel leading to a poorer picture and less successful cannulation attempts.

What cardiac condition do you find most interesting and why?

From a Cardiac Nursing perspective, I find patients with Cardiac Rhythm (Electrophysiological) issues to be the most interesting patients to look after and teach around. These would include ventricular arrhythmias as well as heart blocks and bradyarrhythmias. I really enjoy breaking apart an ECG or rhythm with a student to analyse not only what is going on but what has possibly caused the issue and what is the best treatment for it; as well as what treatments should be avoided to keep our patients safe.

Black Friday

For someone considering a position in clinical education, what would be your top 3 pieces of advice?  

For someone considering a position in clinical education three pieces of advice would be:

  1. Please pursue a master’s degree at your earliest opportunity, preferably in clinical teaching. This will make your life a lot easier when pursuing this career course.
  2. It always helps to have gained some experience in your clinical area before you pursue a career in clinical education. Using stories about what you did in a certain situation, what occurred with a certain patient, or in my case where you messed up royally is always great to help put theory into context for your students
  3. Take as many opportunities as you can to provide education in the clinical area. Investing time in junior staff or students in their education will eventually be noticed as will volunteering to provide talks on certain subjects. Not only will this help your career, but it will also help build and consolidate your own knowledge.

What advice would you have given yourself as a junior nurse if you could go back in time?

This one probably goes against current thinking and attitudes, however, I would tell myself to not worry about where everyone else is going in their career. While it is important to improve and develop your knowledge and practice every day, it is not a race to the top and everyone needs to develop at their own pace.

Whilst being promoted early may feel great, how much better at the role would you be with few more years of experience behind you. It took me 16 years to achieve a Level 7 nursing position and I do not think I would be able to my job as well as I do without those years of experience. Nursing is a career for life so please enjoy the ride and where it can take you.  

Are there any changes you would like to see for the future of cardiac nursing?

When talking about what changes there will be to the nursing profession, I would say the number of skills that nurses have taken on during my career which were once considered “doctors jobs” has been huge. At the start of my career even performing an ECG was not considered a nursing role and now the ability of my nursing staff to read interpret an ECG would be the equal of most doctors, maybe bar an Advanced Trainee or Consultant.

I expect this to continue with nurses in specialist areas taking on more advanced skills. I also see more Nurse Practitioner Roles in Cardiology developing in Cardiology. At the moment there are roles for Heart Failure and Electrophysiology. I also see the need for more Nurse Practitioner roles in Cardiology developing.