As a nurse you know what it's like to feel exhausted at the end of a shift. But that doesn't compare to literally lacking the energy to put one foot in front of the other, or having difficulty simply breathing.

People diagnosed with stage 3 or 4 congestive heart failure do know what that's like, which is why they are seen in the emergency department or admitted to a hospital on a frequently recurring basis. A chronic, progressive disease such as heart failure can destroy the patient's quality of life and shorten their lifespan considerably - unless there are vigilant support measures in place.

That's where the Heart Failure Center at Lourdes Medical Center in Camden, NJ, comes in. Thanks to the foresight and commitment of the heart failure team, a broad spectrum of help is readily accessible for patients with heart failure, both within the hospital and as outpatients. Whether they need a little kick-start in getting out of bed and building up their energy level or frequent weigh-ins to track fluid retention, that and much more, provided by the heart failure team, helps keep them mobile and their condition stable.

Well Known in Field

The 410-bed hospital has long been known for its comprehensive heart programs, and in fact performs the highest volume of cardiac procedures in the Delaware Valley, according to hospital literature. So when Reginald Blaber, MD, president of the medical staff, noticed a few years ago that heart failure patients were experiencing frequent hospital readmissions, he called on a Lourdes cardiology unit nurse with 15 years' experience to extend her outpatient expertise and develop a designated inpatient heart failure unit.

Today, less than 3 years into her role as director of the Lourdes Heart Failure Center, Ann B. Townsend, DrNP, MSN, RN, APN, has nurses working with her both in the outpatient unit and approximately 25 nurses in the recently added inpatient unit. She also can boast impressive results: at the end of the second year of operations, outpatients receiving 6 months of care at the center demonstrated a 59 percent reduction in heart failure hospital days when compared with the 6 months prior to outpatient treatment. Also, there has been a trend recently toward reduced length of stay on the inpatient side.

Making a Difference

The outpatient unit at the center typically sees three to four patients a day - people who have been diagnosed with heart failure and need assistance and education in managing the symptoms of their disease. The most common chronic symptoms are fatigue, shortness of breath during mild or everyday activities, difficulty breathing when lying down, weight gain, edema in the legs, ankles or abdomen from fluid buildup in the body, and general tiredness and weakness www.cdc.gov/dhdsp/library/fs_heart_failure.htm.

"Their symptoms tend to be debilitating and interfere with their quality of life," Townsend explained. "The fluid retention and other symptoms are physically uncomfortable and emotionally distressing, but often they delay in seeking treatment so they are admitted to the hospital for 5-7 days to stabilize. When they finally are admitted there is usually extensive treatment necessary for severe fluid overload."

The outpatient center serves as a safety net, giving patients a chance to report their problems and get help in bringing their condition under control and avoid or at least minimize hospitalization, she added. "In a way we are akin to Weight Watchers - we tend to be vigilant and keep the patients focused on doing things that can slow the disease's progression."