Lions Gate Hospital cardiac nurse heads up unique home care program

North Shore cardiac patients – whether they’ve been discharged from Vancouver General, St. Paul’s or Lions Gate – are in a fortunate position living on the mountainous side of Burrard Inlet. They have access to the only home visiting cardiac nurse clinician in the region, if not the province.

Meet Jennifer Krzyczkowski. Or who some might call the energizer bunny. She’s been the face of the LGH-based Cardiac Home Follow-Up Program since 2008, checking in on patients from Deep Cove to West Vancouver Sunday through Thursday. It’s not uncommon for her to see six or seven patients a day, though she tries to keep it to a maximum of four. Over the last year, Jennifer saw a total of 315 patients and made 594 home visits.

“I try to organize it so I’m in one area and not driving all over the place – traffic can be a nightmare on the North Shore,” says Jennifer with a laugh. “And once I start following a patient, they are a patient forever. They are never discharged. They can call me anytime.”

More than 30 years of success

The unique program started as a randomized control trial in 1982 by general internist Dr. Ozwald Litherland. Initially, the nurse only saw patients after discharge from a myocardial infarction (MI), but admission criteria has broadened under Jennifer’s watch to include patients who have had angioplasty, cardiac surgery or have been diagnosed with heart failure.

With a mandate to reduce readmissions, Jennifer acts as a complement to physician care, ensuring complicated patients are comfortable in their home and following their doctor’s advice. But that’s not always easy. It’s not uncommon for patients to leave hospital confused about what happened and with many questions.

“Often these questions have been answered by nurses or physicians in hospital but they simply forget under the stress,” says LGH cardiologist Dr. John Imrie. “Jennifer is able to go over what happened to them, what treatment they received and discuss their prognosis.

“Many patients remember more of what she told them than they’ve heard from physicians or even a family doctor. Without question, she’s able to reduce re-hospitalization and pick up problems earlier than even their family physician or specialist,” he adds. “We often get called by her directly while she is in the field and are able to help her manage patients.”

Jennifer’s work reduces readmissions

As for her caseload, Dr. Imrie is nothing short of impressed.

“I really have no idea how she’s able to take on this extra workload and manage it so efficiently. Under normal circumstances, I’m certain that at least two nurses would be required to provide this volume and quality of care. There’s no question that the quality of cardiac care on the North Shore has been greatly improved by Jennifer and her predecessors.”

LGH deserves recognition for supporting program

So what drives Jennifer?

“I’m very passionate about cardiac care – it’s my niche. I enjoy the teaching and interacting with the patients,” says Jennifer, who started her health care career as a bedside nurse at LGH in 1996.

“You’re often with a person at a key moment in a health care crisis and you can guide them through it,” she adds. “It’s what we do as nurses and this program only works because of the entire team, which includes key support from the physicians, medical internists and the nurses on 2 East. Lions Gate Hospital also deserves recognition for supporting this program.”

Jennifer’s passion goes beyond her daily visits to collecting good data with the hopes of expanding the program. This October, she will present the results of her Masters in Nursing research study (Home Visits by a Cardiac Nurse Clinician and patients diagnosed with Heart Failure) at the Canadian Cardiac Congress in Toronto. To her knowledge, she is the first LGH nurse to present at the CCC.

“I was very honoured to be accepted to present my thesis,” she said. “It’s a big deal, but ultimately I  hope it will help expand the program to include more patients and home visits.”