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Cardiovascular Nurses’ Actions Speak Louder Than Words

Monday February 8, 2010
A recent study of cardiovascular nurses found that by and large, cardiovascular nurses are serving as good examples.
A recent study of cardiovascular nurses found that by and large, cardiovascular nurses are serving as good examples.
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Nurses who take care of their own health and can speak from experience can be positive role models for their patients. And a recent study of cardiovascular nurses found that by and large, cardiovascular nurses are serving as good examples.

Preventive cardiovascular nurses had lower rates of smoking, higher exercise levels, healthier eating practices and lower rates of hypertension and dyslipidemia than comparable national sample populations, according to the recent study, “Cardiovascular Risk Factors and Lifestyle Habits Among Preventive Cardiovascular Nurses,” sponsored by the Preventive Cardiovascular Nurses Association and published in the July/August 2009 issue of the Journal of Cardiovascular Nursing. But the study did note several areas of concern for cardiovascular nurses, among them high rates of obesity, high rates of life and workplace stress, and a prevalence of family history of premature coronary artery disease.

Cardiovascular nurses who responded to an e-mail survey reported better lifestyle choices than the comparison populations, says study coauthor Joan M. Fair, PhD, FAHA, a consultant and assistant professor at Stanford University’s Stanford Prevention Research Center in Palo Alto, Calif. “Some of that has to be related to what they do on a daily basis and the evidence that this prevents disease,” Fair says. Noting that some of the most successful smoking cessation counselors are former smokers who themselves have quit, she adds, “You get some credibility for having been there, done that.”

Some nurses who deal regularly with cardiovascular patients say they adhere strictly to the advice they dispense. Nicole Myrie, RN, BSN, a nursing supervisor who works for Americare of New York, regularly visits cardiac patients. She helps them seek out healthy diet options, ensures they’re taking the appropriate medications and encourages them to keep their doctor’s appointments.

Myrie does the same for herself. At 28, she has annual checkups, doesn’t smoke, tries to eat a healthy, low-calorie and low-sodium diet, and exercises three to four times a week. Her father has hypertension, so she pays particular attention to her salt intake.

Myrie says she sometimes finds it helpful to tell patients about her own risk factors for cardiac disease and how she deals with them. “I think it definitely makes a difference to let the patients know you also have risk factors,” she says. “I think it also makes the patient feel like they’re not the only one.”


Local schools will bring students in March to Overlook Hospital in Summit, N.J., to see the inflatable heart.
(Photos courtesy of Overlook Hospital)
Younger nurses have the benefit of coming of age in a society that is more aware of heart disease. Gone are the days of smoking at the nurses’ station, or even in or around the hospital. Lisa Fregonese, RN, BSN, who works in the cardiac interventional unit at Hackensack (N.J.) University Medical Center, is 27. She says she has a good family history, tries to eat healthy, does yoga for exercise and doesn’t smoke. She does admit to grabbing a couple slices of pizza for lunch every so often, but she also says she has been moved by some of the heart attack patients she sees who are in their 30s. “Eating right and exercising, sometimes you don’t want to do those things, and then you get a younger patient and you think, wait a second, I should think about myself again,” Fregonese says.

Saint Barnabas Medical Center and Saint Barnabas Ambulatory Care Center in Livingston, N.J., recently launched a free women’s cardiac risk assessment program that includes a personal consultation and assessment. Janie Baranyay, RN, APN, a cardiology nurse practitioner at Saint Barnabas, coordinates the new program. Of the roughly 60 women who have so far come in for the assessments, there have been “a fair number” of Saint Barnabas nurses, she says.

She says she hopes the program helps women personalize the message that heart disease is the No. 1 killer in America by offering them a thorough screening and analysis of their family history and by providing them with educational material specific to their own risk. “The thing that’s important to me as well as many of my nursing colleagues is for people to understand personal risk, to be empowered, to try to do their best to alter their risk through whatever strategy they might use,” she says.


Joyce Passen, RN
Joyce Passen, RN, BSN, a 58-year-old cardiovascular nurse who now manages the community health department at Overlook Hospital in Summit, N.J., always has been aware of her particular risk factors but didn’t always want to think about the possibility of her own mortality. Both of her parents succumbed to heart attacks in their early 60s.

For the past 20 years, she has been helping others in her community become aware of the dangers of heart disease. Most recently, she spearheaded a new program to teach kids about their hearts with a giant inflatable model of a human heart they can walk around and inside. Local schools will begin bringing students to Overlook to see the inflatable heart in March.

Still, for many years she did not deal with her own risks. When she was younger, she smoked for 10 years. She ate fatty foods. She put off getting a nuclear stress test when a cardiologist suggested it. “But I realized to clean up my act, that had to end,” she says. Now, in addition to eating healthy most of the time, she tries to stay more active by walking the stairs instead of taking the elevator. She substitutes applesauce for oil in her baking recipes. As her own children have gotten older, Passen said she has realized how much she wants to be there for them in the years ahead. “The more passionate I am, the more I learn, the better role model I am,” she said.


Cyndi Holt, RN, left, with her son Kevin.
In fact, nurses who have experienced cardiac disease themselves can become some of the most powerful role models for their patients. Just ask Cyndi Holt, RN, MN, CCRN, CCNS, APN, a cardiovascular clinical nurse specialist at Overlook Hospital. Holt, who at age 46, has suffered three heart attacks, the first of which occurred when she was 40 and 28 weeks pregnant.

“I had high cholesterol that was not controlled, I smoked, I didn’t exercise,” she recalls. “All the bad things, I did them all.” Still, she says she was surprised when she was hit by her first heart attack at such a young age. Given the importance of heredity as a risk factor, perhaps she shouldn’t have been. While neither of her parents had suffered heart attacks, all of her father’s nine brothers and sisters had either strokes or heart attacks, she says.

Holt said she is puzzled to this day about why she made the lifestyle choices she did. “I don’t know how to explain it,” she said. “I used to go out and have a cigarette and come back in and tell my patients not to smoke.”

Holt’s own medical emergencies served as a wake-up call. Now she exercises, eats right and controls her cholesterol levels. And her personal transformation has become a powerful message to her patients. “There was a reason I lived, and that was to help other people,” she says. “A lot of them will tell me, ‘I’m exercising. I’m changing my life because I don’t want what happened to you to happen to me.’”


Barbara Kirchheimer is a freelance writer. Send letters to the editor to editorNY@nursingspectrum.com or comment below.
How Nurses Measure Up

Among Preventive Cardiovascular Nurses Association members:

• 63.1% have systolic blood pressure less than 120 mm Hg.

• 89.4% have checked their cholesterol in the past two years.

• 31.7% have one to two alcoholic drinks per month.

• 34.1% drink red wine.

Source: “Cardiovascular Risk Factors and Lifestyle Habits Among Preventive Cardiovascular Nurses” July/August 2009, Journal of Cardiovascular Nursing