The changing role of coronary care nurses

The purpose in this article is to give an overview of the role of a coronary care nurse. No attempt is made to give a detailed account of any particular aspect of care but rather to inspire coronary care nurses to think about their practice and what can be achieved. In the 1960s Coronary Care Units (CCUs) were shown to reduce mortality from fatal arrhythmias and nursing care was based around observation and emergency treatment. The focus of coronary care is now moving towards infarct size reduction and the prevention of infarction in patients with unstable angina. Nurses are adapting their role accordingly--the skill, knowledge and judgement required to recognise reversible ischaemic episodes in the early pre- or post-infarctional period is paramount. It is equally and vitally important that nurses are able to recognise and assess the psychological and rehabilitation needs of patients. These aspects of care can be met ideally by using a system based on primary nursing and focusing on the patients' individual needs. Nursing practice should be research-based, and under constant review with positive change encouraged.