Nursing Training at the Aswan Heart Centre

We have caught up with Stephanie Carncross, who is a Chain of Hope volunteer Nurse Educator from Leeds General Infirmary, to discuss her work at the Aswan Heart Centre.

How did you hear about Chain of Hope and why did you get involved?

 I learnt about the wonderful work of Chain of Hope through a discussion with Dr Carin Van Doorn, lead cardiac surgeon from Leeds General Infirmary, who is also on the staff of the Aswan Heart Centre and a regular Chain of Hope surgical educator in Africa.  I am very interested in Global Medicine. I had recently been working as a volunteer in the Northern Territories in Australia, implementing a vaccination programme and health education project through the Western Australia Variety Club. I have also visited India, working in a hospital in a clinic in Gwalir, and in an orphanage as a nurse at the children’s clinic.

What motivated you to go to Aswan Heart Centre to volunteer?

I have always had an interest in Egypt, having grown up there as a child. Returning there was a wonderful opportunity to return to Egypt and to be able to work there and offer my skills.

In April 2011, three months after the Revolution in Egypt, I flew out to Aswan to volunteer. It was at the time of the opening of the new Children’s Hospital of the Aswan Heart Centre, which was very exciting. I felt very welcomed by the local team, from the nurses to the research staff, the pharmacists, and the doctors, and in particular the cardiologists. They were very friendly and receptive and willing to exchange knowledge and skills.  I have since been back six times to Aswan fitting in my volunteer work around the nursing work in the UK.

What were you asked to teach?

The new infection control officer had just been put in post and I was asked to work closely with him about teaching infection control and the importance of hand hygiene to parents, and nurses, and promoting it within the unit. 

I focused on knowledge-exchange about wound care, the need to prevent endocarditis, an infection which damages the heart beginning with bacteria in the teeth. I  worked with the parents about what to look out for at time of discharge, post op cardiac surgery and to be able to recognise the symptoms should a problem be arising, as well as promoting the need for regular follow up by the parents with the Heart Centre. 

My work also entailed running daily medication awareness classes with the parents on the children’s ward, many of whom were illiterate and needed to receive information in different ways. 

What was the most benefit that you think your visit had on the nursing practice?

I found out that some of the children who had undergone heart surgery, were on diuretics and had gone home and then had passed away due to dehydration from diarrohea, due to simple hygiene techniques. Hence we started a health education programme with the local nurses to teach the mothers about the correct sterilisation process of bottles to use boiled water and to boil the bottles and teats in a pan. These basic techniques have improved the outcomes on the post- op cardiac programme.

Research suggests that more than one pre-op wash is effective in reducing post operative wound infections.  The mothers are now being educated to wash their babies and children with two or three washes which has been overseen by the nurses. This is part of an ongoing health education programme at the Aswan Heart Centre.

Tell us about play therapy...

I worked with the local nurses on the importance of play therapy and distraction for children in hospital. This was a relatively new concept within the unit, but the nurses now recognise that happy children recover better and have a shorter hospitalisation time. The link between psychology and recovery is something that the Aswan Heart Centre is now building on for the future. 

The play room is now a fully functioning play room with age appropriate toys from birth to 16 years. There is a key board and toys dedicated to babies, toys for adolescents and a DVD player with cartoons playing. 

The play room also doubles up as an educational facility with teaching sessions for the mothers about hygiene, sterilisation, prevention of endocarditis, and I understand there are new documentary films in the making about the prevention of rheumatic heart disease. 

What do you feel could be improved at the Aswan Heart Centre?

The ability to support the nursing staff long term with their educational needs is something that I felt needed more attention for the future. It is vital for the nurses to feel that they are valued and that their contribution in caring for the patients is recognised.

For complex heart surgery to be successful, it takes many levels of care from the complexity in the cardiac theatre to the Intensive care, to the ward, and finally to the return home, each care level has its own vital role in supporting the survival of the patient and to return to as near normal life as possible.  Each discipline has the responsibility for the continuation of care for the patient.

What are your plans for the future?

I am planning to return to Aswan Heart Centre in spring 2015 to continue building on the nurse education work there. I am so thrilled to see the changes that have been made on many levels since I started volunteering there in 2011. It is one of the most inspirational projects I have worked on. 

I just love the Egyptian people, their warmth and genuine feeling is incomparable. I feel privileged to be a part of this project in a small way.

Many thanks to Stephanie Carncross, a valued Chain of Hope volunteer, for her dedication to help mend little hearts in Egypt.