They have undertaken specialist training in the management of a variety of cardiac conditions and arrhythmias, and use their diagnostic, assessment, examination and complex reasoning skills to ensure patients receive quality care.

Patient education and support is an important part of the role

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What does the role involve?

Arrhythmia specialist nurses have a varied and diverse role, depending on the needs of the local population.

At Oxford University Hospitals NHS Foundation Trust, we run nurse-led outpatient clinics for new and follow-up patients with a range of arrhythmias, including AF, supraventricular tachycardia, atrial flutter and Wolff-Parkinson-White syndrome.

We also provide patient education and support and carry out consultations virtually or over the telephone where appropriate.

We run a pre-assessment service for patients undergoing device therapy, such as pacemaker insertion, and catheter ablation – where radio-frequency energy is used to correct abnormal activity via a thin wire guided through a vein into the heart. We also provide technical support during these procedures, which are usually carried out by cardiac physiologists.

Some arrhythmia specialist nurses also lead on pathways for conditions such as syncope and AF, and for patients who need a cardioversion, a procedure where a shock is delivered to the heart through a defibrillator to restore a normal rhythm.

Who do arrhythmia nurse specialists work with?

We work with a wide multidisciplinary team (MDT), including consultant cardiologists and electrophysiologists, cardiac physiologists, pharmacists, radiographers, other nursing teams, administrators and managers.

The patients we care for are those who are suspected of or have been diagnosed with an arrhythmia.

What band is the role?

This varies across the UK, depending on the job title and responsibilities. Arrhythmia specialist nurses and advanced nurse practitioners are usually band 6-7 and lead nurses are band 8a. As an arrhythmia nurse consultant, my role is a band 8b.

What skills and qualifications do you need?

Arrhythmia specialist nurses will usually have undertaken a specialist clinical cardiac course, and hold a teaching qualification and a first degree.

I have a degree in health sciences and undertook the year-long ENB 254 cardiac nursing course in 1989 at St George’s Hospital, London. This has now been phased out, but other courses include the cardiac care professional development course at City University London, the arrhythmia module at Teesside University and the British Heart Rhythm Society’s (BHRS) accreditation in nursing, devices or electrophysiology.

Many specialist nurses will be working towards or possess a master’s in advanced practice and have a non-medical prescribing qualification.

I have more than 30 years’ experience as a cardiac nurse. After qualifying in 1986, I worked on an acute medical ward for two years before specialising in cardiac nursing, working as a cardiology nurse and in cardiac intensive care before taking up a post as an electrophysiology research nurse. Having become an arrhythmia advanced nurse practitioner in the 1990s, I took my post as arrhythmia nurse consultant in June 2021.

Arrhythmia nurse specialists have to be able to work autonomously, as well as part of a wider MDT, with excellent communication and leadership skills essential to the role.

You also need advanced clinical skills – I have a master’s in advanced clinical healthcare practice and prescribing and am in the final year of my doctorate in nursing at Oxford Brookes University.

A day in the life of an arrhythmia nurse consultant

8am I start my day by attending the department safety huddle on Teams to look at staffing across the department, any risks that need identifying, what went well the day before, what did not go so well, and any lessons to be learned.

8.15am Meet with the rest of the arrhythmia nurse team to discuss the day’s workload and prioritise any clinical, educational or managerial issues.

8.30am I go to the outpatient clinic and start seeing patients, either face to face or via video or telephone. Typically, I will see a new patient referral, take a history, perform a physical examination, interpret several clinical investigations, and discuss a management plan using shared decision-making with the patient. I then dictate a clinic letter to the GP, including any prescribing decisions, which is also copied to the patient.

1pm Lunch break – outside if it is warm enough – with the rest of the team. This is an opportunity for us to take a bit of time out and refresh before we head back to work.

1.30pm I often meet with a number of different healthcare professionals, academics or industry representatives on a wide variety of subjects related to arrhythmia care. This includes supporting heart rhythm charities the Arrhythmia Alliance and the Atrial Fibrillation Association in trying to improve access to care and support and education for patients, families and clinicians.

3pm I teach on a number of arrhythmia-related subjects, either to ward nurses, other specialist nurses, or junior doctors and cardiac physiologists. I visit the ward to meet the nurses and support the learning of arrhythmia patients in their care.

4pm Check for any queries from patients, GPs or other hospital staff. This involves checking electrocardiograms, looking at the electronic patient record, phoning the relevant person and discussing a plan.

5pm I check on the status of my doctorate study. This involves adding to the database, checking patient follow-up visits, liaising with the administration team on study progress, looking at the data, writing the thesis and reading academic texts.

6pm I reflect on how the day has gone and if I would do anything differently, then make a list of tasks for the next day before heading home.

What can I do if I am interested in a role like this?

Gain experience in arrhythmia nursing to improve your knowledge and skills in this area. As the role requires good collaboration with other services and health professionals, it is also important to develop your non-clinical skills, such as communication, leadership, team working and time management.

Atrial flutter can be detected on an ECG monitor

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The BHRS council nursing representatives can put you in touch with UK arrhythmia nurses for advice, and the Arrhythmia Alliance UK has a wealth of information for patients and clinicians.

You could also seek out your local arrhythmia nurse specialist team to gain a better understanding of what the role involves and to see if you can shadow a nurse for the day.

If you are interested in this type of role, you could also contact me directly for a chat via email at angie.griffiths@ouh.nhs.uk.