The general ward & discharge home

For some people moving to the general ward, after being in an environment of specialist nursing and high-tech equipment where people were closely monitored could at first seem quite alarming. But it meant that they were getting better and would soon be going home.

People said that during their time on the general ward, they gradually built up their strength by walking around the ward and by doing exercises. One man, who found it noisy on the general ward, persuaded the nurse to move him to a side ward.

It was while they were on this ward that plans were made for their return home. People described meeting the cardiac rehabilitation nurse on the ward; she arranged to visit them at home. They were given information leaflets and advice about exercise, diet and healthy lifestyles.

The cardiac rehabilitation nurse visited him at home soon after he was discharged from hospital.

Age at interview 53

Gender Male

Age at diagnosis 49

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During the week, the cardiac rehab nurse came round. She visited me twice actually and she gave me a manual read. You’re supposed to do it in stages but I read through the whole lot just to get an overview and that was to help me through the recovery period and that was quite useful.

What was useful about it?

It gave some, there was some reassuring information about, although it’s happened it’s not the end of the world and if you follow their instructions, it can help you get better. They also provided some light exercises to gradually build up to more or less as you were before you had the attack.

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At this time they were also informed about rehabilitation programmes and given advice about medication and their follow up appointment. Some people found it helpful to have their partners or carers with them at these meetings. One woman described how relieved she was to have been given the phone number of the ward, so that she could ask advice about her medication, the day that she got home from hospital.

She had been given the phone number of the ward and used it to ask advice about her medication.

Age at interview 80

Gender Female

Age at diagnosis 77

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But when I actually did come home that was the terrifying part. I was really frightened. You, you miss that all round support that you get, you know. And it always felt if anything went wrong, well theres always someone to turn to. But they did say to me ‘If you’re, any worries or anything,’ gave me the ward number and ‘just ring us.

And I did ring that first day when I got home because I thought I had my medicine this morning, did I have any later on? And I just, I couldn’t remember, I think I was just worrying so much you know. But, so I had a talk with the sister and so she said ‘No you’re all right, you’ve just taken,’ with the blister packs it helps a lot.

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Some people were told about the support group in their local area, where they later got advice and information about preventing another heart attack. Not everyone got as much information as they would have liked (see ‘Getting information’).

One woman said she was given a programme of exercises to do when she got home before starting the cardiac rehabilitation programme.

Before being discharged from hospital, people said they were expected to be able to walk up and down the corridor or a flight of stairs. Often a ‘modified’ exercise ECG test is done using a treadmill, which will be set at a low level of tolerance. Sometimes an exercise bike is used, if the hospital does not have access to a treadmill. A few men recalled that their treadmill test could not be done or was shortened because the heartbeat had become irregular and they were asked to return to hospital later. One man whose treadmill test caused his heartbeat to become irregular needed to stay in hospital a little longer.

Talks about the treadmill test.

Age at interview 54

Gender Male

Age at diagnosis 54

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I wasn’t given the modified exercise test, which is basically a very simple treadmill exercise. And the reason that I wasn’t was because there was some irregularity on my ECG. It wouldn’t actually show that up. I was worried then that I would be somehow in this catch 22 where because I couldn’t have the exercise, I couldn’t go home. But the cardiologists felt that there was no reason for that, and indeed, I’m now scheduled to have a full exercise test in a few weeks time.

I mean, I think the point about the modified exercise test is that it really is a fairly fundamental low energy walking exercise and I suppose it was perfectly obvious that I was able to do that. I think the full exercise test is more challenging. And it gives more of an opportunity through the ECG, as I understand it, to get a much clearer picture of what’s going on in your heart.

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Some people had the ‘full’ exercise ECG (also known as the “treadmill test’) which involved a higher level of tolerance, at their follow up appointment. Some people could keep going for only a few minutes, others for over ten minutes. One man advised others to attend for the test in running shoes and comfy clothes.

He advises others to wear running shoes for the treadmill test.

Age at interview 71

Gender Male

Age at diagnosis 70

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I had my first thing at [the hospital], you know you go back and they assess you and you run on the treadmill. I was running flat out. I said “If I’d known I was going to be running flat out like this I’d have brought my trainers.” I went in walking shoes, because I thought oh they’ll only let me walk.

And I did thirteen minutes on it and the nurse said, “Nobody does thirteen minutes.” I said “I’d stay on this for an hour at this pace,” mind you they keep speeding it up. That’s why the first three minutes, six minutes, every three minutes they speed it up. By nine minutes I think I was running quite fast.

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People had different feelings about going home. Some felt apprehensive, but were looking forward to starting their rehabilitation. Others said they felt frightened about being at home and no longer having the support of the hospital around them. See ‘Coping with emotion after a heart attack’ for more about how people felt when they got home from hospital.

Talking to doctors & nurses

Someone who has a heart attack may know little about what is happening and may need to take in a lot of information in a...