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BACKGROUND: Monitoring the postoperative course of cardiac surgery patients remains essential but requires creative strategies now that length of hospitalization has been shortened to 5 days or less. OBJECTIVES: To determine patients' concerns in the early recovery period after open-heart surgery and to describe the impact of advanced practice nurses on this phase of recovery. METHOD: A cardiovascular clinical nurse specialist conducted follow-up by telephone for 342 cardiac surgery patients 7 to 14 days after discharge. Patients were asked both open-ended and direct questions. RESULTS: The major problems were leg edema (48%), appetite disturbance (35%), dyspnea (29%), sleep disturbance (12%), and wound drainage (9%). The nurse's interventions over the telephone included reassuring the patient about postoperative progress (86% of sample), giving diet information (31%), instructing about activity (29%), providing emotional support (25%), referring for medical treatment (16%), and explaining medications (13%). In response to these findings, the nursing practice council revised postoperative teaching to emphasize wound healing, sleep, and appetite issues. CONCLUSIONS: Telephone monitoring of cardiac surgery patients after early discharge can alleviate the often stressful transition to postoperative recovery at home. A cardiovascular clinical nurse specialist can provide patients and patients' family members with reassurance and ongoing reinforcement of the discharge information.

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As more patients have a diagnosis of end-stage heart failure, nurses are more likely to encounter the use of left ventricular assist devices (LVADs). Currently, LVADs are used as a bridge to cardiac transplantation. However, current research suggests that LVADs may be used as destination therapy for those unable to undergo cardiac transplantation. The technology has been developed to sustain life, but what is the impact of technology on the quality of life? This article reviews current research on the quality of life with an LVAD.