Yale School of Nursing, Yale University's Graduate Nursing Programs

Jessica Coviello

"Now, we have a better partnership with patients …. We are facilitators."

Jessica CovielloHeart disease is the leading cause of death in the United States, according to the American Heart Association. More than 82 million American adults, one-third of the population, are estimated to have one or more types of cardiovascular disease. On average, 2,200 Americans die of cardiovascular disease each and every day.

These sobering statistics are something YSN Assistant Professor Jessica Coviello MSN '82 deals with on a daily basis with her patients. Practicing with the Connecticut Heart Group, Coviello provides preventative care, in addition to rehabilitation and chronic care management after a heart failure. She helps patients with cardiovascular disease to live active, productive lives while they are both recovering from and working to prevent heart attacks.

Coviello's enthusiasm for her dual career as nurse practitioner and professor is immediately evident, as she calls it "the best of both worlds."

"It allows me to educate others and care for patients at the same time," Coviello said, referring to work in clinical assignments where students become actively involved in patient care. "This is a wonderful asset for students at YSN in allowing faculty the ability to show students how to apply theories and knowledge from the classroom to real-life situations."

One of the more memorable teaching experiences for Coviello came during a clinical assignment with YSN's Graduate Entry Pre-specialty in Nursing (GEPN) program. "We were caring for a patient who spoke Italian primarily," she recalled. "He suddenly developed restlessness, which was a red flag.

"Restlessness always means something, and we watched him progressively over the day. After some time, we were able to point out small changes in the patient's health. Eventually, we were able to figure out what was wrong and ultimately circumvented heart failure for the patient. There is no better lesson than to have students see what is going wrong firsthand before it happens."

Coviello believes a clinical setting teaches "subtle things that are sometimes difficult to explain in a classroom. The ability to notice slight changes in a patient's behavior is a skill that cannot always be obtained by reading a textbook."

While taking action to avert heart failure is very important, primary prevention is the best way to ensure that a patient will remain healthy and avoid potential complications. Coviello often meets with healthy, younger patients to test cholesterol and triglyceride levels and to set future goals.

"In the old days, we used to sit down and give the patient a program detailing exactly what they had to do," she stated. "Now, we have a better partnership with patients where we ask them what they enjoy doing and where they want to go in the future from a health standpoint, then help them get there. We are facilitators." In this way, Coviello encourages her patients to continue focusing on activities they enjoy while improving their overall health outlook.

Coviello also oversees her patients' rehabilitation process after a heart attack, known as secondary prevention, which closely resembles primary prevention. "When a person experiences something catastrophic like a heart attack, that changes their life. But our approach as facilitators stays the same," she added.

"We try to help them look at this as a positive thing. The patient gets involved and we get their family involved," Coviello explained. While it seems contradictory to look at surviving a heart attack as a positive event in one's life, the flip side is that the patient may have never realized that a lifestyle change was needed. "We want to help the person realize that this is their second chance to do things differently; to change, reevaluate, and improve their life."

"Now, we have a better partnership with patients where we ask them what they enjoy doing and where they want to go in the future from a health standpoint, then help them get there. We are facilitators."

Full text:

http://nursing.yale.edu/YNM/11_2/7Coviello_spring11.html