The specialised role of the heart failure nurse rose to prominence during the 1990s. Studies of h
eart failure disease management reported a reduction in the risk of hospital readmission in services with structured follow up that focused on the optimisation of therapy, out-patient follow up, education for self-care and the coordination of care.1 Nurses had already established their role in the long-term management of patients with chronic disease and quickly confirmed their role within heart failure disease management services. Such level of care became recognised in international guidelines and as a marker of a quality service.2 More recently there has been a developing interest in optimising patient outcome through a greater focus on the in-patient admission, faster diagnosis of acute or decompensated heart failure, in-patient management in an appropriate care environment and planned discharge which includes referral to a heart failure disease management programme. Recent recommendations for the early in-patient period acknowledge the clear roles for the nurse in the heart failure team and discussed in this article (Table 1).3