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Coupling sexual health with family planning

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Working across the fields of genitourinary medicine and family planning brings advantages for both nurses and clients.

Working across the fields of genitourinary medicine and family planning brings advantages for both nurses and clients.

Male nurses are still in the minority across most areas of nursing. So it is rare to find one who works in not one but two fields commonly associated with women and which remain largely female dominated.

'Sexual health is perceived as a woman's domain, because traditionally sex advice was given to women by women. But things are changing,' says Steve Kinrade, who divides his time between two jobs as a family planning nurse at St Helen's PCT and genitourinary (GU) nurse at University Hospital NHS Trust, Liverpool.

Having worked as a GU nurse since qualifying in 1997, while juggling childcare and various other projects, Steve decided to train in family planning to further his career. In June 2005 he embarked on his current dual role, which saw him splitting his knowledge and skills between two areas.

'When I first started I was struck by the incredulity of staff and colleagues of being male and working in family planning,'

he recalls. 'On one occasion a female colleague commented she was the only nurse on duty, completely misjudging my role. We laughed, but it made me think about the embedded prejudices we all have. The same thing wouldn't happen in a hospital setting.'

Despite being confronted with various stereotypes and challenges, Steve remains optimistic about the changing role of the male nurse in family planning. 'Strangely, these views aren't reflected in patients, who I find are far more open and accepting.'

Steve believes being male has helped boost the number of male clients attending his clinics. 'There were mostly girls before, but now we're seeing an increasing number of lads who come in for advice and contraception, and we're seeing more couples too, specifically asking for me.

'They feel they can relate to me and, because I can give them a different perspective, they feel more at ease and feel less inhibited,' he enthuses.

Steve felt inspired to combine his GU work, where he is mainly concerned with sexually transmitted infections (STIs), with family planning sessions. He feels the two areas are intrinsically linked and he can offer patients a comprehensive service of health promotion and advice.

'The two areas do overlap and so they should - each service complements the other. I find my patients benefit from my knowledge in both. For instance I've had consultations with patients in family planning who've had unprotected sex and I've been able not only to offer advice on contraception but also to test them for chlamydia, which is usually done in GUM clinics,' he says.

Whereas both disciplines share common interests, they differ in setting and clientele. Steve and his team of 25 nurses and ten doctors see up to 200 clients a day in his GUM clinic from all backgrounds and of all ages.

In comparison, he sees on average 30 clients a day in his family planning clinic. His team is also much smaller, comprising just two nurses.

'You get people from all walks of life in GU. It's fast paced and demanding and it's all based in a small examination room. In family planning we get time to talk about the patient's choices - we often touch upon issues of self-esteem, lifestyle and responsibility - so it's very in-depth and challenging getting my message across to them.'

Good interpersonal skills are essential, with Steve adapting his pitch to each individual's needs. 'It's important to have good communication skills to break down barriers. I'll take in whatever language they use and speak to them on their level. There's no point saying things they don't understand,' he explains.

In utilising his communication skills, Steve has opened doors to projects outside his clinic.

'I've gone into schools and given talks and presentations about contracting STIs. I find that young people these days are well informed about certain STIs through the media but others are completely missed. We need to do more projects like this to get the message across, otherwise it's too little too late,' he warns.

Chlamydia and teenage pregnancies are highly publicised in the media at present, with the government implementing the national chlamydia screening programme in 2003 to help tackle the latter. However, STIs are still proliferating at a staggering rate, with more than 750,000 new diagnoses recorded in the UK in 2004 - a rise of 2% from 2003. As a result, there are more than 1.5 million attendances at GUM clinics in the UK each year.

Measures such as new triage criteria have been implemented to help clinics cope with the influx. However, meeting the demand is an ongoing challenge for all concerned.

'It's an exciting time for us at the moment, with new opportunities appearing all the time,' says Steve. He is upbeat about the future of sexual health nursing, and believes nurses play a significant role in the community. 'The way things are moving, I see family planning and GU nursing being fully integrated in the next 10 years. And with new advances in male contraception, male nurses are going to be at the forefront pioneering this movement.'

'I look forward to my job every day. It is challenging, but I see the difference I make instantly - because I help empower clients to take charge of their lives. It's so rewarding and hugely satisfying.'

How do I become... a sexual health nurse?

THIS COULD BE FOR YOU IF: you are interested in sexual health, enhancing and developing your communication skills, and want to work in a fast, dynamic and lively environment

YOU NEED TO BE GOOD AT: communicating and reaching people quickly at their level, time management and adhering to codes of confidentiality

YOU NEED TO HAVE: a registered nurse qualification and an interest in sexual health. Six months' post-registration experience is desirable but not essential because in-house training is given.

YOU DON'T NEED TO HAVE: previous experience working in sexual health

OTHER SIMILAR JOBS YOU COULD CONSIDER: outreach work in sexual health or substance misuse, in the voluntary sector or NHS

MORE INFORMATION: Genito-Urinary Nurses Association: www.guna.org.uk

The British HIV Association: www.bhiva.org

Society of Sexual Health Advisers: www.ssha.info

Family Planning Association: www.fpa.org.uk

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