Have you considered becoming a clinical nurse speicialist? Find out more about what the job entails
Name - Jane Brocksom
Current post - Urology & Continence Clinical Nurse Specialist
Why did you became a urology and continence clinical nurse specialist?
I started my RGN training in 1988 at Leeds General Infirmary; this was pre-trust status so a “divided” city, the infirmary was Western Leeds and St James Hospital the Eastern side.
I failed my finals a number of times and had to sit the EN exam to ensure I could continue as a nurse - 1992 was to be a defining year.
At my lowest ebb, and in need of a career path, I gained employment as an auxiliary in the operating theatres (a placement I’d enjoyed as a student) and ended up staying for nine years working my way up from A to C grade, then from D to F.
The enrolled nurse qualification proudly sits on my NMC profile. It was two long years until I qualified as an RGN in 1994 but those two years made me who I am today.
Operating theatres are a unique and intense place to work - teamwork, unity and multidisciplinary team openness are the defining qualities and I fitted the role like a hand in a glove. Unfortunately, health issues intervened and I required a less physically demanding role. In 2001 I left the operating theatres, with two ENB qualifications and a sense of pride in where I had come from since 1992.
I had also started a degree at Leeds University which I finished in 2002 (BHSc Healthcare Studies). It was a long road but here I was 10 years on and full of confidence.
From 1997 I had been working in the urology theatres and was givne the opportunity to develop a urology nurse specialist role. It was a role for me to develop catheter clinics - indwelling and self catheterisation, prostate assessment, TURP post-surgery follow up clinics.
I was to remain committed to my male patients for nine years developing the service and enjoying learning and being recognised as a specialist within my field. My current role, since 2011, is a side wards development taking on female patients with continence problems. These days I am dealing with acute continence problems - I run my own conservative management clinics, seeing patients of both sexes. My speciality areas include intravesical botox, sacral nerve stimulation, artificial urinary sphincters, artificial slings, female sexual function, plus difficult catheter changes - indwelling and suprapubic and, more importantly, intermittent self-catheterisation.
What qualifications do you need?
I think we are often perceived as having an easy/cushy number!
My working week is five days and outpatients-based, I am often invisible to ward nurses, although well known by name! I have had to work hard, often in my own time, to develop the knowledge and skills that come with this role. In the early day so much was learnt from consultant urologists - however I am a nurse and the best nurse specialists use this knowledge in a nursing way. Specialist nursing is a career turn like no other, it is a unique, undervalued and ill defined role; the individual requires tenacity and foresight.
“There is no job plan”
There is no job plan. I am in a team of urology nurse specialists but all our roles are individual. We have been in place a long time and were all G grades when we came into post, this experience is essential.
Unfortunately Agenda for Change gives the impression 5 to 6 to 7 is linear.
What do you like about your role?
I am in many ways the developer of the role. I need personal motivation, knowledge and an extrovert personality to run my outpatient clinics with minimal administration support.
To code my clinics is difficult, measuring my service and costing is equally difficult. As a specialist nurse the title says it all, I have been required to develop a specialist knowledge base. I am required to think like a registrar and act as a nurse. Self motivation is essential to develop the role. Consultant backing comes with time and you have to earn this, it’s not given. It’s taken me a long time to get to where I am today - I believe it’s not a job but a long-term career commitment.
13 years down the road as a nurse specialist and I am presenting locally and nationally, sitting on advisory boards and professional development groups, with roles as an NT book reviewer, NT Awards judge, British Journal of nursing author, British Association of Urological Nursing website lead and tweeter @BAUNnurses, plus my own account @HoorayJane.
What are the challenges to this role?
The biggest challenge for me is to remain motivated on so many levels - local and national nursing picture, specific speciality skills and knowledge, technical awareness, teaching and sharing knowledge/information.
I often work alone but need to be able to problem solve, never ever be too proud to ask for help!
I have inner self doubt but I’d never let you know! I have a big mouth, loud voice and it can get me into trouble but it’s not meant as offensive, I’m just passionate about what I do and who I am – urology; clinical; nurse; specialist.
Whilst being in demand is an honour it’s equally a pressure. Being a nurse specialist demands you are a resource to many, learning to voice my worth and value is now my aim for the forthcoming years.
I have also joined the British Association of Urological Nursing (BAUN) council as communications officer to further my broad knowledge base and skills but also to share my knowledge and promote urological nursing in times when urology beds are joining general surgical wards, this brings an added challenge not only self motivation but to inspire and motivate others.
What advice would you offer nurses who want to follow in your footsteps?
It’s not an easy role; you require self motivation, specialty interest but never work entirely in isolation. It taken years to be received, accepted and appreciated. The demands placed on you can be huge from wards, outpatients, consultants, colleagues, peers and the wider hospital. I am the only trust continence nurse but the only role I can fulfil is as the “urology” continence nurse, accepting this has been a huge challenge.
Appreciating that hospital recognition and salary are not the ultimate aim, patient appreciation is paramount. Educational achievement is as equally as important as personality, inner strength, a willingness to work long hard hours on your own and humility to share your knowledge for the wider benefit.
“Nurses have front row seats to watch the dance of humanity” - Taylor BJ, (1994) Being Human: Ordinariness in Nursing. Churchill Livingstone
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