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Steering rheumatology care

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Maureen Cox’s passion for her role as a rheumatoid arthritis nurse is as evident today as when she started out 25 years ago, and it’s an enthusiasm she’s eager to pass on

You’d be forgiven for thinking that after two and a half decades the same rheumatoid arthritis ward could prove boring. Forgiven but ultimately mistaken if Maureen Cox’s story of successful developments, mentoring and continuing education is anything to go by.

“I think the specialty chose me,” she says. “People tend to come to it by chance, I myself was given the opportunity to work on a rheumatology ward for two years. I did a few different things here and there, but always came back to rheumatology. I absolutely loved it from the start.”

Twenty-five years on and a typical day for Ms Cox is varied, from running clinics, educating patients and delivering care in the community to her involvement in strategic planning and patient support groups. She also has an active role in projects for national bodies Arthritis and Musculoskeletal Alliance, the National Institute for Health and Clinical Excellence and the Rheumatoid Arthritis Project.

Most recently she has been instrumental in setting up Commissioning for Quality in Rheumatoid Arthritis (CQRA), a group of stakeholders who provide relevant commissioning metrics to improve the quality of RA services in the UK. They

hope to ensure all RA nurses are learning quality commissioning metrics in order to improve care and, in turn, patient outcomes.

“Quality of service is the most important thing,” she says. “We’re keen to communicate how the project developed, introduce the commissioning elements we’ve added, present results and give an introduction on how people can use the audit data within their own teams and a wider context.”

Ms Cox’s favourite things about her diverse role are, similarly, diverse. “Being able to interact with patients and work with them on a day-to-day basis is incredibly rewarding. There are some I’ve known for many years. I also find the clinical content satisfying and I wouldn’t be able to do any of it without the support of my tight-knit team.”

This support, and that of her friends and family, has proved invaluable in achieving her goals. “When I was looking to move up I completed my MSC in 2002, which I couldn’t have done without lots of support. It’s been a long hard journey, and it’s not finished yet. I’m still studying.”

With a career spanning three decades, Ms Cox has witnessed many changes. “The development of CNS roles has been huge,” she says. “We started out as outpatient nurses and now we’re there supporting doctors as autonomous practitioners in our own right. We’ve also had a lot of success in moving rheumatoid arthritis patients to outpatient treatment.”

Looking ahead she says, “It’s difficult to say what changes the future holds for RA treatment although new developments are on the horizon.” One thing Ms Cox has experienced as a constant throughout her career and doesn’t see changing is the role of RA nurses as a vital point of contact. “Patients will always be there and RA nurses will always be there to pick up the phone and listen to them. We’ll be the constant as the specialty changes around us.”

Ms Cox is pragmatic about the limitations RA nursing faces. “We face the same challenges all nurses face,” she says. “Threats to CNS roles, they’re an easy target for cuts. Experienced nurses are always asked to work on wards and, as with all professions, we’re faced with increasingly heavy workloads. The challenge will be recruiting nurses in the future and getting them enthusiastic about the specialty.”

Her advice to anyone considering RA as a career? “Go for it. It’s fantastically diverse and fast-moving with a huge amount of scope, meaning you can really make a difference. You’ll need to go out and look for opportunities for yourself, but you can take it as far as you want.”

Caroline Stacey





















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