A week in the life of a urology advanced nurse practitioner

14 October 2021
Volume 30 · Issue 18

How immensely proud am I to say I am President of the British Association of Urological Nurses (BAUN). For any nurse in any specialty reaching this pinnacle is an unimaginable ambition. Although the role comes with immense support and guidance, as well as an impressive badge of office, it is something that requires incredible dedication and enthusiasm for personal self-development and self-awareness, so currently I am by no means the finished article.

I have to reflect on how I arrived at this point from being an unimaginative teenager who had no idea what she wanted to do for a career. I feel somewhat ashamed to admit that nursing was not a vocational ambition of mine as a child. It was an unfortunate illness that led me to undergo major surgery at the age of 17, and a period spent in hospital watching the nurses go about their day and the wonderful care that was given to me, that made me realise that I wanted to replicate this experience for others. Some 18 months later I started my nurse training and, to date, I have achieved 32 years in the NHS!

After qualifying as an RGN in 1992, I became a trauma orthopaedic nurse, completed a diploma and BSc degree in health and reached the position of junior sister after 7 years. I enjoyed ward nursing, but felt I could do more to improve care. The realisation that expanding my role was, unfortunately, not going to be achievable in this specialty gave me the impetus to rethink my career path. I moved to a general surgical ward where I experienced urology for the first time and was amazed at the variety of conditions and the scope for nurses to extend their practice. With some determination and a bit of luck, I secured a place on a master's programme for advanced practice in 2000 and continued my passion for this exciting specialty. After 21 years, I am still as enthused as the day I nursed my first patient undergoing transurethral resection of a bladder tumour, and I consider myself very fortunate to now lead a team of wonderful, if sometimes somewhat mischievous, clinical nurse specialists who share my commitment, enthusiasm and vision for improving the patient experience.

‘The holistic assessment of the patient is something I enjoy … Being able to manage a whole episode of care makes me feel that I can make a significant impact’

Organisation is key

The importance of being organised is something I am learning very fast in my first year as BAUN President. I have developed a nervous tick if my diary is not close to hand and my joy of a list has been reborn. Having a well-thought-out job plan and support from my organisation has made it possible to take on this role alongside my clinical and managerial responsibilities.

Being BAUN President has been an eye-opening experience over the past 12 months, and I'm enjoying the challenges it brings. I am learning so much and it is clear that I still have much to learn. I am very lucky to work alongside a wonderful team of trustees who all give their utmost commitment to BAUN and I have been very fortunate to have some amazing role models to help me focus on the critical business of our association.

A typical day?

It takes some creative thinking to describe a typical day or week because, like many specialist nurses, my day-to-day role has changed dramatically over the past 18 months. Virtual working has become part of the normal working day, with a reduction in face-to-face contacts. Although this has undoubtedly increased efficiency, I often miss the physical contact with patients. I never imagined that I would be able to work remotely, but this is something that I now do regularly and I recognise the benefits associated with this way of working. I have become a Zoom/Teams queen and usually have a least two virtual meetings each day, either BAUN or work related. I have a clinical workload, manage my team and, in recent months, have also been working to bring urology specialist nurses from four hospital trusts together as part of a planned integrated care system to explore how we can share practice, develop services and identify gaps in service provision to ensure equitable care delivery. As well as the role of BAUN President, this workload requires organisation and a well-structured diary and often stretches outside of a typical 9am-5pm day.

My clinical role

My role currently focuses on the management of prostate cancer, including the diagnostic pathway and follow-up. This includes telephone triage clinics for patients with suspected prostate cancer and arranging ongoing investigations. And also autonomous face-to-face consultations where a clinical diagnosis of prostate cancer can be made following assessment and a diagnosis is given to the patient. The holistic assessment of the patient is something that I enjoy immensely, and being able to manage a whole episode of care makes me feel that I can make a significant impact at this very distressing time. Follow-up prostate cancer clinics allow me to build trusting relationships with patients and address their inevitable needs as a result of cancer treatments.

Enjoying the challenge: Clare Waymont sailing and combining her role as a urology clinical nurse specialist with being President of BAUN

My week

My days usually start at 6am. I must confess that I am not at my best until I have consumed a few mugs of caffeine.

Monday usually consists of working from home, conducting a telephone triage clinic for suspected prostate cancer patients in the morning and a follow-up clinic in the afternoon. I browse my emails over lunch and then act on them when the clinical work is completed. The benefits of uninterrupted time while at home has to be balanced with the challenge of when to shut the laptop and switch off physically and mentally.

Tuesday is spent in the office once again, running telephone clinics, answering patient queries and catching up with my team, which I consider to be of the utmost importance. Due to the rota of remote working and the ongoing need to socially distance, it can be difficult to maintain effective communication and availability to discuss any issues that may arise that warrant inclusive discussion from all team members.

Wednesday is usually a management and administration day and is often when I slot in virtual meetings about strategic planning of the service and catch up with flagged emails requiring action, both clinical and non-clinical. I have accepted for some years that I cannot ever be fully up-to-date and there are always matters needing forward planning.

With the support of my organisation, I devote Thursdays to BAUN and again work from home. The past 18 months has shaped a very different way of working from previous presidents as my physical presence at meetings are now replaced with virtual representation, which allows me to be more productive and efficient with my time, but inevitably adds to my ‘to do’ list. The trustees have continued to meet via a virtual platform since the beginning of the pandemic, with monthly meetings to discuss and action BAUN business.

Friday sees my only planned face-to-face clinic, which I really enjoy. This allows me to address the holistic needs of the patients and assess and arrange ongoing investigations or commence treatment for suspected/diagnosed prostate cancer. Being able to autonomously manage the needs of the patients gives me a great sense of satisfaction and always reminds me of why I chose urology as a specialty. Our multidisciplinary team meeting is on a Friday afternoon and then I look forward to some well-earned downtime.

Time to recharge

I like to keep fit and dinghy sailing is a favourite hobby of mine. I started this late in my 40s and have found that it enables me to completely unwind and switch off. This recharges me and prepares me to start the week again with enthusiasm.

I look forward to the next year as BAUN President and my continued development. I would urge any of my urology colleagues around the country to be part of our organisation and challenge yourself and see the benefits that this will bring to you and your team.