Expert insights at nurse-led clinic in the UK
My fascination with all that is related to the nursing profession goes back beyond 2004, the year of my registration as a first-level Nurse. Soon after qualifying, I was given the opportunity to join the Operating Theatres Scrub Team at St. Luke’s Hospital, a few years before our migration to the new Mater Dei Hospital.
I initially trained in General Surgery followed by Urological and Neuro Surgery. Excluding Theatre Nurse Specialists, all the rest, are obliged to be proficient in three specializations, not just for flexibility’s sake, but also in case of a national disaster. My main specialisation, however, is urological surgery and I am working my way to become the second Urology Theatre Nurse Specialist here in Malta. Our urology unit is a specialised dynamic environment, where innovative techniques are the norm with the patient as the ultimate beneficiary.
EAUN Fellowship
My interest for the EAUN fellowship was fuelled by my pursuit of knowledge on how other prestigious urological facilities are being conducted and managed by competent nurses. Such first-hand experience will surely boost my understanding, helping me in my main goal to reach a competence level to that of a urological nurse specialist. I can say now that the knowledge I gained from this fellowship also exceeded my expectations and I am convinced that there is always room for improvement.
My primary objective was to witness first-hand the way experienced urology nurses perform and deliver. Unfortunately, such nurse-led clinics are still in their infancy in Malta and this fellowship helped me realised the potentials if we have the same experience and standard in Malta in the future. This is now more relevant than ever, especially with the upcoming Maltese Nurse Specialist Register that will be activated soon.
Host institution
Homerton University Hospital provides general hospital services and full range urology services. It is well known that this hospital supports the development of nursing. The hospital works closely with four other hospitals and includes top nurse-led clinics like Prostate Biopsy, PSA surveillance, haematuria and Intravesical therapy, among others. The support that the aforementioned clinics get from their healthcare institution is second to none. The team I worked with was made up of a Nurse Consultant Urology and Uro-oncology, a Clinical Nurse Specialist Uro-oncology, a Clinical Nurse Specialist Urology and a Urology Staff Nurse.
The unit has a welcoming environment with a highly competent and friendly staff and made me feel part of a competent team. On my arrival, I was greeted by the urology staff nurse with whom I had corresponded. He showed me around the clinics and their respective setup. Though small, the clinics were well equipped with the necessary facilities. All medical equipment was well placed and ergonomically efficient. The competent staff was very knowledgeable in using the equipment and made difficult tasks look easy.
My fluency in English helped me follow the procedures done by the multi-disciplinary teams and their interaction with their respective patients. My mentors were highly qualified and experienced, and were motivated and very professional. Patients in Homerton are treated in a holistic approach, including the relatives in their care. The staff helped patients to turn from passive spectators into active role players in their healthcare plan and delivery. Reassurance, courage and assistance were always on the nurses’ agenda, with care plans presented to patients in a friendly and understandable way.
The unit nurses were helpful and went out of their way in explaining and sharing their knowledge on how to run such clinics in an efficient and costeffective way. Treatment was always given in a friendly manner and with a smile despite the hectic workload. Although I had set out for myself a somewhat loaded and optimistic schedule plan, I was able to observe and participate in many of the clinics in my list, which helped me gain an overview of nurse-led clinical services.
The nursing staff communication skills were commendable and definitely contributed to the effective and speedy manner in which they perform their tasks. As a team they helped each other when problems arise. They back up each other well and efficiently such as when a team member is unavailable, enabling them to attend to all patients and avoid delays in delivering proper care.
The schedule was as follows:
Monday 21st
TWOC and Prostate Biopsy Clinic
Tuesday 22nd
MDT meeting and Prostate cancer follow up
Wednesday 23rd
Prostate Assessment and Haematuria Clinics
Thursday 24th
Intravesical Therapy
Friday 25th
Urology telephone clinics
I believe that I have not only reached my objectives but also surpassed some of them. From this experience I witnessed first-hand the way my European colleagues deliver exceptional service to urology patients. These experiences also helped me to fine tune and hone my mentoring skills. Sharing professional experience with colleagues and students is of paramount importance in our demanding profession. My goal was to return to my practice better-informed in providing a cost effective and efficient service to patients. This objective was reached and the experience gained helped me improve my performance as a team player and motivator at our multi-disciplinary urological surgery team at Mater Dei Hospital in Malta.
Recommendations for future EAUN fellowship beneficiaries
It is an absolute must to plan well ahead for this fellowship, irrespective of one’s choice of venue and with clear goals and expectations. One should research well beforehand the costs of accommodation and flights when submitting one’s application. Applicants must also have a realistic comprehension of the costs when booking since London is no exception to high commuting costs. Taking part in this EAUN fellowship truly boosted my nursing career. The experienced gained will help me provide a high level of nursing care in Malta while still striving to improve my skills, knowledge and commitment.
I thank Bruce Turner, Sasha Ali, Clare Smart and Clifford Astwood for their patience in mentoring me. I felt at home from Day 1 and will not hesitate to have this experience again with such a great team. Finally, my special thanks to the EAUN Board for their commitment to this fellowship programme.
By: Emanuel Vella, BSc, (Hons), Nursing Theatres, Mater Dei Hospital, Msida (MT)