When I heard that I had been nominated and shortlisted for the award, I was surprised, delighted, and honoured. I have worked as an andrology clinical nurse practitioner in a busy specialist London hospital since 2009. I work with a team of five consultants, nine senior registrars, one other clinical nurse practitioner (CNP) and one clinical nurse specialist. My role covers both benign andrology, and penile and testicular cancer. I consider myself to be incredibly lucky to work alongside a fantastic team, and none of my achievements would have happened without their support or encouragement.
I was nominated for my services to andrology. I was responsible for establishing the first face-to-face penile and urethral cancer support group in the country. Penile and urethral cancer is extremely rare with approximately 600 cases in the UK every year. There is a lack of awareness of this cancer among the general population and health professionals themselves, with diagnosis often delayed because of this or because the patient is too embarrassed to seek help. Due to the rarity of the disease, and because it is not something that is widely talked about, I decided to set up a face-to-face support group inviting men diagnosed with and treated for this disease to attend.
The group meets monthly and we alternate an educational meeting with a support meeting. Over the years the group has stayed well attended. As a result of the COVID-19 pandemic, we have had to adapt to providing a virtual meeting for now, but we hope to restart face-to-face meetings as soon as things go back to normal. Since starting the support group, specialist nurses from other hospitals have attended our group, and penile cancer support groups have been set up in other centres.
In addition to establishing the dedicated support group, I have developed pathways to ensure that all patients with a suspected penile cancer are offered an appointment within 1 week of receiving their referral. Therefore, patients are no longer delayed in their treatment, and no patients have waited longer than 2 weeks to be seen in clinic. In addition, over 90% of patients undergo their primary surgery within 4 weeks of their first visit. All patients are provided with a dedicated phone number and an email address and can contact our team easily. I have also set up an initiative where new patients can speak to other men who have been through treatment for penile cancer on a one-to-one basis. Furthermore, to meet the needs of the patients, I have created a fast-track clinic where patients can be seen urgently if they have any perioperative issues, as well as a dedicated end-of-treatment clinic.
I have also set up a penile cancer charity with the purpose of providing financial support for males who wish to attend the support group but are unable to financially pay for their transport to attend. Because of my involvement with penile cancer, I have joined the eUROGEN group, which is part of the European Reference Network, as a specialist nurse advisor. I have also been fortunate to present my work on penile cancer, as well as being invited to write an article, enabling me to further raise the profile of penile cancer both nationally and globally.
As well as supporting men with penile cancer, I also run erectile dysfunction (ED) clinics and care for men with benign andrological conditions. The prevalence of ED worldwide is high. ED is defined as an inability to maintain or obtain erection sufficient for penetration and for the satisfaction of both sexual partners. The pathophysiology of ED may be vasculogenic, neurogenic, hormonal, anatomical, drug-induced or psychogenic. It is often associated with obesity, diabetes, hypertension, and hypercholesterolemia, all of which pose significant risks to health. Treating ED involves identifying and treating ‘curable’ causes, lifestyle changes and risk factor modification and education and counselling. Phosphodiesterase type 5 inhibitors (PDE5i) such as sildenafil (Viagra) are usually the first line therapy, whereas second line therapies include penile injections and transurethral cream. For those men who do not respond to medical management, the surgical option of insertion of a penile prosthesis can be offered. However, this is an end-stage treatment as it destroys the cavernosal tissue within the penis and consequently is irreversible.
My fellow CNP, Fiona Holden, and I established nurse-led clinics for managing and counselling patients with ED. Specialist nurses from other centres and other countries have regularly attended our clinics to observe our practice, with a view to setting up similar services in their hospitals. Together we developed a patient preoperative counselling proforma for penile prosthesis counselling to ensure that patient expectations around outcomes are realistic, as well as enabling patients to make fully informed decisions. This has now been adopted nationally by the British Association of Urological Surgeons. As a result, I deliver invited talks on ED to nurses and doctors.
When I heard the other entries I was amazed and inspired by the outstanding achievements of my nursing colleagues and fellow nominees. I was absolutely delighted and humbled to receive the runner up award in my category, and was so glad to have been given the opportunity to celebrate nursing in this way. Although we could not celebrate the awards at the Underglobe, I thoroughly enjoyed relaxing at home with a glass of champagne watching the achievements of the talented nurses in the online ceremony. I would like to offer a big thank you to the British Journal of Nursing, and I am immensely proud to display my certificate!