What a year it has been. Over the past 12 months we have been pulled from our usual roles as urology nurse specialists to be intensive therapy unit (ITU) nurses and back again into our regular roles, but with a totally new way of working.
The COVID-19 pandemic has disrupted our usual services and flipped our regular way of working upside down. It has been so difficult to go from a busy week filled with clinics, face-to-face conversations on new diagnoses and multidisciplinary team (MDT) meetings, to telephone consultations, Microsoft Teams and video calls. But is this way of working the future?
I for one have really missed the engagement of face-to-face meetings and clinics. However, with the pandemic against us, we have had to change and adapt to the new virtual way of working. In urology, we have to perform a lot of physical examinations, whether that is a check for prostate cancer, an erectile dysfunction clinic or siting a patient for an ileal conduit—it has been extremely challenging to somehow manage these patients virtually.
‘You need to be able to see your patient, assess their physical fitness and analsyse their emotions, all of which is near impossible to do over the telephone’
When we were initially told that all of our clinics were to stop and we needed to adjust to a new way of working, this was met with some resistance. How were we supposed to care for our patients having bacillus Calmette-Guérin (BCG) immunotherapy treatment? How were we supposed to introduce ourselves to patients with a new diagnosis of a urological cancer? How were we supposed to review our prostate-specific antigen-monitoring patients? All of these questions were completely valid and practically impossible to answer at that point at the end of March 2020. Soon after, we were shipped to wards and ITU to help out with the COVID-19 fight.
While away, plans were put in place to create a virtual way of urology nursing. Telephone clinics began, the MDT meeting became a Microsoft Teams event and reviews with patients were being undertaken through video calls. Owing to the amount of work we were undertaking, I was brought back into the urology department to help in any way possible. As our staff slowly began returning to their roles, it became clear that this way of virtual urology nursing was not going away any time soon. It was a huge learning curve for us all and we are still adapting and working out how to better utilise technology.
I believe that virtual nursing is going to be here for a long time, but is this a better way of nursing? On the one hand, patients get to speak to a consultant or nurse specialist over the telephone without even having to move from their sofa, and can be in the comfort of their own home with their loved ones when receiving a diagnosis. Nevertheless, with all of that technology to hand, we are unable to see a patient's expression over the telephone, unable to hug an upset relative over a video call, or have a complete discussion about a patient's plan of care with the urology consultants, oncologists and radiologists.
Today, in our Trust, we are now beginning to allow patients to come for face-to-face appointments for their diagnosis with a consultant and also attend to receive their BCG immunotherapy, a trial-without-catheter and catheter reviews, as well as attending for a physical examination following a telephone triage. Although we are slowly starting to get up and running again, most benign urology nursing is on hold.
I am hopeful that, with the vaccination programme being rolled out, we can begin to have some more freedom and start introducing more face-to-face clinics. I personally feel that, although technology has been wonderful during this pandemic and has enabled us to carry on doing the majority of our work, we need that personal and individual contact. As a nurse, you need to be able to see your patient, assess their physical fitness and analyse their emotions, all of which is near impossible to do over the telephone.
We came into this role to give the best care possible and to make our patients better, yet the COVID-19 pandemic has made this incredibly difficult, and has left a lot of our nurses feeling deflated and slightly broken.
Although we are not sure what the future holds, I can only remain optimistic that we can eventually continue on in our careers and care for our patients without the looming fear of COVID-19.