Narrator: This podcast is intended to support UK health

care professionals with education.

The information provided in this podcast is not a substitute for professional

medical advice or treatment, and patients are encouraged to consult

health care providers, including nurses, for any medical questions or concerns.

Hannah: Welcome to stoma and continence conversations from Coloplast Professional,

where healthcare professionals and experts by experience discuss the latest

hot topics in the worlds of stoma, continence care and specialist practice.

I'm Hannah Patterson.

I've worked in specialist care and I'm currently the ostomy care associate

education manager at Coloplast.

This time we're looking at specialist nurses, the unsung

heroes, transforming health care.

Hello and welcome to the podcast.

Now today I am joined by two guests.

You will be meeting these guys a lot throughout the year and in actual

fact you've met them both already.

So I'm going to bring Paul in first because Paul you will all more than know.

So hi Paul, how are you?

Paul: How you doing Hannah?

So my official job title is ostomy care education manager at Coloplast.

So I put together all of the education and educational resources and support

specialist practice and specialist nurses.

Um, I'm a specialist nurse by background, stoma care, as lots of

people already know, and stoma care and specialist practice and education

are my, are my passions, which for anybody who's listened to me.

knows that I have lots of passions, but they kind of distill down to those three.

Hannah: There is a long list of passions.

That sounds wrong, actually.

That sounds quite

wrong.

But people that know you will know what we mean.

Paul: They know what you mean, exactly.

Hannah: And we're also joined by Emma.

Hi, Emma, how are you?

Emma: I'm good, thank you.

Thank you for inviting me.

So I'm Emma Russell and I am the education manager for the, for continence care.

So very much similar to what Paul's doing in OC, I'm doing for bladder and bowel.

Hannah: Fantastic.

Now, today's podcast, the theme is very much looking at specialist

nurses and how they are very much the unsung heroes within healthcare.

So I suppose my first question to both of you is, how did you

get into specialist nursing?

Paul: I actually came into specialist practice purely by accident.

It wasn't something that I'd ever really thought about or wanted

to do or anything like that.

I started off my nursing career in vascular and then I moved hospitals

and I ended up on a colorectal award.

And this stoma post came up and it was like, do you know what?

I'll give it a go.

You know, what's, what's the worst that could happen?

It'll be a good education curve, learning curve for me.

And I think within two weeks of doing it, I realized that this is

it, this is what I wanted to do.

Not just stoma, but specialist practice, what you can do with

patients and the journey you go on with patients on the wards.

It's such a tiny snippet.

of a patient's journey, but suddenly you go into specialist practice and their

entire journey opens up and you can just follow, support the entire person.

For me, it's true holistic care at its very, very core.

So yeah, so for me, it was accident.

Um, it was just like, let's give it a go.

And I never looked back.

Hannah: A very happy accident, I think we could probably say.

Paul: Very, very happy.

Hannah: And how about you, Emma?

How did you end up becoming a specialist nurse?

Emma: So my first job when I first qualified was on a, um, a placement

where I was going to be doing sort of six months of surgery, six months

of medical and then sort of, you know, preceptorship type of thing.

And I'd never done urology in my life.

I hadn't done anything on the, I had been in any of the wards when I was training.

And within the first two weeks, I spent a day with the urology nurse practitioner,

um, in her clinics and what she did.

And I was like, yep, that's what I'm going to do.

I knew straight away that that's what I wanted to do.

I knew that urology was going to be the speciality that I wanted to, to.

To be part of, I'd seen the nurses on the wards, but I'd actually

seen the input that the specialist nurses has had and the urology nurse

practitioner in the whole journey.

And that just to me, it was lovely being able to see the

patients before, during and after.

Um, and yeah, it got me right away.

Hannah: It's funny, you're really similar to what Paul said there.

It's being able to do that overall journey and that holistic approach.

And it's funny, you both said exactly the same thing there, that once you got into

that role, that was it, you knew there was clearly a very much, uh, Okay, I'm here,

I know this is where I want to be now.

So, it then leads me on to say, obviously you're within two different

specialities, they're both specialist nurses, but different specialities.

What would you consider the main impacts, not just even necessarily,

but within stoma and continence care, the main impact of a specialist

nurse within different specialities?

So, again, I should be doing ladies first, really.

So I'm going to come to you first, Emma, now.

Emma: So I think, I think as a specialist nurse, we have pretty

much more time to see our patients.

We speak on a level of the patients that they want to hear from.

We're quite innovative.

We're quite, we're very caring.

And I think we, we make that, that their journey, that little

bit extra special for them.

I think because we, we've got that time, we've got that knowledge, we've got

that experience with their advocate.

Yeah.

I think that it's huge.

I think it's.

Specialist nurses can really make an impact not only on the patient's

journey but on services in general.

Hannah: Lovely.

And Paul, what would you say?

Paul: Yeah, it's really echoing what Emma's just said.

The word I would say is ultimate advocate.

You know, it's because No matter, you know, nurses are always patient advocates.

And it reminds me of an argument, not an argument, a discussion I had

with a nurse lecturer, to be honest.

And it was about why we, why do you need nurses in theatres?

Why do you need to be a qualified nurse to be a scrub nurse?

And.

The simplest answer which resonated with me was when the patient is

unconscious, when they're anesthetized, that nurse is that patient's advocate.

That nurse is the patient's eyes, ears, mind, heart, etc.

And I think as specialist nurses, It's very similar.

It's a very similar argument.

So if you're an MDT, if you're anything like that, you know, the patient can't

be there when these background decisions are being made and because we know it

doesn't matter what specialty you're in, whether you're in wound care, diabetes,

continent stone, it doesn't matter because we know those patients so well, we can be

their advocates when they're not there.

Potentially when there's decisions being made, yeah.

about them, about their care.

Yes, they're going to be involved afterwards.

But at that point, you are that patient advocate.

And I think it's the purity of that nursing role that's distilled when we

talk about specialist practice, which is one of the things I love about it

is we are just there for the patient.

It's just that purity of what we can do.

Hannah: And what that naturally brings onto then is the benefit then of

specialist nurses, specialist practice, even as a whole is that is then designed

to help improve patient outcomes.

It's not just there for the sake of being there, it's to improve

the patient experience, improve the patient outcome as well.

I've come from specialist practice myself, as you both know, I was

at HCA within the specialist practice and it is getting that.

Appreciation that you're not just another nurse, you're not just another health

care that you have got that specific little niche that you work in and as

much as there are similar specialties and there are a bit of, I was going

to say cross contamination, that's probably the wrong word, but cross

Paul: contamination, that's the word, it's a

Hannah: bit of crossover between, especially and I think within continence

care and stoma care, there's a lot of crossover, there's a lot of cross working,

a lot of similarities to working there.

Other than the obvious that you are working within our specialties, are there

any other real differences that you would say make a specialist role unique compared

to a normal healthcare profession role?

Anything that you would say makes that role unique?

Emma?

Emma: Well, I think when you look at specialist practice and specialist nurses,

we've been in that, that, that specialist.

speciality for years.

So we have that knowledge.

We've had that, we've got that experience and, um, we, we become

sort of, sort of like almost like a leader within those roles, you

know, we're able to educate other.

Nurses were able to do research and development.

Uh, we can change services so we can really make an impact not only

for the patient's journey, but for the actual service itself.

We are great communicators as nurses, aren't we?

But I think you find a different type of communication when you get

to that higher level of nursing and being able to have that strategic

level of thinking, um, and working.

Um, so yeah, that's, that's where the difference is.

Cause you've got those, the four pillars.

of clinical practice, you know, you've got that, that leadership, the education,

the research and development, and it's all pushing those boundaries as

a, as, as a, within the speciality.

Hannah: Absolutely, absolutely.

And Paul?

Paul: Yeah, again, can you ask me the next, the next question first?

I'm just going to sit here and say, yeah, uh, ditto to what Emma said.

Um, but for me as well, I think it's when, when you, you know, when you get your

first specialist practice role, and I don't know how many people out there have

actually ever read their job description, what is involved within their role.

And for almost every single specialist nurse, like Emma said, you know,

you've got these different pillars and education and that sort of thing,

but one part of it is role modeling.

And that is such a vitally important thing.

So, you know, and if we have any generalist nurses out there,

please don't think as specialist nurses, I'm a specialist nurse.

I'm saying, you know, we do a better job than you.

Not at all.

We, you know, we, that's definitely not the case because we all, you

know, everybody is needed from.

Cleaner, domestic, orderlies, porters, if it wasn't for the every cog in

the NHS machine, we wouldn't have the fantastic outcomes that we've had.

But as specialist nurses, we should be role modeling, as in what is best patient

care and supporting ward nurses and generalist nurses in providing the best

possible care, even on a generalist level.

And when That level needs stepping up.

That's where the specialist nurse can come in.

So it's not just about being an advocate and providing

holistic care for the patients.

It's almost that added role, added benefit for the NHS and the ward by

acting as role models of actually saying, no, this isn't correct care.

And sometimes we do have to be the nasty guy.

You know, we have to be the bad one to say this just isn't right,

you know, no, this needs to change.

And like Emma said, whether it's changing service, changing practice, as specialist

nurses, that can sometimes be the real challenging part to our job is actually

going, no, this isn't happening anymore.

Hannah: So I'm going to kind of touch a bit on what you've both said

there, but especially you, Paul.

So, as we.

We've sort of said they're specialists.

It's not just clinical practice.

It is.

So, I mean, I know from the stoma side of things, well, people used to

go with stoma, oh, you change bags.

That's what, that's what you do as a stoma nurse, you change a bag.

And it's more, so much more beyond just clinical practice.

So again, you mentioned those four pillars.

So really break it down.

What other skills are required within a specialist nurse role?

So Paul, I am going to let you go first on this one.

Paul: I think.

Patience is going to be one and that's patience as in patience is a virtue, not

patience as in individuals we care for.

And one of the big lessons I learned quite early on is obviously when you're

a generalist nurse, when you're a ward nurse, it is incredibly fast paced,

you know, and that sort of thing.

And one of the key skills for me as a specialist nurse is

understanding that change takes time.

Development.

Takes time and I am by no means an expert specialist nurse.

You know, if you look at banner and you look at the novice to

expert, we talk about a continuum.

I am constantly learning every single day.

I do my job.

I learn, um, and the day I think I know everything is the day that I need to

retire and hang up a tunic for good pay.

So for me, patients have the understanding that things take time.

And as Emma said, as specialist nurses, yes, time is always tight,

but we do have that extra time.

The second one is going to be passion, because You have to have a love for

something and it's kind of the hint is cut the you know the hints kind of in the

title specialist and it's you do give up a lot of things when you become a specialist

nurse and it might sound strange.

I used to love Doing my morning's backs rounds, waking Pete, you know,

when you're doing it, giving somebody a wash that that lovely hands on

care, you know, somebody wakes up with morning breath and hair everywhere.

And then by the time, by the time you open up those curtains,

they're sitting there, the beds immaculate, they're looking brilliant.

And it's that.

The heart of nursing.

It's that hands on practical, but as a specialist nurse, yes, you still get the

occasional time to do it, but you lose.

You have to understand that you're going to lose that there's certain

things which you are going to lose.

So it's, you know, patience, passion and understanding you and having that

willingness to say, I am going to lose certain things, but the benefits Are

going to outweigh the losses, the gains that I'm going to make, and a willingness

to, to improve, to make things better.

And that's kind of specialist practice for me.

Hannah: Anything for you to add Em, I'm not going to let you say ditto

on this one, because I think that's a real cop out on this question.

Emma: I'm not going to say ditto.

I think we, as a, as a, as a, as a specialist nurse, you need to,

maybe it's not a skill, maybe it's more of an attribute, but I think

you need to be quite resilient.

Um, and I think you have to have those really excellent communication skills,

but on a different level of communication, you have to be a really active listener.

So when the patient's telling you something, you probably have to

read between those lines because actually you're going to get more

of a consultation out of them.

If you're, if you're a better listener, I think also your decision making, you've

got to be really on it because when you are working strategically and having

to change and having to make changes, you have to have that decision making,

you have to be confident in yourself.

So yeah, those are, those are, those, I think some, some of those leadership

skills, I think is really important.

Paul: Yeah, I actually, I actually really like the fact that the

two answers we both gave were almost two sides of the same coin.

For Em, your answer was really kind of, these are the almost, you

know, very relevant, incredibly relevant map, you know, need to be

communication and that sort of thing.

And again, it's that thing of nursing, isn't it?

It was like, mine were almost passion based.

And yours, Emma, were actually, you know, at the end of the day, you can take away

all of the other stuff, but this is what it is, so, yeah, no, I quite like that,

it's almost like we know what we're doing.

Emma: I forgot, I forgot problem solving as well, because,

Hannah: I was actually going to add that one in!

Emma: Because you think, if you think when, when they get to us, they've

probably gone through God knows how many different healthcare providers or

practitioners or wards, and they're coming to you going, I don't know what to do now.

I'm at my wit's end.

And it's actually, I think their problem solving skill steps

up a little bit, doesn't it?

Hannah: I feel like we'd have been really good contestants on the

Krypton factor back in the day,

because really all the attributes that you needed.

bar perhaps the physical Submarine Baby challenge.

I don't think I'd have been so good at that.

But the rest of it, I actually think within Krypton Factor is quite relevant.

Paul: Oh yeah, especially the obstacle course at the end

trying to get out of the office.

Yeah, that's yeah, it's quite Yeah,

Hannah: that sounds about right actually, yeah.

Coloplast Professional offers a lot of educational material for specialist

nurses and healthcare professionals.

Visit coloplastprofessional.co.uk to find out more.

Why is ongoing education so crucial for specialist nursing

and specially nurse practice?

Oh, Paul, as, as the old hat of color plus professional.

Ha ha.

I'm going to come to you first with that one.

Paul: That's fine.

That's fine.

The easy answer is because we have to.

It's part of, it's part of, it's part of the NMC, part of your code, part

of you registering and reregistering and doing that horrible revalidation,

which in reality isn't horrible.

It doesn't take that long.

Emma and I both did it, what, three, four months ago.

I don't know about you, Emma, but it was actually a lovely process.

I

Emma: loved that.

I loved that session.

It was brilliant.

We had a great time.

Paul: We did have a lovely session when we revalidated.

So the simple question is You have to it's part and parcel to be a nurse.

You have to it.

You have to undertake education.

You have to undertake personal development and personal growth

within your scope of care.

Okay, but when it comes to specialist practice and education is

we wouldn't be needed as specialist nurses.

If every patient was a textbook, if every patient came in and it was diagnosed this,

you will have that, you will have this, you will be admitted here, you will be in

exactly two and a half days, you will go home on this medication, you will be seen.

That doesn't happen in real life.

And the art of the specialist nurse.

is being able to flex, adapt to changing situations.

And a lot of the time, we as specialist nurses in general teach and we educate

the textbook approach to a problem, a solution, a diagnosis pathway.

We come into our own when individual step.

Out of that and variance happen which happens all the time

99

percent of the time and a lot of the times you have to think

outside the box for solutions and.

It's only through peer to peer, for me specifically, peer to peer education,

talking to your peers, being in that nurturing educational environment,

where, and again, Emma, you know, I'd be interested to hear your part

on it as well, it's like whenever I do a masterclass, for anybody who's

listened to me doing a masterclass, one of my kind of things I will say at

the start is, I'm I'm not, I don't know everything, you know, my job almost as an

educator is to create questions for you.

I want you to be asking questions.

I want you to almost leave them, leave an event with more

questions than you arrived with.

But distilled questions, specific questions, and I want to make you

curious as an educator because curiosity is at the heart of nursing.

Whether you're doing blood pressures, pulses, temps, water lows, must scores,

it doesn't matter what you're doing.

You do all those to be curious.

And it's only through.

Education that we can create that environment pose new ideas, and I

think I put the emphasis on pose because it's like ideas are fantastic.

They're not all good.

Some won't work, but it's only by going through those.

That you actually find a fantastic solution.

So just that's the power of education and it's that peer to peer support.

You're not on your own and we've got to move nursing forward.

If it stagnates, it's the end of the profession and we can't stagnate.

Hannah: Now for those listening, can you guess that ongoing education

is a passion of also of Paul?

Paul: Just a little bit of one.

Hannah: A teeny tiny bit of one.

Emma, sorry I stopped you mid tracks there.

Anything you wanted to add to that?

Emma: I was just going to say that would segue nicely into, as

a specialist nurse, we have to be providing evidence based practice.

So how are you going to get that evidence based practice, all those

new innovations, those new things in education, how are you going to get that?

If you don't attend education or you don't go to go to events or you don't read.

So yeah, that, that, that just segued nicely into that.

Hannah: I also actually want to add a couple of things in from my perspective

with that is that actually as a nurse, you should want to, because actually

the more you learn, it's only benefiting your patients and your service.

So actually, I know you said you Paul because you have to, but actually.

You should want to as well.

You should want to improve your learning.

You should want to adapt.

And I know that within specialist care and things like that, the

goalposts are constantly moving.

What was relevant five years ago isn't necessarily relevant

five years down the line.

So actually it's that importance as well of nurses keeping

themselves up to date with things.

It's, it's keep yourself your finger on the pulse, excuse the

pun, being healthcare, but of what's happening at the moment.

What you learned five, six years ago, it could be completely different now.

So yeah, it's that want to, and I know you mentioned your way, Paul, that being

curious as a nurse and a healthcare professional, that being curious, what's

changed, what's new, what's different.

So, yeah, really, really good, and thank you so much, guys, and

to everybody listening, we will see you on the next podcast.

Bye!

Thank you for listening.

To see more of the wide variety of education we offer, please

visit coloplastprofessional.co.uk.

See you next time.

Narrator: Stoma and Consonants Conversations is a Vibrant Sound Media

production for Coloplast Professional.