A day in the life of: Continence nurse specialist Elaine Hazell

Elaine Hazell is a clinical nurse specialist (functional urology) at Guy’s Hospital, London.


“I usually arrive at the hospital at about 8am and respond to any urgent emails and phone messages but my day ‘properly’ begins with a clinic, and the type of clinic varies depending on the day of the week. I run both a nurse-led continence clinic and a lower-urinary tract clinic weekly and uro-dynamics clinic three times a week. As well as being a clinical nurse specialist I am an independent prescriber which means I can prescribe medication within my remit such as antibiotics and alpha-blockers. I meet patients who have overactive bladders or trouble emptying themselves completely and prior to them starting Botox treatment I teach them intermittent self-catheterisation. I work with neuro-genic patients with multiple sclerosis and help them retrain their bladder using pelvic floor exercises.”

Elaine is a member of the CAUTI group (CAUTI stands for catheter-acquired urinary tract infection.) This is a group within the trust made up of consultants, nurses and other professionals working to reduce the number of catheter acquired infections as part of a nationwide initiative to develop good practice and educate staff to remove catheters quickly. (It is estimated that 3,000 people in the UK die each year from catheter-related sepsis.)

“We have developed a tool that flags up when a patient has had a catheter in for a long time and we also give patients catheter passports which are booklets so people know why they have the catheter and the implications of that. These initiatives have definitely had an impact on the length of time catheters are used for and the number of infections.”

Elaine typically sees 10 patients in her continence clinics but on a Thursday there is a consultant-led clinic which is very busy with typically 48 patients – a lot of whom have had radical prostatectomies. Twice a month she also does a pre-operative seminar for about 40 patients who are about to undergo radical prostatectomies. Elaine explains to them what is going to happen, the types of complications that can occur afterwards and the importance of doing pelvic floor exercises to regain control.

“I see patients of all ages, anywhere between 17 and 95. Many people assume incontinence only affects older patients but this simply isn’t the case, I see students, young mums and city guys. Many patients I see are in tears and very depressed and socially isolated. Incontinence is not life-ending but it is life-debilitating. They find being incontinent incredibly embarrassing and it has a terrible impact on their quality of life. Some of my patients are young city guys and they are absolutely mortified, they feel that being incontinent effects their masculinity.

“Lots of my patients won’t go out and I know lots of men who after surgery feel they cannot return to work. Being Incontinent is soul destroying, it affects your sex life and can lead to a relationship breakdown.

“That’s why it’s really important that TUF is raising awareness of incontinence because there is so much that can be done to help patients. Many people don’t realise but in most areas patients can refer themselves to see a continence advisor. The right treatment can make a huge difference to patients.

“My job is busy but hugely rewarding. It is such an honour to help patients overcome incontinence. With the help of organisations like TUF we can break the taboo surrounding incontinence and ensure more people get the help they need.”

If you're living with urinary incontinence you can find out more about our World Continence Week campaign this year.


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