Specialist Menopause Care in Nursing – Why do that?

This final blog in our October spotlight on menopause comes from Ruth Bailey and Debra Holloway who give an outline of their specialist nursing roles across both secondary and primary care.

Menopause Specialist in Primary Care- Why do that?

Ruth Bailey MSc BSc (Hons) RGN DCSRH Onc Cert QN

ANP, Sexual Health, HavensHealth

I currently work as an advanced Nurse Practitioner, sexual health, in a large GP practice and I can honestly say it’s one of the most rewarding posts of my career. I work clinically to support patients with their contraceptive choices, cervical screening, sexual health and menopause management. As an ANP, I have a role in practice development, education and training and acting as a resource.

Originally, I was a practice nurse specializing in Women’s Health, through that route I became a nurse team leader in a sexual health clinic where I gained a diploma in sexual and reproductive health, letters in competence in fitting long-acting reversible contraception and a College Registered Trainer Education & Training | CoSRH

Many of the patients I supported were experiencing symptoms of perimenopause and often choosing to have a hormonal coil fitted for both contraception and HRT. Our service was not funded to provide menopause care, and I felt frustrated that I could not give fully comprehensive care because of this service limitation. I recognized that I could not advise women answer their questions on menopause so I decided to extend my knowledge by undertaking Menopause the foundations course Menopause – The Foundations (2-day course for nurses) – British Menopause Society and I haven’t looked back!

After my initial qualification I moved to Primary Care as an ANP, and with the support of my GP supervisor was able to see patients for menopause as well as contraception, extending my skills and enabling me to provide a more holistic service.

I was then able to undertake the BMS advanced certificate in principles and practice menopause care BMS Principles and Practice of Menopause Care – British Menopause Society and was extremely lucky to have a clinical placement at Guys specialist clinic with Debby as my trainer. This placement gave me experience in managing patients with more complex needs and connected me with a professional community who are equally passionate in their pursuit of excellence in women’s health.

Since then, I have continued to support patients in primary care and enjoy deep professional satisfaction on being able to advice on menopause choices, prescribe appropriately, fit hormonal coils if required and manage any side effects.

Through my role on the RCN women’s health forum, Women’s Health Forum | Royal College of Nursing I have had opportunity to develop resources for Nurses, contribute to a wide range of publications and educational events and to shape policy development through the RCN’s voice on All Party Parliamentary Groups.

There is still a long way to go to ensure every woman in the UK receives an evidenced based personalized management plan of their choice, but by supporting nurses to extend their skills in this specialist area, we can be part of this much needed transformation in women’s heath.

Secondary care menopause – why do that!

Debra Holloway MBE, FRCN, FRCOG, RGN, MSc, BA (hons)

When I started my career in women’s health menopause was not a big specialty. However, as I progressed into outpatient clinics I was encouraged by a very supportive consultant and mentor to work within the menopause clinic. At this time there were a lot of HRT implants, not much choice in HRT but a lot of help that could be given to women. My interest increased over the years as did my learning, membership of the very inclusive British Menopause society https://thebms.org.uk and the expansion of the clinics as knowledge increased. Fast forward a few too many years (including the difficult time after the publication of the Women’s Health Initiative study) and a lot of learning and opportunities and the clinic was a specialist tertiary centre for menopause.

But what did this mean for a nurse. I was able to:

Become a specialist in menopause as recognized by the BMS
Become a trainer with both BMS and the Faculty to develop others, again this was multi-professional training, educational sessions after clinic
Sit on the first NICE menopause guidelines group to represent nurses
Use my prescribing sills.
Work with the RCN on a range of publications, including a position statement on menopause, guide to specialist nurse in menopause, the menopause a guide and be involved with study days and conferences.
Seeing women and helping them through the menopause journey and getting them on the right treatment pathways was so satisfying and the range of women seen in the clinic was huge. The case load ranged from advice and support through to complex individual prescriptions.
As well as the clinic I was able to advise via the ‘advise and guidance’ service meaning women could get the correct treatment without having to wait for an appointment.

We were seeing women with general menopause enquires, complex medical conditions (that may not have been able to have HRT without the clinic) women with hormone dependent cancer, women who requested testosterone and women with premature ovarian insufficiency.

Working within menopause also allowed the opportunity undertake education sessions for staff in the Trust and in primary care, to work with occupational health to undertake education sessions for the Trust, menopause and women’s health events and a staff menopause clinic.

For anyone in women’s health would I suggest menopause, definitely an exciting and worthwhile part of my role in a very much changing landscape.

RCN Resources

Menopause: RCN guidance | Publications | Royal College of Nursing

Nurse Specialist in Menopause | Publications | Royal College of Nursing

Menopause and you at work| Royal College of Nursing

BMJ Blogs