Aldons Chua is a nurse manager of the endocrine investigation suite in Eastbourne. In our interview he tells us about how he came to this role and the research he is doing with his Endocrine Nurse Grant.
How did you get into endocrinology?
I began my career working as an endoscopy and liver transplant nurse in the Philippines. I set foot in England in 2016 and started as a staff nurse in an acute medical unit at Eastbourne DGH. Endocrinology nursing was unknown to me until a colleague and friend who is now my manager, Maria Ravelo, invited me to do some extra shifts in the endocrine suite. During my shifts, I met patients with rare endocrine conditions and hearing their stories made me fascinated with the specialty.
Can you tell us about your current position?
My main role at present is managing the endocrine investigation suite, covering two district general hospitals, which includes performing dynamic function tests and providing health education for patients with adrenal insufficiency. I also facilitate the commencement and monitoring of treatment for general endocrine disorders.
What do you most enjoy about your work?
What I really enjoy is the autonomy as a nurse and collaboration with the multidisciplinary team. There is also so much support from colleagues even from different organisations and a variety of opportunities to grow personally and professionally. And, of course, seeing my patients have an improved quality of life through the care our team provided is the most rewarding part.
What are you most proud of in your career?
Becoming a nurse in the UK is what I consider as my proudest moment. As an overseas Filipino worker, it was a big leap of faith to move away from my family and homeland to work in another country with so much difference in language and culture. But it is such a blessing to have very supportive colleagues and managers who I have worked with since the very beginning, especially when it comes into my career aspirations.
How has your work been affected by the COVID-19 pandemic?
It has been very challenging. My associate practitioner and I were re-deployed to a COVID ward for 2 months during the first lockdown and our endocrine service was placed on a 10% service capacity. This caused a significant impact on the timings of our patient appointments, especially the investigations and teaching. However, it also made us resilient and innovative in our efforts to maintain the quality of care we provide while ensuring patient safety.
What do you think are the biggest challenges in your field?
We have a vision in our endocrine nursing service to provide excellent, safe and compassionate patient-centred nursing care. The biggest challenge is to keep the vision going, knowing that we only have very limited time and resources.
You have been awarded an Endocrine Nurse Grant, what was the application process and how did you find it?
Initially, I was reluctant to apply, as I had reservations about whether I qualified as I am still an early career nurse. I am very grateful to my mentor/research supervisor Dr Sofia Llahana who encouraged and guided me throughout the process. Also, the Society for Endocrinology set clear guidance on the website and the team were helpful in responding to my queries which made the process easier to follow.
What will the grant be used for?
The grant will be used to fund our research project which is investigating the barriers and enablers in the use of injection devices during adrenal crises for adrenal insufficiency (AI) patients. In the UK, most centres provide 3ml syringes and a needle or a safety syringe, depending on the centre, which are included in an emergency hydrocortisone injection pack. Although AI patients receive training on how to use these syringes there are still reports that they are unable to administer the hydrocortisone injection during an adrenal crisis due to the complexity of the device. First-hand reports of these problems from our own AI patients led to the research project. Adrenal crisis is a life-threatening event and the emergency injection of hydrocortisone can save a patient’s life. This grant will help us explore the experiences of AI patients on their use of the current hydrocortisone device during an adrenal crisis. The outcome will provide evidence of potentially modifiable barriers associated with the use of the current parenteral hydrocortisone in preventing adrenal crisis and will inform the development of future interventions.
What are your plans after completing this project?
I am looking forward to take on future projects looking at how we can further help and support our patients with adrenal insufficiency manage their condition even better. We are starting new nurse-led clinics soon and expanding the endocrine nursing service to help accommodate our increasing number of endocrine patients.
What advice would you give to anyone considering applying for the Endocrine Nurse Grant?
My first challenge was how to begin, so I connected with a mentor who works in the same area. Then, I familiarised myself with how to make a competitive research proposal as this is my first application. I believe that as nurses we have a huge desire to make a difference to the lives of our patients, and research is just one way. Take courage, and if you fail on the first attempt don’t lose heart, just keep on trying and improving.