Meet Joanne Brown – Early Career Nurse Member

Joanne Brown is the first Endocrine Clinical Nurse Specialist at Stockport NHS Foundation Trust. She tells us about her nursing career path, experience at our Endocrine Nurse Update meeting and her role in the Society.

What inspired you to choose endocrinology?

My career started in theatres, recovery and then critical care. I completed an MSc in advanced practice whilst working within a busy regional neurosurgical centre. I then returned as an advanced critical care practitioner and independent prescriber for a couple of years. It was during my time working as an advanced nurse practitioner in neurosurgery that my interest in endocrinology was sparked. I then started to look for a job in endocrinology that would give me a better work life balance, but that I still found interesting and challenging.

What do you enjoy most about your work?

One of the best things about my role is how varied it is; I have my own nurse-led clinics for thyroid and I’m developing my knowledge for hyperparathyroid nurse-led clinics too. I also manage a weekly endocrine investigation unit, develop clinical protocols and standard operating procedures and produce patient information leaflets. I have led on a service evaluation and organised a way to receive patient feedback for the endocrine investigation unit. I teach and support patients and staff throughout the Trust about how to manage adrenal insufficiency safely. I am also a member of the Society’s Early Career and Nurse Committees. My role has also opened opportunities for me to be involved with writing for peer-reviewed publication and to participate in a podcast about my career. It is truly very varied.

“Being involved with the Society can enhance patient care or your services and will expand your knowledge, whilst building on your CV”

There is something special about supporting patients, for example, those who are newly diagnosed with adrenal insufficiency, teaching them and their family members; being there for them when they have concerns or questions. It’s rewarding to have a long relationship with patients and understand how their disease impacts on them personally.

What you are most proud of in your career so far?

I am really proud to be the first endocrine clinical nurse specialist at Stockport NHS Foundation Trust and I believe my role is now making a difference to patient care. Setting up an endocrine investigation unit was challenging but a huge achievement and is benefitting patient care and management. I’m also proud that I successfully managed to contact all our patients with primary or secondary adrenal insufficiency during the start of the COVID-19 pandemic to provide them with support regarding sick day rules. I haven’t yet completed any research, though I have an interest in patient experience and would welcome research opportunities in this area.

How has the COVID-19 pandemic affected your research work?

I started my role just before lockdown, so I can’t really compare it to before COVID-19. However, during the pandemic whilst face-to-face clinics were cancelled, we set up a telephone clinic. I could run the clinic from home, contacting our patients with primary or secondary adrenal insufficiency and provide education about sick day rules and COVID-19. I also ensured that each patient had an emergency injection kit prescribed and were provided with a new steroid emergency card. This clinic proved that some elements of our jobs can be completed over the telephone, it also highlighted that many patients prefer face-to-face contact. I think it’s important and beneficial to be able to offer a range of appointment styles to patients, to support their preferences and clinical need.

How did you enjoy your first Endocrine Nurse Update meeting?

It was so nice to meet other endocrine specialist nurses from around the country and swap contact details, to support each other. It was fantastic to meet members of the Nurse Committee too and to be involved as a speaker. It was all such a great experience.

The lectures were all interesting and relevant, I particularly enjoyed the clinical case presentations and steroid management group session, which gave me a lot to think about how I could improve my practice. The exhibition stands enabled me to speak to various support groups and that has proven very beneficial.

Since attending the meeting I have placed thyroid information leaflet QR codes in our out-patient area to make the information more readily accessible for patients.

I have also been supported by the Addison’s Disease Self-Help Group and carried out a successful Addison’s Disease Awareness Day event at Stockport NHS Trust for staff.

What have you gained from joining the Early Career Committee?

“I would recommend getting involved in events and any activities that are advertised through the Society, it’s an excellent way to meet other endocrine specialist nurses”

The Society website had lots of supportive information that benefitted me as a new endocrine specialist nurse, so I joined to gain full access to the nursing resources. The Society helped me to contact an experienced nurse who listened to my plans and ideas for my role and offered me support, guidance and encouragement. I then presented an Endocrine Nurse Skills webinar on nurse-led clinics, and hosted another.

These were both great experiences and something I hadn’t done before, so I found it all really interesting. I then applied to be part of the Early Career Committee, as I had ideas about how early career nurses could be better supported by the Society. It has also enabled me to be a voice regarding what other early career nurses feel would benefit them. I then applied for a position on the Nurse Committee, which is useful for linking early career ideas into the Nurse Committee and fantastic for supporting the wider nursing community.

What do you think are the biggest challenges in your field?

The biggest challenge I find is managing patient expectations with limited resources, when we all want the patient experience to be good. There is a lot of pressure on the service for appointments with the consultant team. There is much more that could be done by a clinical nurse specialist and I would hope in the future to expand the service. Patients are however very grateful for my support and the part I play in their care.

Would you advise others to apply for roles within the Society?

I would recommend getting involved in events and activities advertised through the Society, it’s an excellent way to meet other endocrine specialist nurses. I received peer support from Emily Falconer, who was also relatively new to her role at the time when I first started my job.

Being involved with the Society can enhance patient care or your services and will expand your knowledge, whilst building on your CV. Check the Society’s website for details of the committee roles available and I’m always happy to talk to you about the role and the areas I am involved in, so feel free to contact me too.

How have mentors helped your career so far?

My clinical mentor is Dr E.D Aflorei, who has been incredible at supporting me to build my knowledge, experience and confidence with patients. Dr Aflorei also encouraged me to join the Society. I will remain grateful for this advice as it enabled me to contact Sherwin Criseno, who then supported and guided me. Sherwin helped me to focus on the Society for Endocrinology Competency Framework for Adult Endocrine Nursing a bit at a time, rather than feeling overwhelmed with it all and guided me with regards developing clinical guidelines and patient information leaflets.

Support from a nurse mentor and clinical mentor is essential when you are developing your role, it gave me confidence to get involved in Society activities too and reach out to other nurses across the country. Working as the only endocrine specialist nurse in a district general hospital could feel lonely, but knowing I can contact many nurses, very easily, really does support me in my practice.

Visit our dedicated endocrine nurse careers webpages for more advice and opportunities.

Meet Louise Breen our first Nurse Committee Chair Elect

Louise Breen is an Advanced Nurse Practitioner and Lead Nurse in Endocrinology at Guy’s and St Thomas’ NHS Foundation Trust. Here she tells us about her path to nursing and her involvement in the Society which culminated in her becoming the first Chair Elect of the Nurse Committee.

How did you get into endocrinology?

My interest in endocrinology was triggered in 1996 working as a staff nurse for pre-assessment and endocrine testing during a 3 month line of work at the Diabetes and Endocrine Department at St Thomas’. I returned the following year as a research nurse undertaking pharmaceutical company sponsored clinical trials in diabetes and endocrinology. It was the research in adult growth hormone deficiency that interested me most.

I was extremely fortunate to work with Professor Peter Sonksen who had a very progressive and supportive attitude to the advancement of endocrine nursing, he encouraged me to push myself in developing my knowledge and skills. I continue to be surrounded by an innovative, enthusiastic and supportive team.

“If you feel you don’t have time for a committee position, think about putting yourself forward to present at Society conferences, Chair a session or submit and present an abstract”

What do you enjoy most about your work?

  • Team work
  • Making a difference to patient care
  • Continued learning & development in my role, clinically and strategically
  • Mentoring staff

Can you tell us what you’re most proud of in your career, so far?

When I started out there was no designated endocrine specialist nurse, in 2003 we successfully proposed the first ESN role, I got the job and our ESN service has continued to grow.  We now have a team of eight, and provide the following services: Nurse-Led Clinics, MDT support (Pituitary, Adrenal and NET), Endocrine Testing and Reporting, Patient Education, Education for other HCP and active input into research, audit, the development of guidelines/protocols and standard operating procedures.

My qualifications in Advanced Assessment and my registration as a Non-Medical Prescriber have allowed me more autonomy in practice and improved my knowledge and skills in endocrinology.

In 2011, I established the Nurse Led Virtual Thyroid Clinic which was well received by patients and has gone from strength to strength. Pre-COVID we undertook on average 30 virtual reviews per week, which put us in a good position during the pandemic.

How has the COVID-19 pandemic affected your work?

Fortunately we were well set up for virtual reviews and maintained a reasonable amount of scheduled activity, albeit with staff deployment. We are gradually getting through the backlog and returning our focus to ongoing service developments, research and audits. Remote meetings have been invaluable and in many cases a more productive and inclusive way to meet.

On reflection I have identified areas where we can be more efficient and recognised that we had little give in our service for ESN cover, as a result we proposed and created Band 6 and Registered Nursing Associate roles.

Why do you think it’s important to get involved with Society roles?

The Society are an excellent organisation to work with and the team supporting the Nurse Committee are very motivated, enthusiastic and supportive. I have served two four-year tenures and am now in my one year term as Chair Elect before I proceed to the role of Chair. My organisation views these roles as important for professional development, supporting me to attend relevant Society meetings.

Being at the hub of endocrine nursing in the UK has so many advantages in improving your knowledge and expertise in endocrinology and in my case has aided career progression.

The progression and advancement of endocrine nursing and my career have motivated me to continue my work with the Society. I have been extremely fortunate to work with exceptional people in this role and have made long lasting friendships.

What inspired you to apply to be Chair Elect of the Nurse Committee?

It is a pivotal time for the advancement of endocrine nursing and I wanted to be part of that ongoing process. The GIRFT report made it clear that we must focus on the retention and progression of nurses in endocrinology.

My experience and close working relationship with the Society and the Nurse Committee has readied me to take on this position. As Chair Elect it is a huge advantage to work alongside Anne Marland, our current Chair, to better understand the roles and responsibilities of the position and to continue to push the nursing agenda forward as I move into the role of Chair.

“The Society is an excellent organisation to work with and the team supporting the Nurse Committee are very motivated, enthusiastic and supportive”

What advice would you give to anyone considering being more active in Society activities?

Believe me when I say there is always something you can contribute. Many nurses hold back from applying for committee positions, thinking they don’t have enough experience, expertise or time. The committee is very welcoming and supportive.

Getting your employer on board to support time to attend meetings and undertake committee tasks is an important consideration, most employers will generally see the mutual benefit of this role. Travel expenses are covered and there are a number of virtual meetings to avoid too much time out of clinical roles.

If you feel you don’t have time for a committee position, think about putting yourself forward to present at Society conferences, Chair a session or submit and present an abstract. Get in touch with the Nurse Committee if you have any queries.

Visit our dedicated endocrine nurse careers webpages for more advice and opportunities.