I often start my working day early, seeing patients from 7.30am.
I do this for two reasons. It allows me to fit in more consultations and I can sometimes see 20 patients in a single morning. Secondly, a lot of my patients are in full-time work, and employers aren’t always sympathetic to people taking time off for medical visits.
Monitoring patients on disease modifying therapies is very important
A lot of my time is spent monitoring patients who are receiving disease modifying therapies (DMTs) for relapsing MS. These are drugs which can alter the progression of MS and reduce the frequency or severity of relapses. However, many of them come with significant risks associated, and patients need to be very carefully and regularly monitored.
I take blood and urine tests routinely from these patients, and I am responsible for analysing and interpreting the results. It’s a lot of responsibility, and understandably this work needs to be prioritised.
Keeping in touch helps people live well with MS
I like to see my other patients at least twice a year, often just to check in and make sure that they are managing their condition effectively. But also to identify if they might need any additional support or referral onwards to another service, either within the NHS or in the external support community. I have built a lot of strong networks across my health board to support these referrals.
By keeping in regular contact with patients, I can be more responsive to any changes. I know that this is helpful in reducing hospital admissions and helping patients self-manage, so it's a very important part of my job.
I also like to stay abreast of opportunities for patients to get involved in the wider MS community – that might be opportunities such as clinical trials or surveys, or it could be in learning and development opportunities. My patients really value being part of a joined-up community, and I recognise that I play an important part in helping to reduce isolation and disengagement from services.
Our role is diverse and our job is important
The role of the MS specialist nurse truly cuts across all parts of the care community.
On the one hand, it demands highly specialist clinical expertise and a developing knowledge of a wide range of drugs and therapies. On the other hand, it may involve very holistic and humanitarian acts, such as comforting the distraught spouse of a person who has been diagnosed with MS, or arranging respite provision for a family in crisis.
There are lots of other elements to my job, which create diversity and challenge in equal measures. I frequently write letters of support for patients who are claiming benefits or applying for grants, and I also provide clinical expertise to social care colleagues.
Even though I’ve been involved in MS care for around 20 years, I still feel that I am learning and developing my practice every day. It truly is a specialist role.