Tuesday 18th November 2008
IVF nursing is emotionally challenging but incredibly rewarding work, says Jeanene Stevenson, Nurse Educator at Sydney IVF.
When NSWNA member Jeanene Stevenson was appointed Nurse Educator at Sydney IVF two months ago, she became the first IVF Clinical Nurse Educator in NSW, and only the second in Australia.
Having worked at the state-of-the-art clinic for a decade, Jeanene is one of the most experienced IVF nurses in the country and has a clear understanding of the attributes and qualities needed to pursue this specialised form of nursing.
‘It can be difficult work but incredibly rewarding. Firstly you need mountains of emotional stamina. You have to be an excellent listener and a very empathetic person,’ said Jeanene.
‘Our patients often arrive here emotionally exhausted and very vulnerable. They bring stories of infertility, miscarriage, grief and loss and nurses need to be very sensitive to that.’
As Jeanene explains, emotions like anxiety, jealously, anger, guilt, fear, sadness and loss of self-esteem commonly accompany infertility, but sometimes patients slide into more serious states of panic and despair. Nurses need to be constantly alert to the signs that often come with a ‘palpable sense of urgency’, especially among older patients who feel the ‘clock is ticking’.
‘Some feel like they can’t even afford to wait another month,’ she said, explaining that IVF consultation involves a fine balance between the real possibilities and false expectations.
A typical day at Sydney IVF begins before 7am, with up to 50 patients arriving for their daily blood tests. There are drugs to issue, injections to give and, ‘lots of TLC and tissues to dispense’. The mornings are filled with assessment interviews, phone calls to-and-from patients and last minute ‘drop-ins’ to accommodate. By afternoon, the blood tests and ultrasound results trigger another round of phone calls, this time to doctors determining treatments and organising procedures like egg collections and inseminations.
An upside to IVF nursing is the regular hours – for some, it is as close to ‘a normal job’ that they’ve had – though there can be some lively ‘negotiation’ as to who takes home the after-hours’ phone.
‘That can involve standing on a crowded bus trying to respond to a patient wanting to discuss her period, which can be quite awkward,’ said Jeanene.
Jeanene oversees the training and development of the clinic’s 15 ‘nurse coordinators’, who manage patients’ ‘journey’ (a key word at Sydney IVF) through the program.
‘IVF nurses need to counsel and guide patients and their partners through the difficult periods, calmly reassuring them while constantly reassessing outcomes and options,’ she said.
‘Our nurse coordinators meet regularly with the doctors, pathologists, sonographers, scientists and day-surgery staff, coordinating treatment and keeping patients as informed and relaxed as possible.’
Sydney IVF’s Patient Services Manager Sally Muir has seen the full evolution of the nurse coordinator’s role since she started as an IVF nurse 20 years ago.
‘The key to IVF nursing is relationship and trust. As we are handling their precious eggs and sperm, patients have to be able trust us and confidentiality is crucial. There is still a surprisingly strong social stigma attached to infertility that can be very difficult for patients to deal with and we have to respect that,’ said Sally.
‘But it’s an incredibly exciting place to work. When I started here 20 years ago the pregnancy success rate was only about 10%. Our figure today is about 50% for women under 36 years of age.
‘I used to go home and worry all night – which is not a bad thing in itself because you have to care to be a good nurse – but I learnt to cope. I’d go to the gym or go out and have a glass of wine. But really, it’s the team element that’s essential. We all help each other to debrief and download when tragedy strikes.
‘I love being a part of this team. We all have a similar philosophy and a strong belief in what we are doing and it’s a privilege to be a part of our patient’s journeys.
‘We call it a ‘journey’ because that’s what it is. No one knows where it will end. Some end in healthy babies, some don’t – and when it doesn’t, we have to help them close the book on that and move on. It can be very difficult but sometimes we have to be very honest.
‘Some stay in touch, some come back for three or four babies, and some just want to forget about it and we never see them again. Everyone copes differently.’
Leaving the clinic, this Lamp journalist almost misses a corner covered with baby photos and thank-you cards. For a display that so touchingly signifies the ultimate success of IVF, it is surprisingly understated. It is then that I realise, while this is not intensive, emergency or palliative care, these nurses still practise daily on the sharp edge of life and death. Jeanene explains that while these photos are their most precious and treasured artefacts, they too must be careful to not attach themselves too tightly to the outcomes. If, as the proverb goes, life really is about the ‘journey’ rather than the destination, then nowhere at this moment is that more beautifully expressed than here at Sydney IVF.