In the footsteps of Florence Nightingale
This week we honour of National Nursing Week across the USA, and are celebrating the contribution of nurses to the treatment and alleviation of infertility.
National Nursing Week starts on 6 May and lasts until 12 May, which is International Nurses Day, celebrated on the birthday of the founder of the nursing profession, Florence Nightingale (1820-1910).
Florence herself, although she had suitors and male friends throughout her life, never married or had children of her own. But the nursing profession that she founded has played a bigger role than any other in bringing babies into the world. And nowadays, in the era of assisted reproductive technologies, nurses continue to be at the forefront of that process.
Nurses have been an essential part of the IVF healthcare team since 1978 when the world’s first ‘test tube baby’, Louise Brown, was born in the UK. The nurse on the team, Jean Purdy, was the first one to observe the fertilised egg, which was to become Louise Brown, dividing to make new cells.
She went on to help with the conception of a further 370 babies and wrote 26 scientific papers on the new technology. Jean Purdy sadly died prematurely in 1985, and is remembered as the world’s first IVF nurse.
Her co-workers on the first IVF team, gynaecologist Patrick Steptoe and physiologist Robert Edwards said of her, “There were 3 original pioneers in IVF and not just 2!”
A memorial plaque at their ground-breaking hospital, Bourn Hall, the first IVF clinic reads, “Jean Purdy: the world’s first IVF nurse and embryologist. Co-founder of Bourn Hall Clinic.”
During her career Jean Purdy therefore established the principle of the specialised IVF nurse right from the beginning, and provided an instant role model for the nurses, which then began to populate the brand new therapy area.
The core IVF team of gynaecologist, scientist, physiologist/lab specialist and nurse is still in place today, with other specialists being added in as required.
Following Jean Purdy’s model, nurses are at the front line of fertility treatment, supporting patients undergoing IVF and using their full range of generic nursing skills when caring for patients.
However, when it comes to the nurse’s specialist role in this area, the work is highly technical and includes the following main areas:
- Utilisation of extended specialist clinical skills, such as involvement in the processes of egg retrieval and embryo transfer, and scanning. This ensures the all-important ‘continuity of care’ for the patients undergoing these procedures
- Psychological support of patients during the entirety of the IVF process. This can be particularly important if the IVF if/when cycles are unsuccessful
- Patient education: patients need to be fully informed regarding the options and implications of treatment. Tailoring the information to the needs and level of understanding of the patient is vitally important and it is here that nurses play the role of educator, both informing and then checking that information is fully understood by the patient before the patient makes treatment decisions. This is crucial right from the early stages when patients are exploring the possibility of IVF
- Coordination, management and communication: because of the nurse’s professional closeness to the patient it is generally ideal that she/he is the primary coordinator and communicator for the allocated team for that patient’s pathway through IVF treatment
It can be seen from this that the nurse is not impinging on the roles of other healthcare practitioners, but is performing as an autonomous and vital team member in his/her own right. As one nurse specialist said: The extended role of the IVF nurse is not to become a ‘mini-doctor’, but rather to become a ‘maxi-nurse’.
What do IVF patients have to say about the role of the nurse? Here are some thoughts from a patient:
“One of the more positive aspects of IVF is actually having regular contact with your IVF nurse. Your nurse will fill in all the gaps that your Doctor hasn’t told you about or that you have forgotten to ask. Your nurse takes you through the whole IVF treatment process step by step. She will get you to repeat everything that she has told you to make sure that you understand everything that is going on.”
“The nurse is the person who will make all your blood test and ultrasound appointments for you, at times that they know are convenient for you! They will be your first port of call if anything goes wrong while you are undergoing treatment, like breaking a vial of medicine, or like having unusual pain when you shouldn’t. They offer solace and advice when unusual things happen during the treatment process.”
“They will be the one who will be the one who rings you with your pregnancy test results positive or negative. They will lend their ear in times of distress. They will recognise when you are close to breaking point and get you in touch with a counsellor if need be.”
It’s been nearly 200 years since the birth (on 12 May 1820) of Florence Nightingale, and 41 years since the birth of the first test-tube baby, Louise Brown. In those years since 1978, IVF nurses, inspired by the examples of Florence Nightingale and Jean Purdy, have played their essential roles in bringing 8 million babies that would not otherwise have been born into the world.
