Author Fran Lee - Nurse Practitioner: Urology
Fremantle Hospital

The role of the Nurse Practitioner (NP) in Urology is fairly new. At present there are only four in Australasia. Each Urology NP develops their practice to suit the needs of the unit in which they work. It is a great learning opportunity and incredibly rewarding but it does take time to become one of the team. NPs are not doctors but nurses with expanded practice. The Consultants that I work with are very supportive but there have been some instances, which have made me very aware of the responsibility of my role.

At Fremantle Hospital I have established clinics to see patients with a variety of urological problems. I also see patients pre and post surgery for a number of urological

procedures. However the most exciting part of my role is the ability to perform flexible cystoscopies. This was a first for a Nurse Practitioner and was a great learning curve. I am able to do these procedures while patients are in hospital, which allows for timely intervention for investigating haematuria, (these are checked by the urology registrar) removal of ureteric stents and guidewire insertion of indwelling urethral catheters. I also have an outpatient list once weekly for low-grade bladder cancer surveillance and removing stents.

In May 2008 a one-stop haematuria clinic was commenced. The patient has either a renal tract ultrasound or CT urogram in the morning and in the afternoon is seen by a Urology Consultant. I then perform a cystoscopy. The patient may then be discharged, waitlisted for surgery or need further investigations. I follow up any further investigations. If normal I inform the patient and send a letter to the GP and if abnormal the urology consultant advises the next course of action. This is a partnership that works well for both the patient and the consultant.

The benefits of a Nurse Practitioner in Urology are many. Continuity of care is one of the greatest, but also the ability to write scripts for timely treatment and order investigations both laboratory and radiological to provide the best streamlined service for the patient.