GUM Clinic, a Sexual Health Clinic - Assignment Example

Literature Review: GUM clinic, a sexual health clinic Executive Summary The focus of this literature review is on the importance of healthcare intervention relevant to nursing intervention in relation to GUM clinics or sexual health clinics. The paper would attempt to understand the importance of nursing intervention in sexual health clinics and what are the primary roles of nurses in GUM clinics. My paper would also provide a background on the responsibilities of nurses in GUM clinics, especially focusing on the problems and issues faced by the staff while dealing with sexual health patients. The primary source for information in this paper is secondary research, especially focusing on various medical and nursing-related academic papers. By the end of this study, I would try to establish the importance of nursing professionals in providing successful intervention to sexual health patients. Rationale behind the study The research attempts to find out the importance of nursing professionals in providing successful intervention to GUM clinics patients. I have chosen this particular topic because experts have indicated that the role of the nursing professionals in the field of sexual health is ever increasing. As per experts, nurse has established such a prime position in sexual health that they have been included in the primary care services as well (Seibert 2001). The nurses in the sexual healthcare are no longer just caregivers; instead they also have to provide advices and guidance to their patients. Their roles are continuously evolving from being health assistances to that of advisors. Nurses in sexual health clinics definitely have an enviable role and a very privileged position to interact and directly influence patients about their health and lifestyle choices. Thus, my research would try to find out whether nurses in sexual health clinics truly hold an important position or not. Methodology I propose to use secondary research methodology for undertaking this study, as I believe that secondary research is significant for analysing the role of nursing professionals in GUM clinics. A secondary research is the best fit for this topic because it provides an initial understanding about GUM clinics and problems encountered by nurses while working in such clinics, as well as provide a base for further research. I have also relied heavily on secondary data and research, especially secondary literature and academic papers on the subject written by various experts. Most of the study papers, used in this research, are peer-reviewed articles written by sexual health experts, who have significant amount of experience in the field of sexual health intervention. I have used databases such as Cinahl and Nursing Times as my sources of information. Further, I have taken help from other specialised medicine-based databases such as the British Journal of General Practice and Medscape. My search strategy involved finding relevant articles on the topics that are written by reliable writers and most importantly peer-reviewed for their authenticity. Literature Review Introduction Gentio-urinary medicine (GUM) clinics are commonly referred to as sexual health clinics. These kinds of clinics are usually found at the local hospitals or as an entity within a health centre. In the UK, the Family Planning Association lists all the sexual health clinics in the country in its website. These clinics usually conduct tests to find out sexual or urinary related diseases such as sexually transmitted infections, bladder infection or any such infections of the genitals. Most of these clinics are usually referred to by the general practitioners for cases such as HIV/AIDS, syphilis and genital warts. GUM clinics not just test patients for sexual diseases but also provide consultancy for family planning. Such clinics provide advices for contraceptive use and give free condoms. The most important support that these clinics are providing these days are counselling patients with HIV positive status. GUM clinics also provide an open environment for the patients to discuss their problems and their issues are kept completely confidential. Further, a person can choose to remain anonymous in case he or she wishes to (‘What services do sexual health clinics (GUM clinics) provide?’ NHS). The role of the nursing professionals in the field of sexual health is ever increasing, informs the national strategy. As per the strategy, nurse has established such a prime position in sexual health that they have been included in the primary care services as well (Matthews 2001). The nurses in the sexual healthcare are no longer just caregivers; instead they also have to provide advices and guidance to their patients. Their roles are continuously evolving from being health assistances to that of advisors. Nurses, these days, are educated and given special trainings to handle patients with sexual diseases. These nurses are asked to impart sex education to their patients as well, and provide them information about safe sex and various health problems associated with sexually transmitted diseases (Matthews 2001). Further, researchers have highlighted that often sexual diseases affect the mental health of a person and can cause depression. Therefore, nurses in this field of work need to be well-qualified and experienced to handle such patients and should be able to catch any signal regarding emotional stress or depression and inform the doctors accordingly. This would ensure that a patient receives the right counselling and treatment at the right time, as delays in such matter can result into grave consequences (Stokes 2002). Sexual health nursing and HIV/AIDS GUM clinics play an important role in providing HIV tests to the patients, and handling such patients requires both skill and patience. The nurse’s role rises tenfold in case the patient is found HIV positive. A nurse from the Nursing and Midwifery Council, Liz Plastow, says that once a patients is diagnosed HIV positive, the nurse also have to find out other people who might have got infected by the patient and provide them with guidance and support. Further, the nurse should also be cognizant of the fact whether the infection is prevalent among a particular area, and if so, should inform the appropriate authorities accordingly. Sexual health, which was previously considered a stigma in the society, has now being accepted as a part of our total wellbeing. This has helped in integrating it with the other health-related services like family planning or gynaecology. This in turn gives an opportunity for the nurses to specialise in inter-related disciplines and have a rotational responsibility. Many believe that in order to work for sexual health clinics, one doesn’t even necessarily need a nursing degree. As the subject is very much related to social work and social consequences, many social workers are found attached with such a profession. However, in treating higher-end diseases such as HIV/AIDS, one definitely needs to have masters-level education in nursing (British HIV Association 2008). Sexual health counseling Counselling becomes an integral part of sexual health care. As most of the sexual health diseases are also related to strong emotional well-being of a person, nurses are also required to provide advices and couselling to their patients. Research has been found that sexual intimacy has emotional connections as well, and many couples find sex as a means to connect themselves with each other. It is often the manifestation of their emotional self. However, sexual dysfunction can cause immense stress in their sex life and in turn in their relationships as well. Thus, sexual diseases are not just an isolated physical ailment, but have far-reaching impact in terms of psychological and mental well-being of the patient and his or her immediate family and friends (Stedman 1995). Further, this kind of disease also has different meaning for each individual and therefore, such diseases should not be treated on the basis of mass treatment but should be customised according to the need of the patient (Sabo 1999). As a nurse is the closest to the patient, he or she needs to be aware of the requirements of the patient and suggest the course of treatment to the doctors. Similarly, such diseases might have different implication in different cultures. While, in some male virility might be of prime importance and in others female fertility. Thus, the nurses should also be aware of various cultural implications of the diseases and treat them accordingly (Pritchard 2009). In order to tackle sexual health problems, the most common model most GUM clinic nurses use is the PLISSIT model. This tool helps in providing in-depth sexual counselling, which is generally divided into four levels of intervention. With the advancement of each level, the clinical intervention of the nurses also increases and therefore, the skills and knowledge to handle patients also need to be at par with the intervention provided. The model provides the following interventions: Permission (P), limited information (LI), specific suggestion (SS) and intensive therapy (IT) (Seibert 2001). The permission is the first step towards initiating a patient towards sexual health treatment and counselling. This involves seeking the permission from the patient to discuss sexual problems and issues and providing them with the permission to explain their sexual desires. The next step, limited information, involves providing an opportunity for the patient to start the discussion about their sexual problems. This is considered to be one of the most difficult parts of the entire intervention, as many patients might not be forthcoming in discussing their personal problems to a third-party. In such cases, the nurses should be skilled enough to make the patient comfortable to initiate the discussion. The nurses have to provide the comfort level to the patients so that they can discuss their problems without any hesitation, while maintaining a professional attitude. Although, most experts believe that this is the most relevant step in the entire intervention, the skill-sets required to address this step is not fully developed, and nurses should be provided with training and education to handle such situations (Seibert 2001). In the specific suggestions stage, the counselling goes further into providing specific treatments, setting up intervention goals and suggestions such as monitoring sexual behaviours are given to the patient. This step requires specific education and training in providing sexual counselling, and often times, skilled nurses are entrusted with this kind of work. Intensive therapy is generally given by specialists such as sex therapists, gynecologists and urologists. In this step, the involvement of the nurses becomes limited and most of them just provide assistance to the specialists. However, the nurses should be adapt in understanding the requirement of the patients and should be able to refer him or her to the specialists or give suggestions to the doctors to refer the patient to the specialists. Often times, the task to convey the news about visiting specialists also falls with the nurse as he or she becomes quite close with the patient by this stage. Thus, the nurses need to be patient and excellent in his or her communication skills to convey the message to the patient (Seibert 2001). Identifying sexual problems and providing support to the patients are complex mechanisms and require skills and expertise. Nurses should be aware of each and every step of the treatment, right from screening for sexual diseases, to finding about the sexual history of the person, to the medical condition of the patient, to the final termination of the treatment. The nurse should be involved in each step, as they are the one who are providing the maximum support to the patient, and often becomes the trigger point for any panic situation (Walker 2005). Problems in practice Providing sexual health services or caring for sexual health people is different from the regular nursing job. Most of the nurses entering into the profession for the first time might learn the job while working on actual assignment. This kind of field is more dependent on experience rather than theoretical knowledge. Every situation might be tackled in a different manner, as sexual health problems are not just physical ailments but also affect the mental health of the patient tremendously (Schnare 2001). Therefore, the nurses need to be adept in sociological consequences of the disease and provide support to the patients accordingly. Further, they should also have some practical knowledge about psychology so as to assess the mental state of the patient and inform the medical staff accordingly. Many experts also believe that due to the sensitive nature of sexual health diseases and especially, its contagious nature, such diseases often incur lawsuits and court cases. Therefore, the nurses must also be aware of the legal tangle in dealing with such diseases and maintain strict confidentiality about their patient’s health status (Department of Health (2007). To provide nursing assistance to sexual health patients is a daunting task in itself and requires more than education, all-round experience to deal with any situation. Thus, experts suggest that nurses should be well aware of all the pros and cons of a particular disease, its social and legal implications, as well as the psychological effects (Department of Health 2007). Nurses should not be afraid to ask questions to their seniors and clarify all their doubts. Further, they should be adept in their communication skills and choose their words carefully and not offend the sensibility of their patients (Speroff 1994). Experts also say that it is generally the lack of know-how or experience that is a major roadblock for most nurses in treating sexual health patients. Nurses who are not able to tackle with emotional needs of their patients would find their tasks daunting, however, this can be overcome with experience and changing their attitude towards their jobs (Moore 2009). Many other believe that nurses should devote time in this kind of profession to gain skills and experience that they will learn while treating different patients. Further, enrolling for sexual health courses also helps in understanding the subject in a better manner. Research has found that nurses who have attended sexual health courses are much more adapt in discussing sexual health issues with a positive attitude (Stokes and Mears 2002). Therefore, the need gap in this profession is to provide all-round education that would help the nurses to overcome their fears and develop their expertise in the field. Conclusion For any adult human being, it is imperative to have a sexually satisfied life. In case sexual problems occur, it is mostly seen that people suffer adverse reactions. Most of them either gets into depression or become worried about their well-being. GUM clinics nursing professionals should acknowledge this aspect of the sexuality and should be able to provide their patients with the right guidance and advice to maintain the right sexual behaviour while undergoing treatment. They should be able to guide their patients in the entire course of the treatment, and ask them pertinent questions that might help the doctors or specialists to provide successful intervention. Health promotion by nursing staff in GUM clinics to their patients is a very important aspect of sexual health treatment. The professional bond and the day-to-day interactions with the patient make the position of the nurses very potent in the intervention. They can become the trigger point to raise any panic situation to the specialists or provide suggestions for customized care for the patient. Nurses also need to make many informed decisions to provide critical support to the patients, especially people suffering from life-threatening diseases such as HIV/AIDS. However, nurses should also be aware of their shortcomings and should not hesitate in taking second opinions while providing counselling services to the patients. As sexual health diseases involve social and cultural aspects as well, the nurses should be well-informed about every aspect. They should be able to provide a well-rounded care to the patients. Further, they should also be able to recognise the need for specialised help and refer the patients at the right time to the specialists. Nurses in sexual health clinics definitely have an enviable role and a very privileged position to interact and directly influence patients about their health and lifestyle choices. However, this also means that the nurses should ensure that the patients are given proper education and advice together with medicinal treatment. The nurses need to be skilful sex educators and good communicators to advise and convince their patients to follow certain sexual behaviour given the nature of their disease. Formal training and knowledge-sharing sessions would definitely help the nurses in developing their expertise and in promoting sexual health among their patients. Sources ‘What services do sexual health clinics (GUM clinics) provide?’ April 18, 2008, NHS, viewed April 18, 2009, . 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Pritchard, Jo (2009), ‘Nurses must seize the opportunity to be innovative’, April 8, 2009, Nursing Times, viewed on April 19, 2009, . Sabo D, Miller K, Farrell M, Melnick M, Barnes G. High school athletic participation, sexual behavior and adolescent pregnancy: a regional study. J Adolesc Health. 1999;25:173. Schnare S., Sexual health. Program and abstracts of the National Conference for Nurse Practitioners 2001; November 7-10, 2001; Washington, DC. Session 345. Seibert, Diane (2001), ‘Sexual Health: Counseling in Primary Care’, Medscape, viewed April 18, 2009, . Speroff L, Glass RH, Kase NG. Clinical Gynecologic Endocrinology and Infertility. 5th edition. Baltimore, Md: Williams & Wilkins; 1994. Stedman Y, Elstein M. (1995), ‘Rethinking sexual health clinics’, BMJ. February 11, 1995, pp. 342–343. Stokes T, Mears J. (2002), ‘Sexual health and the practice nurse: a survey of reported practice and attitudes,’ Br J Fam Plann, 2000 April, pp. 89–92. Walker, Tim (2005), ‘Sexual Health Nursing: 'At least you can make people better', The Independent, November 24, 2005, viewed April 18, 2009, . Read More