QX talks to Luke Byrne, a charge nurse at CNWL’s Mortimer Market Clinic, about the realities of working in a sexual health clinic.
By Patrick Cash
Why did you become a nurse?
I remember thinking if I became a nurse I’d travel around the world working in a wide variety of hospitals and settings… So far I’ve been from Liverpool to Exeter to London!
Why did you go into the sexual health field?
My last placement whilst I was doing my nurse training was in Sexual Health (GUM) and I found it really interesting. I liked the delivery of care provided for patients. It seemed that nurses were working very independtly and this I liked.
What was attractive about working at Mortimer Street Clinic?
After moving to London (from Devon) I really wanted to see a different demographic of patients and see how large inner cities approached sexual health and HIV care.
Have you developed any particular techniques you use to put clients at rest or develop a rapport?
I think the key to a good consultation and rapport with patients in sexual health is all about the non judgemental approach. There are many techniques we all employ in our work as health professionals, but I’ve always found that with sexual health; patients really feel most at ease when we don’t judge.
What was the first time like when you diagnosed someone positive?
We hear very personal information from our patients and so there is always a certain privilege I feel when they have felt able to discuss their stories with me. Therefore, whenever there is a positive result, whether it’s HIV or any other STI it’s up to us to deliver it in the most sensitive way. My first time in giving an HIV positive result was both upsetting and hard work. We have to make sure that we can offer good support and advice for our patients at all times.
How did they respond and what did you feel? What do you say in situations like this?
I think they were in shock. Information like this is usually life changing for anybody. It’s also a result that I never get used to giving. Every patient is different and I know it will affect them differently. I need to make sure I can provide the support and information that’s right for them. We always need to ensure they have understood the diagnosis, but also reassure them of what we can offer as a modern health service. It’s also good to dispel any myths or falseness that still gets applied to HIV diagnoses today.
What reasons do most clients give as to why they haven’t used protection?
Many people will have sex without the use of condoms, and a large proportion of them know there are risks involved. I think for a lot of people they tend to get caught ‘in the moment’ as it were.
Do they give reasons?
When we have patients attend for sexual health testing, we always discuss the use of condoms and advise on the benefits of them. Patients can sometimes offer reasons like: “You don’t have the same feeling during sex” or “I didn’t have any on me”. Talking about options available with condoms is good as people aren’t always aware of the variety. Giving out free condoms and advising that it’s good to keep one on you is also good advice!
How does your professional life intrude upon your personal life, at all?
I think there’s certainly topics of discussion that you have as a sexual health professional that you wouldn’t have anywhere else!
What are the best and worst things about working in sexual health and the NHS?
I feel with sexual health there is a real personal element and direct way to try and change behaviour for the benefit of health. I’m a huge advocate of any kind of public health, but I just happen to prefer the sex side of things! I think sometimes though, like with any public health care, the level of change has to be so great and so can feel a little overwhelming at times.
As for the NHS, I feel passionately about it. Now more than ever, it is something which I think needs to be preserved. I genuinely worry that people feel there is nothing that can be done/improved and are giving up on it. If we want the NHS, then we need to fight for it!
Do you ever find bureaucracy within the NHS to be an obstacle?
In short – Yes. I think any large organisation has a level of bureaucracy, but I also think there can be too much.
Does anything really anger you about your work or the clients you treat?
I think anger is a strong word. There are certainly times of frustration though. I’m passionate about sexual health and I quite often show that passion, but I certainly don’t get angry with patients or colleagues.
And finally, what drives you on in this line of work? What gives you hope?
Change. I still think that there’s always improvements that out service/NHS can make that will benefit people in the best possible ways.
Mortimer Market Clinic is at Capper Street, off Tottenham Court Road, WC1E 6JB.
