Career advice

Colorectal: an underrated specialty

Choosing a specialty seen as one of the least glamorous was never an issue for colorectal consultant nurse Fiona Hibberts, who approaches her work with humour and pragmatism

Choosing a specialty seen as one of the least glamorous was never an issue for colorectal consultant nurse Fiona Hibberts, who approaches her work with humour and pragmatism

Fiona Hibberts says colorectal nursing provides opportunities for a great career.
Picture: Mark Hakansson

It was an encounter with one particular patient that led Fiona Hibberts to discover her passion for colorectal nursing.

As a newly qualified nurse Ms Hibberts was working as a cardiac staff nurse when one patient, who had received a heart transplant, needed surgery for a bowel obstruction. Watching his progress made Ms Hibberts reassess her priorities.

‘Even though cardiac was exciting, this episode taught me that we often overlook the real fundamental problems that we face,’ says Ms Hibberts.

‘The heart transplant had worked, but it was the bowel obstruction that was causing the real problem for that patient at that time. It made me rethink what I wanted to do, and the first step involved widening my experience.’

So much variety

Today Ms Hibberts is a colorectal consultant nurse at Guy’s and St Thomas’ NHS Foundation Trust in London. She joined the trust in 2000 after working in general surgery nursing, first as a staff nurse, then a sister, practice development nurse and lecturer practitioner – qualifying with a postgraduate certificate of education and a master’s degree along the way.

Since joining the trust as a clinical nurse specialist she has taken on new roles, learned new skills and continued to develop her practice. For example, she trained as an endoscopist and a non-medical prescriber and has taken on trust-wide roles in strategy and service development.

Ms Hibberts became a nurse consultant in 2006 – and loves it. ‘There is so much variety. I sometimes think that colorectal nursing is a misrepresented part of nursing. It’s a fast-moving specialism and there are a lot of exciting things happening both surgically and medically.’

Nurse-led clinics

Since beginning her current role she has developed a number of nurse-led clinics covering areas such as family history screening, rapid access one-stop clinics, perianal surgery and telephone triage.

She also set up a nurse-led biofeedback clinic, which involves holistic and conservative management of patients with bowel dysfunction, such as faecal incontinence or chronic constipation.

Other achievements include developing what is believed to be the first national nurse-led proctography clinic and helping to set up a pelvic floor unit, alongside surgeons and a multidisciplinary team. This has grown into one of the largest tertiary referral centres for complex pelvic floor dysfunction in the UK.

She also set up the enhanced recovery after surgery programme, which aims to reduce length of stay and complications while not changing the discharge criteria. In the first three months, it reduced length of stay for major colorectal resection from 14 to eight days, and the programme has since been adopted as standard practice in colorectal surgery across the UK.

Ms Hibberts has supported other specialties to develop similar initiatives in their areas.

Childhood ambition

She decided she wanted to be a nurse when she was a small child and never wavered from that ambition. ‘It’s a bit of a cliché I know, but when I was a little girl both my nanas were poorly. They had some amazing nurses and I really liked the idea of walking along with people on their journey, whether it is sad or happy. It sounds a bit twee, but it’s true,’ she says.

After qualifying, she at first thought community nursing would be the area for her – she loved the idea of caring for people in their own setting – but an unexpected obstacle got in the way. ‘I was frightened of dogs, so I really couldn’t cope with that at all,’ she says.

Community nursing’s loss is colorectal’s gain, although she would be the first to admit that, as a specialty, it is not seen as one of the most glamorous. She deals with this with a mixture of humour and pragmatism – and a huge amount of passion.

Taboo area

‘When I was working as a nurse endoscopist I used to joke that I was spending a lot of time where the sun don’t shine,’ she says with a laugh. ‘Humour is important when you’re speaking to patients. It’s a taboo area – nobody wants to talk about their bum or their bowel.’

She believes that this is beginning to change, albeit slowly. ‘A few years ago, I was on a bowel cancer awareness double decker bus that we took out around south London. People were embarrassed to talk to us. I hope it would be different now as there is greater awareness, although it is still seen as a taboo part of the body.

‘What I would definitely say, however, is that colorectal nursing is a fantastic area to work in – it’s dynamic and underrated and has brilliant opportunities for a great career. I’m really glad I went down that path.’

Jennifer Trueland is a freelance health journalist

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