Career advice

Enabling patients with MS to take control of continence issues

A nurse specialising in multiple sclerosis drew on his earlier experience in urology to develop a potentially life-changing service for patients

A nurse specialising in multiple sclerosis drew on his earlier experience in urology to develop a potentially life-changing service for patients

Consultant urologist Sheilagh Reid and MS specialist nurse Liam Rice
have developed pathways to resolve bladder problems.

Bladder and bowel problems can be among the most distressing side effects for people with multiple sclerosis (MS) but they are also very common, affecting more than three-quarters at some stage, according to the MS Trust.

Now a pioneering nurse-led service is helping patients with MS to receive timely treatment that can be life-changing.

‘People feel they’ve got a bit of help at last with their bladder,’ says MS specialist nurse Liam Rice, who set up the service with a consultant urologist at Sheffield’s Royal Hallamshire Hospital in 2014. ‘Problems can mean patients become isolated and don’t want to socialise. But when they get their continence back they’re able to get on with their lives.’

After qualifying in 1997 in Sheffield, Mr Rice spent most of his career working in urology before taking up his current specialist post almost nine years ago.

Tapping into experience

Although he admits he knew little about the condition when he began, he had experience of looking after a patient with MS when he was a hospice support worker before starting his nursing degree.

‘I was keen to learn something new that was exciting and challenging,’ says Mr Rice. ‘This felt like a good way of progressing.’

Over the years he saw many patients with MS who had bladder and bowel problems, with difficulties sometimes developing several years after initial diagnosis. Usually patients were referred to local continence teams.

‘Then it dawned on me that I have a massive amount of experience in the field of urology that I hadn’t really tapped into,’ explains Mr Rice. Consultant urologist Sheilagh Reid, who was managing many of the patients, had begun to feel similarly frustrated. ‘We emailed each other almost at the same time. It was serendipity,’ says Mr Rice.

Joined-up thinking

Together they have developed pathways to manage various problems, including an overactive bladder and recurrent infections, and have seen more than 400 patients since the service began.

‘We call it the joined-up thinking approach,’ says Mr Rice. ‘It’s unique in the sense that what we provide is quite bespoke.’

Mr Rice has yet to audit the service but believes it is delivering results. ‘I’m sure the numbers going to A&E with recurrent urinary tract infections have reduced because we’re seeing those patients now. Infections can also exacerbate MS symptoms, so it’s important to manage them.’

Providing the service has enhanced his career fulfilment. ‘I really enjoy it and it has given me a great sense of purpose,’ says Mr Rice. ‘People put up with these problems sometimes for years, thinking there’s nothing that can be done. But now they come into the clinic and I can say to them, there probably is something we can do to help.’

Lynne Pearce is a freelance health journalist


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