My Story as a Renal Nurse Specialist

I’m Eduardo, a registered nurse working as a Renal Specialist Nurse in one of the NHS Hospitals in England. I have worked in renal nursing for over 10 years. I started working as a kidney staff nurse at Cambridge University Hospitals NHS Foundation Trust and then was a Junior charge nurse in one of the satellite units of St George’s Hospital University Hospitals NHS Foundation Trust. I completed my postgraduate renal certificate at St. Georges University London and was initially introduced to genomics medicine through Health Education England’s (HEE) Genomic Education Programme (online modules).

HEE provided me with a taster of the advances in genomic medicine along with the evolution of nursing practice in the genomics era. It was to my delight that I was able to transition to my current role and had the opportunity to further upskill by applying for an HEE grant to enrol in St. Georges University London to complete my PG Certificate in Genomic Healthcare (upgradable to PG Dip & MSc). I joined South East Genomics Medicine Alliance around December 2021 as the lead renal (kidney) genetics nurse specialist to support NHS/E mainstream and integrate genetic testing in kidney care pathways.

Role of a Renal Genetic Nurse Specialist

The role of a renal genetics nurse specialist is quite transformative in kidney care. Having worked in the renal (kidney) speciality for over 10 years, genetic/genomic testing would further support already existing pathways in renal management and patient-family-centred care.

We have incorporated a nurse-led renal genetics clinic (Guy’s Hospital) to coordinate care pathways in partnership with nephrologists and aim to include the advances in genomic medicine in kidney patients across their whole pathway.

I see patients primarily with but not limited to suspected cystic kidney disease, Alport’s syndrome, Steroid-Resistant Nephrotic Syndrome and even unexplained young onset end-stage renal disease (<36 y/o) to help answer patient’s ‘diagnostic odyssey’ through genetic testing and improve tailored renal care (precision medicine, transplantation decisions, family testing, pre-implantation genetic diagnosis, genomics counselling).

We have followed a model to implement through our ‘Think DNA, Think Genetics’ initiative by engaging in academic meetings with nephrologists, linking with practice development nurses and department managers to introduce, develop, educate and help upskill healthcare professionals.

Specifically, through tailored study days, ‘Lunch and Learn’ webinars and by working closely with renal nurse educators at London South Bank University, Kings College and St George’s/Kingston University to introduce genomics healthcare in their postgraduate renal nursing module. This is furthered by the support of the Association of Nephrology Nurses UK (ANN-UK) to improve delivery across the national professional group.

Challenges of the Role

The demands on the NHS and staff shortages mean that there are different levels of engagement and support from each of the NHS Trusts that I work with. At the moment, nurses, midwives and clinicians are to a degree underprepared to integrate genetic/genomic health information into usual clinical management.

The knowledge–practice gap could hinder patients’ and their families' access to needed genetic information. Efforts have now been initiated through the 7 GMS Alliances and stakeholders in building the capacity of existing and next-generation of HCPs to incorporate genetics/genomics into usual routine clinical practice. Continuity of the progress made with key stakeholders will be essential if opportunities afforded by precision medicine are to be fully realised in patient kidney care.

My aspiration as a Renal Specialist Nurse

My ambition in this is to help develop and integrate more nurses, midwives & allied healthcare professionals through education and upskilling to become genomic champions to support their local clinical kidney team to help improve patient-family management.

In similar importance, if not more, is that we have been keen on Patient-Public Involvement including Polycystic Kidney Disease Charity, Nephrotic Syndrome Trust, Alport’s Society Foundation and further plan to approach more groups to empower patients, support in the plan, delivery and evaluation of renal (kidney) genomic pathways to enhance patient equity and diversity of access.

We have seen a 111% uptake in renal (kidney) genetic testing (southeast region) in less than a year since we first initiated the renal transformation project. We continue to be determined to further improve metrics and to transition along NHS England’s (Network of Excellence) strategy in embedding genomics as part of the NHS long-term plan. The guidance involves accelerating the use of genomic medicine across the NHS, providing a world-leading, equitable service to populations and individuals.

We hope this article provided you with some insights and inspiration on how you can progress in your nursing career especially if you are in the same area as Eduardo. Always remember that you possess not only technical nursing skills but also soft skills that you can transfer to a job with a similar background.

Whatever path you may choose, be it a specialist, ward or special area staff, be proud of who you are and what you have achieved. Because at the end of the day, we are nurses, working at the heart of the healthcare system for our patients always aiming to achieve the best outcomes.