Ambu Celebrates Urology Nurses and Associates Week
Ambu celebrates Urology Nurses and Associates Week with this special section of articles that highlight the important work, challenges and future of these vital healthcare professionals. Please share this page to help us give them some well-deserved recognition.
Urology Nurses and Associates Week: Celebrating Urology Nurses for Their Patient Care and Education
The Society of Urologic Nurses and Associates (SUNA) is celebrating those healthcare workers the week of Nov. 1-7 for their work with patients of all ages, in a variety of settings – and their dedication to patient safety is in the spotlight like never before thanks to the COVID-19 pandemic.
Urology nurses and associates have jobs that require not only a deep wellspring of clinical skills. They also perform their work with high levels of compassion and discretion due to the sometimes uncomfortable topics they must help patients navigate. 
“Urology nurses and associates deserve the highest recognition for their amazing contributions and never-ceasing commitment to their patients,” said Amy Hull, president of the Society of Urologic Nurses and Associates in a letter to celebrate Urology Nurses and Associates Week. “Urology healthcare professionals treat men, women and children who experience a variety of urologic diseases and conditions, and these experts are highly adept at providing guidance and treatment to patients who often require complicated sub-specialty care.”
Here’s a list of frequently asked questions about these professionals and the important work they do.
What do urology nurses do?
Urology is a broad term, and urology nurses can specialize in any of a dozen practice areas to assist patients and medical staff with problems related to the urinary tract and reproductive organs and processes. These professionals administer tests, document vital signs, participate in check-ups, assist with surgeries, and diagnose and treat problems such as infections, kidney stones and cancer. They also educate patients and their families on illnesses, expectations for recovery and prevention measures.
Who are their patients?
Urology nurses may work with specific age groups or genders or help with patients of all ages and categories who need care for urological issues such as prostrate problems, kidney stones, incontinence and reproductive problems. They share many of the same responsibilities as medical staff, and because of their expertise and knowledge, often work independently or under minimal supervision.
Where do urology nurses work?
Urology nurses are found in hospitals, fertility centers, outpatient facilities and doctors’ offices. They may assist medical staff outside of urology, sometimes helping surgeons, intensive care workers and cancer specialists with procedures including biopsies, catheter insertions and scans. In the case of pediatric urology, they may also work closely with pediatric staff.
What are their biggest challenges?
Urology nurses help treat patients who may feel uncomfortable or embarrassed about their symptoms. That means nurses must be skilled at making people feel at ease discussing uncomfortable topics maturely. They also need to be observant so they can identify patient problems from sometimes vague descriptions. Being compassionate and discreet are key job requirements.
What are the education requirements to be a urology nurse?
Requirements vary by location and credential type, but a nursing certification such as a licensed practical nurse or nurse practitioner is needed. Individual states may require specific education or field work for these certificates.
What innovations are occurring in the field?
Among the innovations and new technology in the field are advances in laparoscopy, robotic surgery and digital imaging that offer increased precision. Telesurgery enables surgeons at remote locations to be trained by videoconferencing. There are new forms of cryosurgery (using a local application of intense cold to destroy unwanted tissue), while brachytherapy uses radioactive “seed” implants to help patients with low-grade tumors.
A recent meeting of the European Association of Urology Nurses included such agenda topics as ephrostomy care, catheter troubleshooting, bladder irrigation, manual washouts, uroflowmetry, bladder scanning, stoma care and flexible cystoscopy.
Urology Nurses and Associates Week: Advanced Practice Providers Seen Filling Projected Urologist Void
The Society of Urologic Nurses and Associates (SUNA) is celebrating Urology Nurses and Associates Week. This annual event, held Nov. 1-7, provides an opportunity for employers and patients to recognize the important work of urology nurses in caring for patients of all ages.
And, as the number of private practice urologists across the U.S. declines, the role of advanced practice providers – especially nurse practitioners – will be even more important in private practice urology.
“[Urologists are] retiring at a much great rate than we see residents coming into urology and achieving certification,” Diane Neuman, a nurse practitioner, said in an April 2020 presentation on the future of urology. “We’re going to need those advanced practice providers, especially in rural areas where you don't have urologists. We also are going to need them to be able, especially nurse practitioners, to practice to the full of their capabilities.”
The American Association of Clinical Urologists is projecting a shortage of 130,000 physicians by 2025, and half of this shortage is expected to be of specialty physicians like urologists. The organization also reports the average age of a urologist is 52, and close to half of urologists are 55 and older.
As the general population ages and the demand for urologists increases, advanced practice providers such as nurse practitioners and physicians’ assistants are expected to fill in the void left by retiring urologists.
Nurse practitioners in urology may work with patients to diagnose and prescribe treatment for a variety of urinary tract issues or problems with the bladder or kidneys. Unlike registered nurses, nurse practitioners can prescribe medicine, order medical tests, and refer patients to other specialists when required.
For private practice urology, there is now a push for nurse practitioners to have formal training in cystoscopy, to address the decreasing number of physicians as the general population ages and demand for urologists will increase. SUNA recently developed an official training program for nurse practitioners to learn cystoscopy.
Similarly, the American Urological Association (AUA) has advocated for advanced specialty training for nurse practitioners in urology.
The AUA supports a collaborative approach to patient care when it comes to advanced practice providers and physicians, according to a 2015 consensus statement on the subject.
There were more than 3,000 practicing nurse practitioners in private practice urology in 2012, according to the latest statistics from the AUA. In Nov. 2013, 62 percent of private practice urologists reported having advanced practice providers working in their offices.
“We're going to need more and more urologists, but that is probably not going to be the case,” Neuman said in her spring lecture, “NPs and PAs: The Future of Urology.”
“What you're going to see is that growth of the advanced practice provider, that nurse practitioner or physician assistant will grow in these urology practices,” she added.
Urology Nurses and Associates Week: How Urologic Nurses are Adapting Through the Pandemic
All members of the healthcare community showed the ability to adapt on the fly throughout the COVID-19 pandemic.
Urology nurses are no exception.
The University of Oklahoma Health Sciences Center Urology outpatient clinic operations previously saw 100 percent of its patients in person, but for a stretch of approximately six weeks, 90 percent were suddenly seen remotely.
Glenn Sulley, writing in a guest editorial in the Urologic Nursing Journal, noted that he and his colleagues “were fortunate to remain in operation.” In surrounding areas, nurses were furloughed or redeployed to directly aid in COVID-19 relief.
The telehealth transition meant learning new IT skills to make telemedicine possible and revolutionize how care is provided. High-tech barriers needed to be overcome – many elderly patients were either uncomfortable with it initially or didn’t have access to the technology. As elective surgeries and in-office procedures were postponed, routine tasks like catheter changes were deferred to home health agencies.
“The tribulations were not necessarily unique to urology, but they obviously impacted the way urology services could be provided going forward,” Sulley wrote.
Screening protocols were implemented and new requirements regarding personal protective equipment were added for in-office procedures.
Teams at the clinic worked alternative weekly shifts in clinic “supporting screening, triage, and ongoing clinical operations.” When working remotely from home, they supported scheduling of virtual visits and administrative tasks.
Sulley, a nurse manager at his institution, is the director-at-large for the Society of Urologic Nurses and Associates.
Urology Nurses and Associates Week: How a Damaged Reusable Cystoscope Was Traced to UTI Cases
A single damaged cystoscope resulted in 11 patients presenting with Pseudomonas aeruginosa urinary tract infections over a span of nine months.
The incidence of urinary tract infections after flexible cystoscopy ranges from 2 percent to 21.2 percent, according to various studies. But cystoscopy-related outbreaks have been scarcely reported, so “the risk of patient contamination through cystoscopy is poorly known.”
The research, presented in the American Journal of Infection Control, examines an outbreak from several years earlier that followed outpatient flexible cystoscopies. The four reusable cystoscopes used in the institution’s urology consultation would be hand-cleaned and disinfected after each use according to national recommendations.
Microbiological controls were performed at least annually and before reuse after a scope received maintenance. Between July 7, 2015, and May 31, 2016, 389 patients underwent cystoscopies, including 104 who were examined using “cystoscopy number 419.” Every Pseudomonas aeruginosa urinary tract infection could be traced back to it. Three other cystoscopes were used on the remaining 284 patients with no documented infections.
On July 1, 2016, “cystoscope number 419” was sampled and two types of Pseudomonas aeruginosa were identified. It was returned to its manufacturer where it was found to have a channel scratch. The infection-causing bacteria was “probably in biofilm attached on to the channel scratch, which allowed it to resist disinfectants,” according to the researchers.
This is common in other areas of endoscopy, and several outbreaks following bronchoscopy have been “associated with the use of a damaged device, inadequate disinfection, and manufacturing defect.”
The rate of Pseudomonas aeruginosa urinary tract infection caused by the contaminated cystoscope exceeded 10 percent, but the others assume the true number to be higher because of the difficulty to follow up with outpatients. Additionally, benign infections such as UTIs are often untreated.
“This situation underlines the interest to record every cystoscopy procedure and to perform a medical feedback for urinary or infectious symptoms in the month after cystoscopy for inpatients and outpatients,” the article reads.
The authors conclude: “The example of this outbreak urges us not to trivialize UTI occurring after an elective cystoscopy. Patients should be advised to signal the occurrence of urologic symptoms after urologic exploration.”
