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A day in the life of...A BPAS nurse manager

Carol Gough

My day starts at 8am with a 10-minute car journey to work. Located in the Warwick Green Belt, the Blackdown Clinic is a beautiful old house with views over the River Avon. It is surrounded by extensive grounds, which are well used by the local rabbit population.

The Blackdown Clinic has been providing an abortion service for more than 28 years. It was the first midlands British Pregnancy Advisory Service (BPAS) clinic to open; now we have a widespread network of clinics, daycare centres and consultation centres throughout the country. At the Blackdown Clinic we offer a range of abortion ­services including early medical abortion and procedures under both local and general ­anaesthetic. We also carry out vasectomies and sterilisations.

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We try to provide a service that is sensitive to the needs of all the different women we see. There is no typical woman who has an abortion at BPAS clinics.
People tend to think of unwanted pregnancy as a ­problem for young, single women. But we see all kinds of women from all manner of social backgrounds - many are mothers, most are ­accompanied by a partner, some have travelled from places, such as Ireland, where abortion is not an option. Some women want to talk about their circumstances; others don't want to reveal any more than necessary.
An increasing number of clients have their treatment paid for by the NHS under "agency arrangements". This is particularly good for women because it means they have the advantage of being cared for by BPAS specialist staff in a dedicated clinic - but they don't have to pay. However, because we run on a not-for-profit basis, even our private clients find the fees affordable.
I begin the day by checking the operating lists, ­updating and adding names as necessary, and then I send the lists for typing. I spend a few minutes at my desk before joining the rest of the staff at 8.30am for a team briefing. This briefing includes administration staff, theatre staff and admission nurses. We discuss the operating list, ­highlighting any items that need special attention from the doctors. This is the responsibility of the preparation nurse, who will chaperone the clients to theatre and inform the doctors when they arrive.
After the briefing, depending on where we are working, we set up our different areas and are ready for the clients to arrive.
If I am in admissions I will admit clients, checking through medical details such as venepuncture and ultrasound scanning. The client will have already attended an ­appointment at one of our consultation centres to have her pregnancy confirmed and to discuss which procedures are appropriate. She will also have gone through her medical history with a doctor and will have been asked about medical problems, current ­medication, allergies and ­sensitivities. It is my job to review this information with the client to make sure that everything is correct. I will also check the blood results for the client and inform them of their blood group and whether they are Rhesus positive or negative. The client's blood pressure, pulse and temperature are also taken at this point.
In addition, we try to encourage clients to ask any questions regarding the abortion. The consultation centre from where the client was referred would have counselled the client regarding her decision. When she felt ready an appointment for the treatment would have been booked. However, it is important that they feel they can ask ­questions.
By the time a client is ready for theatre, all paperwork and any preparation are complete to avoid any delays with the running of theatre.
In my role as the admitting nurse, I am responsible for answering medical queries that come from ­postoperative clients and any queries that come from the administration staff and consultation centres.
I will continue admitting until approximately midday, when clients who have opted for an early medical ­abortion start arriving. The paperwork for this procedure is set up, prescriptions signed and tablets administered before lunch. Once admissions are complete, discharging early surgical clients begins.
A late nurse will relieve me at 12.30pm, at which point I will go for a half-hour lunch break. I get to sit down with other members of staff from different departments, and we generally catch up with each other. Usually I'll find time for a chat with the clinic manager.
After lunch, the same process starts again. At some point in the afternoon, I may get a chance to visit my desk to catch up on office work like checking invoices, sorting out duty rotas, ordering drugs and other items that are on my desk.
I have worked for the BPAS for 12 years and am a level 1 registered nurse. I have two teenage children and a hospital-phobic husband. I work fulltime, although many staff at the BPAS are part-time. I have been nursing for 20 years and did work at the local hospital on a general women's ward until I left to have my children.
I saw an ad in the local paper for a ward nurse at the Blackdown clinic and have been here ever since. In my time here I?have moved from ward nurse to deputy nurse-in-charge to nurse-in-charge and finally to nurse manager. I have a team of 16 nurses, which includes ward nurses (level 1 and 2), theatre nurses and auxiliary nurses. As the nurse manager, I feel I have more input into decisions and the overall running of the clinic.
All the staff get on well together, and there is quite a hectic social scene outside working hours.
The BPAS is a good organisation to work for and there are lots of opportunities for personal development. I have been on numerous courses, including "Firstline managers", "Ultrasound scanning", "Violence and ­aggression", "Welcoming diversity", as well as many others.
We also have a very good network, and we can meet other nurse managers and other staff at all the clinics via the nurse managers' meetings, doctors' conferences and managers' conferences. I am also a member of the staff forum, which meets quarterly to discuss staff concerns. This is of great value to the clinic staff as I am their spokesperson and am able to discuss all their issues.
The BPAS has a very good support system and is concerned about all members of staff. If we have any queries or worries, we know that we can speak to our line managers in confidence.
I enjoy working for the BPAS and have a ­tremendous amount of job satisfaction. People ­imagine that we get bogged down with it all. But it is not like that - we have clients of all ages and from all walks of life coming to our clinic and everyone is treated equally.
Women never expect to need an abortion and often aren't sure what they'll find when they come to an abortion clinic. Often they're surprised because they expect to be "told off", or they expect a very depressed and sombre atmosphere. But it really isn't like that at all. We accept that abortion is a part of women's lives and it's not down to us to judge them. It's our job to make their experience as acceptable as possible. This job is valuable, especially when a client thanks you for helping them through a difficult ­decision. That's when you know it was all worth it.

The BPAS is Britain's largest provider of abortion services. Information about the BPAS and issues relating to unwanted pregnancy can be obtained online at www.bpas.org
There are currently nursing vacancies with BPAS throughout the country. For more information, contact Maggie Smith or Janet Kitchen on 01564 793 225 or email info@bpas.org