A Day in the Life . . .
Lynsey Bissell has been in her job at MFS for six months now. As a brand new role, the detail of the job description for the clinical administrator was yet to be written, but already Lynsey’s days are filled to the max, constantly varied and still the role continues to evolve. Even working 8.30am-5.00pm, Monday through Friday, her days are anything but routine.
By 8.45am Lynsey is working her way through the 43 emails and phone messages the clinical team has received from current patients since 6.00pm yesterday. This vital function really defines the main characteristic of the clinical administrator’s role – to act as a bridge between patient enquiries and the nurses and doctors, and to provide patients with a quick response.
Lynsey pulls the patients’ files for all the enquiries and assesses which she can answer and which need to be referred to one of the fertility nurse specialists or a doctor. This morning’s enquiries include Mrs K wanting to know which needle she should use for her hCG injection tonight and Ms L who has phoned in, as planned, to confirm her LH surge in advance of her IUI insemination. Lynsey is able to handle both queries and reassure the patients about what they need to do next.
“Essentially I can answer any enquiry which doesn’t need specific clinical advice, or which are not about fertility drugs and drug protocols,” she explains. “Instead of patients having to wait for a call from a nurse or doctor between their appointments, I can help patients with queries about whether test results are available, or booking scan appointments for patients who call in with a positive pregnancy test result, or spend some time with them on the phone if they call in with a negative result and then book a follow-up appointment for them.
“I make a note of any contact I’ve had with the patient in their notes and file any emails they have sent so there are no gaps in the contact they’ve had with the unit.”
Today is a busy Tuesday with five egg collections scheduled for the morning and four embryo transfers in the afternoon diary. Before patients leave the unit following their egg collections , Lynsey prepares their discharge letters, detailing the number of eggs, their medication, confirming the time and date of their embryo transfer and providing any specific additional advice requested by the nurse or doctor responsible for their care.
“I first joined MFS in June 2008 as one of the secretaries, so I’m familiar with the number and types of letters needed to keep patients informed of each stage of their treatment. But now I’m based at the nurses’ station I get to meet them at the start or end of their appointment, rather than knowing them only through the letters I prepare for them and file in their notes.”
As well as the standard egg collection discharge letters, Lynsey also produces urgent one-off letters requested by the clinical team. Dr Adi has completed an egg collection but noted that the patient has a polyp which needs to be removed before she can go ahead with her embryo transfer , as it could affect the implantation process. Lynsey writes a letter to the hospital consultant requesting that the polyp is removed and confirming that all the embryos will be frozen until this has been completed.
Between writing the letters and booking appointments, some of the calls Lynsey takes are from patients phoning in the results of their pregnancy tests. “They can be some of the most lovely and some of the hardest calls I take,” she says.
“It’s fantastic to get news of the positive results and to hear the total happiness in the patient’s voice as she tells me she’s pregnant and I book the scan appointment for two weeks time. When it’s a negative result patients can either be really angry, or terribly upset, sometimes totally deflated and even a little confused – and sometimes a bit of all of these. But if I can spend some time with them on the phone and arrange a date for a follow-up appointment or even offer them the counselling service, I hope I can make things just a little better for them.”
The day’s blood results are passed to Lynsey and she presents them to Dr Adi to be signed off before filing in patient’s notes ready for their next appointments. Two of the nurses are waiting for test results so they can plan the next stage of their patients’ treatment and Lynsey lets them know they are now available.
By 1.00pm all the egg collections are all complete and the patients have been discharged, so she joins some of her colleagues in the staff room for lunch. Immediately afterwards she prepares the paperwork for the weekly nurses meeting, for which she takes the notes.
This week the team are reviewing new consent forms about donor anonymity and the development of the HFEA Donor Sibling Link.
“I graduated with a law degree and so am interested in how the unit operates within the terms of the HFE Act and the impact of this on the day to day running of the unit – and of course, how it affects patients,” said Lynsey.
Before she begins her afternoon appointments, nurse manager Mandy Godwin, briefs Lynsey on some changes that are needed on the Data Management System (DMS) diary. As a DMS ‘super-user’ Lynsey can change patient appointments and also programme the diary to indicate when clinical staff are unavailable for appointments because of annual leave or training events. Having someone to manage the administration function means the nurses have more patient contact time.
“Eventually the patients’ notes will all be electronic and join-up with the DMS diary system. The finance team will also use it to generate invoices based on the appointments each patient has. In preparation of this I make a note of any patients who have not arrived for their appointments so that their notes are up to date and the system knows that they will need a repeat appointment in the future.”
Once all the letters for the afternoon embryo transfer patients have been issued, Lynsey checks over the day’s referral letters from consultants, before allocating appointments to the patients. “All patients have access to all the clinical team, but if woman cancer patient is referred to MFS for fertility preservation treatment I need to act fast and make sure she receives an appointment within 24 hours with one of the dedicated egg freeze team. If she has had unsuccessful treatment cycles at another clinic or if one of the couple has a condition which could make their treatment particularly complicated, such as a bicornuate uterus or a previous history of testicular cancer, I may need to make their initial consultation appointment with a specific member of the clinical team.”
Towards the end of the afternoon Lynsey completes one of her favourite tasks – confirming the day’s pregnancy test results with the information analyst, Jo Patel. “Today I’ve had six results, two positives and four negatives. One of the positives was for a couple who has had three egg collections and four embryo transfers in the last three years, so this is brilliant news.
“The other positive was from a patient who called on Friday to say she’d had a negative result and she was really upset, but this morning the blue line is really strong. She came into the unit this afternoon for a sensitive test so we could double-check the results and she was ecstatic when fertility nurse specialist Tracey Lewis confirmed that she really was pregnant! We’ll see her again in two weeks for her scan to see if she’s expecting one or two babies.”
“I’ve previously worked in training and HR admin at other companies and although I enjoyed being a part of the MFS office team and occasionally working on reception, my new role allows me to be more involved in the clinical activity of the unit, and to see many more patients face to face. It’s my perfect job.
“I’ve planned about 60% of the work I have to do tomorrow, but as ever the other 40% will be in response to the calls I get or the emails I receive – but that’s the way I like it. I just wish there were a few more hours in the day to finish the other 20%!”