Sterilisation counselling: a role for the gynaecology nurse-practitioner

A recent publication of an evidence-based clinical guideline for male and female sterilisation by the Royal College of Obstetrics and Gynaecology (RCOG) created a stimulus for a review of our female sterilisation service. We arranged for a gynaecology nurse-practitioner (A.O.) with extensive experience in general gynaecology and contraception to undergo additional training in counselling female sterilisation. She then took over the daily running of the sterilisation clinic using a care pathway and pre-printed letters. She had open access to a consultant (R.F.) for advice. A review of 100 consecutive referrals showed that the nurse followed the guidelines extremely closely both in terms of referral to the medical team for advice and/or further counselling and quality of documentation. A total of 59% of the women attending the clinic were cared for by the nurse-practitioner alone. Only four had to see a consultant. All women questioned expressed very positive comments about the style and content of counselling and just one stated she preferred to see a doctor.