International Nurses Day 2023: Q&A with a DBS nurse

12 May 2023 marks International Nurses Day with this year’s theme being: Our Nurses. Our Future.

We know that people with Parkinson’s will see several health and care professionals throughout their Parkinson’s journey, especially if they receive additional therapies or treatment, such as Deep Brain Stimulation (DBS). 

This year, we spoke to Russell Mills, DBS Nurse Specialist at the Royal Victoria Infirmary (RVI) hospital in Newcastle, who shared insights into his role and why he’d recommend a career specialising in DBS and Parkinson’s.

Tell us about your role and how you support people with Parkinson’s. What does your day to day look like? 

I am part of a team of staff at the RVI at Newcastle, working with neurosurgeons, neurologists, neuropsychologists and several other allied health professionals (AHPs). Patients are referred into our service and are reviewed in clinic by a neurologist and myself. We will identify the patients who we think are good candidates for DBS surgery and then start the assessment process. This process has several stages, including question testing to assess how a patient responds with and without their Parkinson’s medication and an MRI scan of their brain. After all the assessments have been carried out, the multidisciplinary team (MDT) will come together to review and discuss the reports and decide whether DBS is suitable for that individual. As a DBS nurse, I am involved in the whole process and am often the person who patients will come to if they have any queries or worries.

Why did you decide to become a DBS nurse specialist? 

I qualified as a general nurse in 1989 and then began working in the neurology department at the RVI and am yet to leave! I began in my role as a DBS nurse in 2013 but prior to this I had been heavily involved in using medical devices and was familiar with the programmes. To begin with I mainly looked after patients with dystonia and tremor and I have gradually become more involved in caring for Parkinson’s patients.

I knew that after qualifying I wanted to work in a more specialist area. During my nurse training, I had looked after patients with neurological problems and that really interested me so I chose to pursue a career in this area. I’m lucky enough to have worked in the same department for over 34 years, alongside many other members of staff who are also still here so we’re a close team and know each other well. 

What's the best thing about being a DBS nurse?

I would say it’s seeing the positive outcomes for the patients. Often these are things that we may take for granted on a daily basis, like being able to get out of bed. In my role I will meet the patient at the beginning of their DBS journey and follow them to after they’ve had the surgery so it’s really rewarding from that perspective. I am also proud of how far technology has come in recent years. When I started, there wasn’t a vast amount of treatments available to people with Parkinson’s and so we’ve come a long way in a relatively short period. 

What is the hardest part of your role?

It’s always really difficult when you see people suffering because of a chronic illness such as Parkinson’s and this is often the case for the patients I meet, who may not have had access to other advanced therapies. It can be really difficult for them and their families and friends, so my job is always focused around trying to support them. Every case is treated on an individual basis and it’ll be different for each person.

Is it difficult when you and the team decide a patient isn’t a suitable candidate for DBS?

Again, it’s always going to be really disappointing to be told that news, but when the decision has been made for the right reasons and is in the person’s best interests, most patients will understand. We’re lucky at the RVI that we offer other alternative treatments and therapies, such as duodopa and so in some cases, we can offer the patient another treatment option. I always try to be honest with the person and ensure I’m delivering the message with compassion and care.  

This year’s theme for International Nurses Day 2023 is ‘Our Nurses. Our Future’, what does this mean to you?

It’s really nice to work alongside student nurses - it takes me back to the start of my early career! As someone with over 30 years experience in the field, I enjoy being able to pass on some of my knowledge and experience to the younger generation of nurses and it’s also lovely to watch a member of staff develop over the years too. 

When we talk about ‘Our Nurses. Our Future’, the word ‘progression’ comes to my mind as this is important for us too. This isn’t always easy when you’re working in a large hospital where there are tight costs to maintain but providing a clear progression pathway for staff helps to retain them in the long-term. My colleagues in the Deep Brain Stimulation Nurse Association (DBSNA) wrote a competency framework in collaboration with the Royal College of Nursing and the Parkinson’s Excellence Network. The framework outlines the competencies required by specialist nurses and AHPs working in DBS. This was a great step as prior to this, there wasn’t any written evidence to refer to for mine and other DBS nurses' roles. Myself and others on the DBSNA committee will be reviewing the competencies in the near future.

What would you say to someone thinking of a career as a DBS nurse or specialising in Parkinson’s?

I’d say definitely consider it. My advice would be to look for opportunities where you can, for example if you’re working in neurology try and get experience working with patients with Parkinson’s or other movement disorders. If you’re interested in seeing what we do, you could contact some DBS centres and see if there’s any opportunities to come and observe us. 

It’s such an interesting field to work in and also fairly small - the majority of nurses probably won’t come across our area of work but for those that do it is so rewarding. We offer treatments that will be life changing for many patients and which will have an extremely positive impact on their lives, and that is very special to be part of. 

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