Bowel Nurse - diagnostics

NHS Jobs; West of England; On-site; GBP 30,000 - 60,000; Full time

Job summary

NHS Jobs is seeking a qualified clinician to undertake comprehensive clinical assessments for patients with bladder and bowel problems. The role involves detailed history taking, pelvic floor assessment and DRE, and applying evidence-based guidelines to plan and deliver care tailored to individual needs.

You will manage caseloads, provide remote support where appropriate, and participate in anorectal physiology and bowel management planning under supervision.

Job description

Clinical assessment and care

Complete comprehensive, holistic clinical assessments of patients with bladder and bowel problems, taking a detailed history and using validated symptom and quality-of-life scores. Undertake intimate clinical examinations, including pelvic floor assessment and digital rectal examination (DRE), recording findings accurately and following evidence-based guidelines for care and clinical procedures. Assess, diagnose, plan and promote an excellent standard of bladder and bowel health for every patient, irrespective of age, ethnicity, gender, religion, disability or sexuality. Encourage patients to take ownership of their pelvic floor problem, supporting them to improve symptoms through education and engagement with treatment, self-help and lifestyle approaches. Observe, report and act on any changes in a patient's condition, using clinical judgement to recognise when action or escalation is required. Work within your own clinical competencies, following the agreed competency framework, and seek advice from colleagues within the service or from external sources when required.

Caseload, triage and telephone advice

Manage your daily patient caseload and appointments during your shift. Undertake telephone-based initial clinical assessments, and provide advice and follow-up by telephone and other remote methods to patients, carers and colleagues.

Anorectal physiology

Undertake a structured training programme in anorectal physiology, working under supervision until signed off as competent. Perform anorectal physiology tests, such as anorectal manometry and rectal sensation testing, and use the results to inform patient care. Once competent, run anorectal physiology clinics, including preparing patients, carrying out and recording tests, and producing accurate reports. Maintain, calibrate and clean equipment in line with infection prevention and manufacturer guidance.

Bowel management

Develop and review individualised bowel management plans, including dietary and lifestyle advice, fluid intake, toileting position and routine, and medication optimisation. Escalate complex cases to senior colleagues and seek medical advice where appropriate.

Biofeedback and pelvic floor rehabilitation

Learn and, once competent, deliver biofeedback-assisted pelvic floor and anorectal retraining for constipation, evacuation difficulty and faecal incontinence. Teach patients exercises and techniques, monitor progress and adjust treatment accordingly.

Transanal irrigation

Learn and, once competent, assess patients' suitability for transanal irrigation (TAI) and initiate treatment. Train patients and carers to use TAI systems safely and confidently, with follow-up to review effectiveness, troubleshoot problems and support long-term adherence. Recognise contraindications, complications and when to seek medical or senior advice.

Bladder care and urodynamics

Assess patients with bladder dysfunction and develop and review individualised bladder management plans, including fluid intake, toileting routine and lifestyle advice, escalating complex cases to senior colleagues. Learn and, once competent, perform urodynamic studies and use the results to inform patient care. Teach patients and carers specialist methods of bladder management, such as intermittent self-catheterisation (ISC), and review effectiveness and any complications. Maintain, calibrate and clean urodynamic equipment in line with infection prevention and manufacturer guidance.

Communication and relationships

Communicate effectively, assertively and non-judgementally with a diverse range of patients of differing ages, ethnicity, gender, religion, disability and sexuality, and with family members, carers and other members of the multidisciplinary team (MDT), including GPs when appropriate. Communicate sensitively about intimate and often distressing symptoms, showing an empathetic and compassionate approach and supporting informed choice and shared decision-making. Work collaboratively with colorectal surgeons, gastroenterologists, urologists, gynaecology, continence services, dietitians, physiotherapists, GPs and community teams. Contribute to MDT meetings and case discussions. Work with integrity and maintain patient confidentiality at all times.