IBD Nurse Specialist Ana Explores Apps for Self-Management

Hello, my name is Ana Ibarra and I'm an IBD Clinical Nurse Specialist, originally from Spain but currently living in London and working at The Royal London Hospital, which is part of Barts Health NHS trust. I have worked in the health sector since 2011. Just after I graduated, I moved to the UK and my first job was as an agency nurse in a Gastroenterology ward. My interest has always been in gastroenterology since I was a student. I knew that I wanted to work for the NHS and so as soon as I could, I applied for a job in an Endoscopy Unit, where I met many patients with Crohn's or Colitis, mostly newly diagnosed.  I realised very quickly working there how much I could contribute working within Inflammatory Bowel Disease (IBD). 

Luck was on my side when a job was being offered to start working in, at the time, a pretty small but powerful team. I was going to become a specialist nurse in an area which I knew I was going to love and I could not wait to start the job. The team helped me become who I am today, I had all the opportunities in the world to learn new things and attend different conferences and educational meetings. I was working (in my opinion) with the elite, so I worked (and still work) very hard to make sure we continue to offer the best care we can.

I have been an IBD Nurse Specialist for almost six years now and I am grateful to work in an IBD centre where I am part of a big multidisciplinary team, including doctors, surgeons, radiologists, nurses, pharmacists, dieticians and psychologists. 

As an IBD Nurse Specialist, I work very closely with the team and on a regular day I will have interactions with patients on the ward, within outpatients, over the telephone and in our biologics infusion and injections services. Being admitted to the hospital with Crohn’s or Colitis can be a very worrying time.  I support patients while they are hospitalised to try and help them make decisions, provide education and play an advocacy role for them.

We play a key role in delivering biological therapies, from helping patients decide which therapy is more suitable for them, to teaching them how to administer it, or administering the treatment for them.

I also see patients independently in outpatient clinics. I see them for all sorts of reasons, from being newly diagnosed to learning how to self-manage their condition. I provide them support when they start new treatments, organise appropriate investigations and educate them around lifestyle.

At The Royal London, we also have telephone appointments as an alternative to face-to-face appointments. These can be very useful for patients, as this means they don’t have to travel to see us, but we can still give them the same level of support. I strongly believe in patient centred care, particularly as Crohn’s and Colitis are lifelong.

In my first interview six years ago, I mentioned to the panel that as I wanted to develop an app. I was and still am convinced that we should use e-health technology to improve IBD care and its management.

Once again I was very lucky as at the end of December 2018 I was offered to start working with MyIBD Care app. MyIBD Care is a smart and clinically driven digital therapy solution for patients with IBD to deliver care, promote self-management and empower patients with IBD.

I have been involved in testing the app, in patient's feedback, in developing pathways and ways to introduce this new and completely different way of taking care of our patients.

Using technology as part of the care we provide will mean a much more flexible service that reflects the nature of Crohn’s and Colitis. It will mean less time off work, university, or college, as well as less time travelling for patients. This will allow us to manage more patients by maintaining the same quality of care. The app will enhance communication and patients will be in much more control of their condition, acting upon how they are rather than waiting for an appointment with the specialist or their GP. 

Unfortunately, there are no benefits without risks. In the NHS, we have a model that has been going on for over 50 years and despite being overworked and short staffed a lot of the time, it has worked well. Through apps, less face-to-face contact will mean having a different relationship with our patients. This could lead to more difficult conversations with them, especially if the bond we have changes by not seeing them in clinic as often.

All of these are things that we constantly think about to make sure the introduction of an app works in the best interest not only for our service but also for our patients. That is why we work very closely with patients to work together to decide what is best for them.

MyIBD Care is a massive project for me and it can be quite challenging, especially at the beginning when I had to find new ideas, meet new people, and ask patients for feedback. The most challenging thing is trying to change the way we are currently working but despite all of this, I enjoy the work thoroughly and feel amazing in taking part in what I believe is the future.

Working as an IBD Nurse Specialist is an incredibly rewarding job. I have amazing relationships with my patients - we help each other and learn from each other everyday. I have grown massively as a person and I could not be more grateful for the job that I have.

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September 2019