Community-based vasectomy services: from medical to holistic care
The Sandyford Initiative, Glasgow, UK
Introduction: The vasectomy service within the Sandyford Initiative,
Reproductive and Sexual Health Centre, Glasgow has traditionally been
medically-led, with medical staff performing both the counselling and operating
sessions. It was felt that the service could be more holistically driven, by
improving the surroundings and increasing the input from family planning nurses.
Method: Five designated FP nurses attended in-house training, to give
them an overview of the procedure, it’s complications and failure rates and
completed a short supervised practice session prior to staffing individual
clinics. The nurses counselled the client and obtained written consent, but did
not perform scrotal examination. ‘De-medicalisation’ during the procedure
itself was also improved with background music and, after consultation with the
Trust infection control team, green operating gowns were replaced with plastic
aprons and no masks were worn. Clients were audited during a one-month period
for their views on the counselling and operative visit.
Results: 66 attended for counselling all of which completed
questionnaires (100%). All reported the reception and counselling staff to be
courteous with the length of appointment (20 mins) adequate and the information
given comprehensive. 43 had a female nurse counsellor and all felt comfortable
with this. 85 attended for vasectomy and all completed questionnaires (100%). 83
felt the counselling prepared them for the procedure with 27 stating the
discomfort was as expected, 53 less and 5 worse than expected. All clients who
wished background music (30) felt it was useful in distracting them but only 4
of the 23 clients who chose not to have background music felt afterwards that it
may have been useful. 5 clients asked for their partners to be present and this
was agreed by the surgeon involved.
Conclusion: It is possible to provide a more holistic vasectomy
service without compromising on the level of medical care received. The
introduction of a nurse led vasectomy counselling service in a holistic setting
led to a high level of client satisfaction.