Fertility Counsellor

Helping patients to

Deal with infertility and treatment, providing information, implications, support and therapeutic counsellingComprehend the medical factsUnderstand the alternativesChoose the course of actionUnderstand the legal aspects and implications of treatment to them and both potential and existing childrenMake the best possible adjustment to their infertility, and where necessary come to terms with treatment not working and continuing childlessnessDeal with cryopreservation of gametes due to cancer or gender reassignmentUnderstand the implications of donating or receiving eggs, sperm and embryosMake lifestyle changes, e.g. weight loss, giving up smoking

Key relationships

Administrators, Counsellors, Nurse Specialists, Clinical Scientists, Consultant Gynaecologists, Quality ManagerGeneral Manager, MatronUHL ethics committee, patient safety team.Other specialties [oncology, endocrinology, urology, genetics, EPAU, GAUExternal inspectorsInternational egg donation clinicsPatient and donor support groupsGPs

Patient care

Act as named counsellor for patients and their partners before, during and after treatment consultation.Ensure that the views of patients, or those speaking on their behalf, are well received; and that complaints, both formal and informal, are received courteously and responded to promptly in line with Trust guidelines.Maintain a good working environment in which patients receive a high standard of care.Assess patients to determine where there is a need for referral to specialist therapeutic counselling and make appropriate referral e.g. psychosexual, adoption, fostering, surrogacy.Maintain client confidentiality except in cases where the client is at risk of causing harm to either themselves or to others and refer on to specialist service where appropriate.Take responsibility for accepting referrals from GPs, hospital doctors and other health care professionals, prioritizing action accordingly.Maintain standards of care in accordance with BACP Code of Conduct and code of Ethics and Practice.Respectful, welcoming, supportive approach for inclusivity, e.g. correct use of pronouns and preferred names for transgender patients; organization of interpreter services.Take appropriate action when patients present with suicidal ideation or intent.Conduct welfare of the child assessments for existing and unborn child, and communicate any concerns to the team via reports to clinical review meeting and referral to tertiary parties as required (ethics committee, safeguarding, GP).Ensure patients have proper understanding of legal parenthood.

Communication with patients and donors

Elicit clients concerns and expectations, building rapport.Take and accurately document clients detailed family history.Interpret medical, family and psychological history.Confirm diagnostic information.Communicate test results and treatment information to patients and their partners.Receive and provide highly complex and possibly conflicting information.Identify and respond to emerging issues for the client or family.Identify changes of risk within the family.Take responsibility for communicating and applying new scientific information for the benefit of the individual/couple/family over an open-ended time frame.Interpret and communicate normal and abnormal test results to patients and health care professionals.Expertly communicate highly sensitive and potentially psychologically damaging information, which may cause high levels of distress e.g. giving a couple an abnormal test result, confirming that the use of own gametes is not possible.Communicate with patients whose treatment has failed or who are bereaved and provide support e.g. around loss of pregnancy or stillbirth.Following genetic counselling, help patients with genetic conditions to explore how this affects them psychologically.Offer support to prospective donors who are unsuitable to accept for donation.Implications counselling for donors considering removal of anonymity.Assist donor conceived people and families wanting information about donors and half siblings from the register.Liaison with relevant colleagues in arranging an evacuation of uterus following an abnormal ultrasound scan result.Support patients of deceased partners who have previously stored gametesUse non-directive and other counselling skills to counsel patients about various treatment options and to facilitate decision making.Identify and manage conflict within couples created by sensitive treatment management options information.Manage conflict when patients demands are incompatible to professional responsibilities and resources.Deal with patients who have great difficulty accepting a clinical diagnosis or an infertility test result.Use counselling skills to communicate sensitively in the presence of language, cultural and/or medical issues, or when dealing with cases where there is antagonism and/or highly sensitive atmosphere, e.g. in the presence of a complex ethical, cultural or psychiatric issue.Facilitate the development of patient information leaflets.

Communication with Colleagues

Ensure good communication with counsellors to facilitate provision of a safe, effective service, where staff are well supported.Liaise with laboratory colleagues regarding tests and their interpretation.Liaise with other laboratories and departments to obtain and provide information.Liaise with colleagues in other Assisted Reproduction centres to obtain and provide information and to establish understanding and cooperation.Discuss cases with clinical or ethical complexity with colleagues where appropriate.Challenge negative attitudes/ practice.Liaising with donor coordinators and HFEA for requests to open the donor register.

Governance

Responsible for ensuring appropriate systems are in place to evidence ongoing compliance of counselling provision with local and national policies as required for HFEA, CQC, BICA, BFS, and ISO 9001 standards. Represent counselling service at inspection to support maintenance of HFEA licence and ISO 9001 certification.To attend and contribute to departmental meetings.To actively promote effective clinical governance within the Assisted Conception Unit and UHL NHS Trust.To ensure that the recommendations of relevant professional and national bodies related to fertility counselling are disseminated to staff and that the best practice identified is adopted by the department.Encourage survey return; continually review uptake and performance against KPIs, proactively addressing areas of concern and undertaking audits as required.Conduct regular protocol review and staff competency assessments.Support the quality manager with complaints/ incident reporting and corrective actions.

Educational Activities

Prepare and present scientific articles in the clinical and departmental journal clubs.Participate in the teaching of infertility issues and counselling to other professionals.Act as an educational resource for medical and other personnel attached to the Assisted Conception Unit team.

Continued Professional Development

Complete Trust induction process, engage in annual appraisal.To achieve and maintain own registration as a fertility counsellor.Take personal responsibility for continuing professional self-development and keep up to date with changes in the practice of fertility counselling.Attend regular clinical/counselling peer supervision sessions as provided by the unit or as arranged individually in line with BICA guidance.Actively participate in local, regional and national networking and relevant professional bodies to maintain and develop expert knowledge in the speciality.Actively promote the training of fertility counsellors.Maintain up to date knowledge of professional issues for instance by membership on appropriate working parties/committees.Complete all statutory and mandatory training as required by the CBU/Trust.Support the introduction of new procedures/ technology for service improvements.

Information Resources

Ensure all clinical documents are up-to-date, accurate, contemporaneous, legible and appropriately filed.Take minutes of meetings as required.Diary management, accurately record data on patient information systemsEnsure that in house databases are used effectively and developed according to service need thus facilitating provision of local and national data requirements.Provide summaries of workload and reports as required to manage systems of evaluation including quantitative and qualitative data.Redaction of donor codes for patient facing information.Support use of paperless working when possible.

Research

Access and critically appraise research findings and literature reviews relating to clinical practice and modify practice accordingly.UHL has strong links with local universities and there are opportunities for the postholder to initiate and participate in research as part of their continued professional development.

Health & Safety

Support the implementation of annual CMG H&S action plans.Provide safe environment for employees, patients and visitors; stagger lunch breaks.Ensure staff understand and comply with legal H&S obligations at work.Report any accidents, verbal abuse.Assist quality manager with risk assessments.