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As a paediatric continence advisor I see children aged 0-16 suffering from bowel or bladder problems. This can include anything from babies born with severe and potentially life-threatening congenital bladder or bowel abnormalities, to toddlers struggling with potty training or teenagers devastated by bedwetting.
I originally worked as a special school nurse at a time when children were left in nappies if it was thought they could not be toilet trained. This sparked my interest in continence promotion as I was sure we could do better for them. At this time, paediatric continence promotion services did not exist; all that was in place was a 'free' nappy service. Over the years we have succeeded in improving the way we manage children with continence problems and about 15 years ago I developed one of the first nurse-led paediatric continence promotion services.
I now work two days a week as a Paediatric Continence Advisor and the rest of the week as Director of PromoCon based at Disabled Living in Manchester. PromoCon provides impartial advice and information relating to continence aids, products and services and is involved with grant-funded projects from the Department of Health and elsewhere, giving a national perspective to our work.
No two days are the same and I find I learn something new with every family I meet. It is important to work effectively as part of a multi-disciplinary team. For example, one of my current projects involves working with staff from the Autistic Spectrum Disorder Pathway to help develop toilet training programmes for children with autism.
What I like most about my job is the difference we can make, not only to children's lives but to those of their families as well. Although my job is very rewarding it can be challenging too. However, seeing the smile on a child's face makes it all feel worthwhile. Sometimes the child is too shy or embarrassed to speak to us so this is a really good sign that they are starting to make progress.
I have recently been involved in the case of a 5-year-old schoolboy, still in nappies because of a longstanding problem with constipation and soiling. Despite the family having consulted various professionals over the years there had still been no improvement. After introducing a more appropriate treatment and engaging with the child, progress soon started to be made. Happily, he is now out of nappies and opening his bowels appropriately on the toilet. Ensuring that the child is receiving the right treatment is only half of the story. Equally as important is working with the child and their family, on a one to one basis. This is where Paediatric Continence Advisors can really help make a positive difference to treatment outcomes.
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