Nicola Burgess is a Nurse Endoscopist at Noble's Hospital in the Isle of Man.

What attracted you to a career in gastroenterology/hepatology?

Honestly I came to Endoscopy completely by accident, my family relocated to the Midlands and I needed more family friendly hours (previously I had worked on a Surgical Urology ward following my qualification). When I was looking at job options locally, the Endoscopy Unit at Princess Royal Hospital in Telford looked the most interesting as it was still very hands on Clinical work but the shifts would fit – I was very honest with the manager about my motivations but she suggested we should ‘suck it and see’ and if it didn’t suit me then I could always look at other options. Months later, she told me it was like watching a duck take to water! I loved the technical aspects of the work, I quickly read everything I could on the subject as well as every technical manual I could get my hands on, and I discovered that my long term crafting hobbies translated to good fine motor skills and an aptitude with the delicate equipment. My long term challenges with Dyslexia (I qualified as a mature student having never been very successful in school) actually gave me a different skill set. I’ve since worked on Endoscopy at Royal Lancaster Infirmary and for over 10 years at Noble’s Hospital in the Isle of Man. Endoscopy quickly became a passion - my family would probably say a bit of an obsession, so being able to train as an Endoscopist, despite the additional workload, has been the fulfilment of a long held ambition and has given me my dream job.

What advancement in gastroenterology/hepatology are you most excited about and why?

My job role is purely in Endoscopy with the specialist nurses already in place to support the GI service, so although I keep abreast of the speciality, I tend to be more focused on the Endoscopy service. On the Island, we tend to deliver the more standard Endoscopic procedures as our population is 85k with more complex cases being transferred to hospitals ‘across’ (in the UK), however we have still seen many improvements in the delivery of Endoscopic care during my time here. I always get quite excited about technical advances (I’ve always enjoyed the process of introducing new equipment and devolving training to our staff, and as an Endoscopist learning my new role has given me insight into other factors in this development process). On the Island, we are beginning a procurement process to replace our older equipment, which is likely to bring the use of AI which will be yet another learning process, but with such scope for diagnostic improvements. AI technologies and improved image quality seem to be the biggest advances for me as I still remember the old fiberoptic (look down) Sigmoidoscopes with OVC convertors. I think as my job role is as an upper and lower GI Endoscopist, any technology that can assist with diagnostic accuracy excites my inner geek!

What do you enjoy most about your work?

I really enjoy all aspects of being an Endoscopist, as I loved being an Endoscopy Nurse for so long - I think the combination of patient contact, technical skills, and a close team is what I find most appealing. My motivation in my new role continues to be local service improvement. I am particularly aware that there has been an ongoing challenge for adequate service provision to meet increasing demand. Our service depends largely on surgical colleagues with one Gastroenterologist to cover the hospital, so by introducing a Nurse Endoscopist, role we are able to create a real service improvement in terms of availability. Having been able to move to a larger purpose-built unit, increasing the staffing, and now providing extra capacity with my qualification, it feels like the future for Endoscopy on the Island is on the right track. By completing the training whilst being Island-based (albeit with some commuting ‘across’), we have proved that it is an achievable goal and I hope there will be another Nurse Endoscopist colleague in the future to work alongside me to continue improving the local service provision for patients.

What is the one thing you would change?

I would have loved the training to not have had some of the delays I’ve encountered – not being in the UK meant it’s taken time to get the local Manx Care Hospital Trust into the JAG system and this has had knock on delays for courses etc, plus of course Covid caused delays (the Island closed its borders as a protective measure), and I would definitely have changed that in favour of no pandemic!  However, I’ve identified the potential speed bumps which can be removed and that should improve things for all future trainees locally. I’ve had to be quite single minded to achieve this progress, but with the support of my team and manager and improving communication with UK hospitals, these issues shouldn’t remain.

What’s the best advice you’ve been given in your career?

Probably my original Endoscopy boss when she said to ‘suck it and see’ – I would likely have been too apprehensive to move from ward nursing to Endoscopy without that advice, it’s such a different and technical environment and I have always been a bit scared of change, my only ambition previously was to achieve my registration and work on a ward. By seeing beyond the straight career path, she set me on a much more interesting one that’s drawn on all my previous experiences – I had studied 3d design when I first left school and that tuition in thinking around structures albeit from an arty perspective has come in surprisingly useful in navigating scopes through the GI tract.

What does being a BSG member mean to you?

Being potentially quite isolated on the Island, becoming a member has increased my support network and allows me to access ongoing development, I’m already ‘attended’ the ‘Give us a clue’ course to improve my lesion recognition and management via Zoom which was brilliant and very interactive. With more online resources available via BSG, living more remotely is becoming less of a hurdle thankfully!

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