09. Fertility, Oncofertility, and Endometriosis: Nursing in a Women's Health Sub-Specialty

UC San Diego Spring 2023 - UC San Diego Health Journal of Nursing: The Unique Power of Nursing Title 09. Fertility, Oncofertility, and Endometriosis: Nursing in a Women's Health Sub-Specialty Permalink https://escholarship.org/uc/item/25q95675 Journal UC San Diego Health Journal of Nursing, 16(1) Authors Arnold, Amanda, BSN, RN Stavang, Brooke, BSN, RN Publication Date 2023-04-01 Peer reviewed eScholarship.org Powered by the California Digital Library University of California or menstrual cycle irregularities. Our nursing staff plays a key role in ensuring patients receive a seamless experience navigating the clinic and broader health care system: patients receive immediate appointments (48-72 hours timeframe), schedules are coordinated around surgical and oncology appointments, information is reviewed during appointments in a clear and detailed manner, and assistance is provided helping patients maintain follow up with outgoing referrals. Looking forward, we have current research projects established to continue to build our Oncofertility program by accepting referrals from Rady Childrens Hospital, Eisenhower Health, Scripps Health, and expanding our own internal referral program within UCSDH. UC San Diego Health also houses our Center for Endometriosis Research Unique to Reproductive Endocrinology, UCSDH provides immediate medical options for patients with recent cancer diagnoses. Dr. Irene Su leads this program by providing extensive education on potential impacts on future short term and long-term fertility following radiation, surgery, and chemotherapy. In partnership with Reproductive Partners San Diego, patients can receive egg/ embryo freezing options to preserve fertility prior to treatment. Our team ensures referrals are made to facilities equipped to support patients facing financial burden while undergoing this process. The clinic also provides non or low hormonal contraceptive options when cancer treatment is determined to be the immediate priority. Patients with a history of pediatric cancers are also seen when they reach adolescence to treat and manage early stage menopause Fertility, Oncofertility, and Endometriosis: Nursing in a Women’s Health Sub-Specialty Amanda Arnold BSN, RN is a native San Diegan who received her Bachelors in Nursing (BSN) degree from San Diego State University in 2010. She has worked with infertility patients since 2011, working in private practice before joining UC San Diego Health as the Clinical Nurse Supervisor in 2016. In 2021, Amanda was a co-author of a research study on Endometriosis published in BMC Womens Health. She is a resident of Carlsbad and a mom of three. EXCEPTIONAL ADVANCES IN NURSING PRACTICE Authors: Amanda Arnold BSN, RN and Brooke Stavang BSN, RN The Department of Reproductive Endocrinology and Fertility (REF) is a subdivision of the Department of OB/GYN and Reproductive Medicine at UC San Diego Health (UCSDH). The clinic provides a variety of care for reproductive aged women facing issues with Infertility, Polycystic Ovary Syndrome (PCOS), Endometriosis, Fibroids, and a variety of reproductive disorders. In partnerships, Reproductive Endocrinologists work with a team of nurses to provide comprehensive care coordination and treatment within this highly specialized field. 29 Brooke Stavang, BSN, RN received her Bachelors in Nursing (BSN) degree from Azusa Pacific University in 2014. Brooke has worked with patients in the fertility field since 2015 starting as an IVF clinical coordinator in private practice. She has always had a passion for fertility, as she is an IVF baby herself. Brooke values relationship building and compassion needed for patients in the fertility field as well as the continual growth reproductive endocrinology has here at UCSDH. Brooke is a commuter from Dana Point, CA where she lives with her new husband and puppy. She has been happily working at USCDH since 2021. Program—a subspecialty that brings patients from around the country to treat women suffering from pelvic pain. Pelvic pain is a disease that can frequently go undiagnosed or misdiagnosed for long periods of time. Leading the Endometriosis team, Dr. Sanjay Agarwal and Dr. Antoni Duleba along with the nursing team provide multidisciplinary referrals to treat patients medically and holistically. Patients are connected with dietary, psychology, pain management and physical therapy to treat the disease’s inflammatory effects. It is a priority to provide our patients with medicinal and therapeutic options prior to surgery, as surgery may lead to additional scar tissue and longer recovery times. Dr. Duleba shares his expertise in this field by providing on site pain management therapy to desensitize specific trigger points for these patients. Our nursing team is highly trained in securing prior authorization requests for high cost medications that have been found to be highly successful in treating pelvic pain in a safe and minimally invasive way. This population is burdened by long- term pain and stress responses, and the REF team is diligent in providing frequent follow up. We have a specific goal of maintaining quality of life for these patients. Research on diagnosing and studying long term effects of endometriosis are ongoing, and patients within our clinic are frequently recruited to participate in hopes of finding a more effective cure for this debilitating disease. In collaboration with UC San Diego Health’s Gender Health Coordinators, our health system is able to provide information and treatment for transgender patients seeking reproductive medicine therapies. Some of the treatments that we offer include: 1. Fertility preservation options (egg and embryo freezing) and education prior to starting gender affirming hormone therapy 2. Menstrual suppression and 3. Hormonal replacement or suppression therapy. We partner with other clinics within the institution to provide gender affirmation surgery, electrolysis, and mental health support. Our team is proud of the equitable and inclusive care we deliver to all patients. Reproductive Endocrinology and Fertility is located at 9333 Genesee Avenue Suite 340. Our clinic is shared with UCSDH Men’s Health to treat our infertile male population. Our location is staffed with 3 bachelor degree prepared RNs and 1 LVN with extensive backgrounds in women’s health and reproductive medicine. As a team, we strive to provide nursing excellence and are committed to a culture that is caring and inspiring. UCSDH JOURNAL OF NURSING | SPRING 2023 30