Star Alumni Series: Dr Nikki Cotterill and Improving Confidence in Continence

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The scholarship was phenomenal from start to finish. It provided such a breadth of learning that was needed at that stage of my career.

The modules were extremely empowering, stand-out learning opportunities as they enabled an exploration of my potential to be a leader, and understand how to be effective for the benefit of patients, colleagues, and the wider system.
Dr Nikki Cotterill
Dr Nikki COtterill
FNF Scholar

CONfidence IN CONTINENCE 

I am an Associate Professor of Nursing with a focus on Continence Care at University of the West of England. I am also the Continence Lead for North Bristol NHS Trust. Additionally, I am the Director for BABCON Health Integration team (Bladder and Bowel CONfidence), bringing a city and systemwide approach to improving the experience for all with bladder and bowel leakage.

I have worked in the field of continence research since 2003 and completed my PhD in 2009, which embedded the desire to bridge the gap between people who experience bladder and bowel symptoms and the available treatments and strategies that can help. This is such an overlooked area, and I am determined to raise the profile to improve outcomes for all those affected. In truth, continence found me rather than me seeking a post associated with bladder and bowel care. From the outset, I was struck by the impact of bladder and bowel leakage on everyday lives and the hidden nature of these symptoms.

NURSING LIT MY FIRE

I undertook my nursing degree as a natural progression following school and had always known that I would work in healthcare, given my unwavering interest in everything related to health. Undertaking a nursing degree opened my eyes to nursing research as the whole of the fourth year was dedicated to conducting a research project alongside completing practical training. Conducting that research project truly lit the fire for me to pursue research. After consolidating my training with acute medical and surgical posts, I sought a career in nursing research.

EMERGING LEADERS SCHOLARSHIP PROGRAMME

I attended the Emerging Leaders Scholarship programme that commenced in March 2019, sponsored by HEE Kent, Surrey and Sussex and under the fantastic mentorship of Joanne Bosanquet, CEO of the Foundation of Nursing Studies.

The scholarship was phenomenal from start to finish. It provided such a breadth of learning that was needed at that stage of my career. The leadership module, provided by the King’s Fund, was a fantastic foundation and I also undertook the Leading Through Influence residential with Ashridge Hult. These were both extremely empowering, stand-out learning opportunities as they enabled an exploration of my potential to be a leader and understand how to be effective for the benefit of patients, colleagues, and the wider system.

As I had a particular interest in understanding the route to impact for the research I undertake, I also pursued political learning opportunities provided by the Parliamentary Office of Science and Technology in addition to the module provided by Eden and Partners, to navigate the health and social care landscape. The latter was particularly informative in helping me to consider the ‘so what’ of all that I do.

By far the most enlightening aspect of my scholarship was the realignment with my nursing profession that occurred across the year. Nursing academics carve a difficult path and do not follow a well-trodden route to achieve their successes. I was fortunate to have had excellent supervision throughout my career through medical and academic colleagues who made it possible for me to flourish. The scholarship enabled me to recognise what this means through a nursing lens, to contribute to my profession and champion this career path going forward.

MY QUALITY IMPROVEMENT PROJECT AND IT’S IMPACT

I applied for the Emerging Leaders Scholarship with a vision to develop the BABCON Health Integration Team (HIT) for my local area as an exemplar for national improvement. To initiate this process, I secured funding to lead engagement activities within my local area bringing together patients, carers, multidisciplinary health and social care staff, charity providers and commissioners, to focus on improving continence care, titled, ‘Best Bristol’. Key areas emerged for prioritisation including education for all and improved integration of services to better serve the people who move between them. An underpinning drive to promote continence was adopted, with recognition that this requires a higher profile nationally.

To date, BABCON has secured in excess of £100,000 focusing on specific projects such as continence education for children and adults, evaluating the impact of Covid-19 on continence services and has contributed to national reports to inform policy change. The opportunity to continue working with the Florence Nightingale Foundation, leading their continence policy work, has also been pivotal to the development of a self-help app to provide signposting, education and advice for people with bladder and bowel symptoms. The CONfidence app has just been shortlisted for a Nursing Times award for Continence Promotion and Care: https://www.bristolhealthpartners.org.uk/CONfidence-app.

THE LAST TABOO

Assumption is that bladder and bowel issues increase in old age, but anyone can be affected at any time. Children especially deal with a lot of issues. Every age has different challenges whether its the bladder or bowel. Bowel is so often overlooked because it’s the last taboo. You have to think about it very broadly and that it can affect people for many different reasons. A

My mantra is about making sure that people realise its not ‘just it’, but that treatments are available. The more we talk about it the more we realise that things can be done and that a much broader segment of the population than we imagine can be affected.

PREVENTATIVE MEASURES

Incontinence is often perceived as a women’s’ issue, however, although one of the common causes is childbirth, men can also experience incontinence following treatment for prostate cancer. Commonly men can find it hard to discuss health issues and it is not surprising that this is even harder where continence is concerned.

Good bladder and bowel health are key. What you’re drinking and eating, and when can make a big difference but we don’t learn much about this in general. Where the topic of Mental Health was 10 years ago, is where we want to see Bladder and Bowel health moving towards. It’s all about awareness raising, empowering people to talk about it, and the promotion of good health and wellbeing.

I am genuinely driven to improve the lives of people with bladder and bowel symptoms as my life’s work. I have many smile moments through the achievement of all the little differences that come together to build a better bigger picture for those affected. I love working with my patient and public partners whom I learn from every time we meet, and keep everything we do grounded in the real world.

IMPOSTER? ME? NO!

I am ambitious to secure a full Chair post to maximise the potential to develop, fund and conduct research that has real benefit to people experiencing bladder and bowel symptoms, and for those providing their care. To achieve this, I was aware that I needed to take on larger scale opportunities with potential for wider impact. This was already underway, but the Florence Nightingale Foundation scholarship has helped me to strive for those opportunities with confidence and vigour.

Much is discussed about ‘Imposter syndrome’ throughout the scholarship year and developing the skills of effective leadership has been key to going forward with belief, and to undertake these opportunities with the insight to continue to develop.

I am eternally grateful to HEE Kent, Surrey and Sussex and to my amazing mentor Joanne, for this fantastic opportunity for personal development and growth. I am unlikely to experience anything like this again and cannot thank them enough for putting their confidence in me and their commitment to enabling me to realise the full potential of this opportunity.