Q&A with Marie Taniacao, Surgical First Assistant and the UK’s first Robotic Nursing Fellow
Funded by The Royal Marsden Cancer Charity, the Robotic Nursing Fellowship is the first hospital-based fellowship of its kind in the UK.
What is the Robotic Nursing Fellowship?
It has been designed to equip theatre nurses – like myself – with the advanced knowledge and skills required to assist surgeons during robotic operations, and with other surgical specialities comparable to those of a junior doctor.
I started my training in 2019, and as part of this have been studying towards a master’s degree, accredited by the Royal College of Surgeons, in Surgical Care Practice – specialising in gynaecological, upper gastrointestinal, and colorectal surgery.
I feel hugely privileged to be the UK’s first hospital-based Robotic Nursing Fellow, particularly at The Royal Marsden, one of the world’s leading cancer centres and a globally recognised centre of robotic excellence. This Fellowship will place me and all future trainees in a better position to ensure patient safety and a high standard of care during robotic surgery.
What is a typical working day at The Royal Marsden like?
I arrive at The Royal Marsden in Chelsea between 6.45 and 7am and prepare to head to Theatres. During this time, I read through the list of patients coming in for surgery – not only for that day, but up to a week in advance.
At 7.30am I head to Day Surgery to conduct preoperative visits with patients who have been prepared for surgery. I welcome them, reconfirm their consent with the Gynaecology team, and answer any questions they may have. During these visits, my aim is to ensure each patient feels as settled and comfortable as possible for their upcoming surgery. If a patient feels particularly anxious, I or a member of the Gynaecology team will sit and talk with them, to offer reassurance.
We have a team huddle at 8am, which is followed by a briefing with the Gynaecology team in Theatres.
After the briefings, which take about 15 minutes, I participate in ward or Critical Care Unit (CCU) rounds to review our postoperative patients. These sessions include physical examinations of the patients – such as abdominal and wound assessments – requesting their bloods, checking over their results and reviewing imaging and documentation.
At 8.45am we begin operating in Theatres. On a normal day, I will be here for between four and six hours. The operations will range from minor cases, such as a diagnostic laparoscopy or examination under anaesthesia; to major cases, such as a pelvic exenteration (where some of the organs of the pelvis are removed).
We usually take a half-hour lunch break at around 3.30pm, after which my team and I return to Theatres to complete the remaining surgeries scheduled for that day. This is usually finished by 6.30pm.
Once we have completed all scheduled procedures, we carry out a final ward round where we visit and check-up on the patients who we have treated that day. We talk with them, explain the outcome of their procedure, make sure they are feeling well, and answer any questions they may have. As with our postoperative patients, my aim is to ensure each patient feels comfortable, safe, and reassured after their surgery. I end my day around 7pm.
I am extremely thankful to The Royal Marsden Cancer Charity for funding the Robotic Nursing Fellowship and providing me with such a wonderful opportunity to develop my skillset and expertise. This has enabled me to continue to improve the quality and standard of care that I deliver to our patients, and I couldn’t be more grateful.
What do you enjoy most about your role?
My fellowship training has made me more capable of attending to patients during surgery while the surgeon is operating on the da Vinci Xi, our robotic surgical system. I dock and undock the robot, and provide the patient with bedside assistance while the consultant and fellow are operating via the console. All in all, I make sure that the equipment is positioned in the correct way throughout surgery and that everything is available for the surgeon to use. My experience within gynaecological surgeries has provided me with a developed awareness and understanding of what the surgeon needs during the procedure and when; meaning I can accurately predict these requirements.
I really enjoy my role, as it means I can now be more involved in every aspect of our patients’ care than I have been before and therefore I can get to know each patient much better. Being able to follow and support patients throughout their treatment pathways and see the positive outcomes of our work is something I find highly rewarding.
Working at The Royal Marsden is very special as we don’t just focus our efforts on treating cancer, but also on understanding each individual patient’s needs and concerns, and supporting them throughout – which really makes such a difference.
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This interview was originally published in Nursing Standard.