An insight into the work of an ‘Outstanding’ Clinical Nurse Specialist (CNS) in Gastroenterology

For a CNS, no two days are the same - because no two patients are the same.

Nobody understand this more than Kate Waters, Clinical Nurse Specialist (CNS) at London Digestive Centre – an outpatients and diagnostics centre which has just been rated as ‘Outstanding’ by independent healthcare regulator Care Quality Commission (CQC). With a gastroenterological nursing career spanning more than 25 years, she lets us in on her life in nursing and what she thinks makes an ‘Outstanding’ CNS.

Always there, always caring

A Clinical Nurse Specialist’s role is to always be there, always caring – a statement which was echoed in the London Digestive Centre’s recent ‘Outstanding’ report from the Care Quality Commission (CQC):  

"Clinical Nurse Specialists (CNSs) work with patients as a first point of contact following a cancer diagnosis. The team provides a range of specialist care, including nursing for pancreatic, liver and bowel cancer. While this approach has a clinical function, staff ensure they are patient-focused, and use the time to understand how a patient feels and involves them in their care.”

What does a Clinical Nurse Specialist (CNS) do?

CNSs are nurses who are certified in a specialty of choice. This certification demonstrates an advanced level of knowledge as well as advanced clinical skills in that particular area. They are leaders in the field of nursing and their importance shouldn’t be underestimated.

Kate Waters adds: “CNSs are there to join up the dots in the healthcare journey. From the moment a patient undergoes a consultation at London Digestive Centre, I will be involved in their care. From booking appointments and arranging diagnostic imaging and surgery, all the way through to allaying fears about an impending operation or helping with post-operative care, I am there for patients. We provide that seamless continuity of care.”

Some of the responsibilities that CNSs have include:

  • Coordinating patients’ healthcare journeys. This includes booking consultations, tests and surgical procedures.
  • Treating diseases which are unique to their specialty.
  • Collaborating as part of a multidisciplinary healthcare team to review and revise treatment plans.
  • Educating and mentoring nurses.

What qualities do you need to have to be an ‘Outstanding’ Clinical Nurse Specialist?

“I think it’s critical that CNSs possess an abundance of compassion, are able to adapt the care they provide depending on the patient’s needs, as well as being honest with patients.

For example, some patients may need to have a stoma bag following gastroenterological surgery, which can understandably make patients anxious. I’m there to talk them through the operation, what to expect and its potential consequences. I will also help patients understand what a stoma bag is, how to use it should they need it following surgery and explain that it should be treated as a friend rather than an enemy,” Kate explains.

What is the hardest part about being a Clinical Nurse Specialist?

For Kate, nothing is more difficult than being in a room with a patient when they receive a cancer diagnosis: “At that moment a patient has to process so much clinical information which they’re not prepared for. As their dedicated gastroenterological Clinical Nurse Specialist (CNS), I can process the information, understand the diagnosis in depth and write down as much information as possible, so that when the patient leaves the room I can do my very best to answer any questions they have.

I am a huge part of each patient’s support system. Whilst some people might find that daunting, for me it is an honour to be able to say that in the most difficult moments of someone else’s life, I can be there to support them.”

To get in touch with London Digestive Centre or to book an appointment, please:

Call: 020 3905 3900 Email: ldh@hcahealthcare.co.uk

To read the full CQC report for London Digestive Centre, visit