Celebrating the Year of the Nurse: April Conway is a VA nurse and an innovator for SCI services

VHA Innovation Ecosystem and Office of Nursing Services are proud to celebrate the Year of the Nurse by highlighting a unique nurse-led innovation, or promising practice, each month for the remainder of 2020. With over 80,000 nurses throughout the VA health system, VA is the largest employer of nurses in the nation. 

When April Conway had a calling, she knew it. While still in high school, Conway started on the path to be a nurse. By 21 she was a registered nurse, living her dream of supporting others through care.

She started her career on the spinal cord injury unit at the St. Louis VA in 2003. At age 29, she became a nurse practitioner, working alongside Veterans at VA for 9 years in all different settings. That’s where she saw Veterans with a spinal cord injury/disorder, or SCI/D. She found they struggled with something many are remiss to talk about: sexual health.

For Veterans with a SCI/D, sexuality can often be a daunting and uncertain topic. Research shows that they can suffer from a perceived loss of sexual function, leading to isolation, withdrawal and depression. Those with an SCI/D are more likely to express their sexuality and feel desirable if they understand their body and feel comfortable with themselves and their injury. That isn’t a small task, however.

“For Veterans living with SCI/D it can be incredibly challenging to discuss sexual health concerns due to lack of comfort on the topic,” said Conway. “Addressing sexual health issues through patient and staff education is a simple practice shift which yields enormous gains for people with SCI/D. Assisting patients in connecting with their own sexuality and working toward family building goals are among the best practices in rehabilitation medicine.”

Conway wanted to make sure that the Veterans she worked with were getting the right care, both physically and mentally, to be able to address their sexual health needs and desires to have a family. To this end, she developed a process for addressing sexual health in SCI veterans. The process incorporates assessment, education, medications, adaptive equipment, and referrals specifically for SCI/D patients to address sexual health. The program will provide services for semen analysis and fertilization. This will also help develop a standardized clinic involving telehealth and face-to-face encounters for screenings and procedures.

VA found that over 50% of SCI Veterans want to discuss sexual health after SCI. Veterans appreciate addressing the topic. Additionally, Veterans can learn about treatments offered in the local clinics where they feel most comfortable.

Conway’s program, “Sexual Health and Fertility in SCI: An interdisciplinary approach,” was selected as part of the VHA Innovators Network’s 2020 Spark-Seed-Spread Investment Program (SSS). Through SSS, she will receive support and training that will allow her to build, test, and adapt her practice. This will allow it to grow, changing and saving the lives of Veterans across the country.

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