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Ever heard of an Endovascular Neurointervention nurse? Meet Gabrielle Clifford, a Clinical Nurse Specialist in ENI within Hunter New England Local Health District, New South Wales. Thank you to NSW Health HNELHD for allowing us to interview Gabby!
Tell us a little about you!
Hi, I’m Gabby, a Clinical Nurse Specialist in Endovascular Neurointervention (ENI). I graduated with a Bachelor of Nursing from the University of Newcastle in 2019 and stepped straight into radiology for the first rotation of my new graduate program in 2020, right as COVID hit. While it was a wild time to begin a career in healthcare, the passion and unique work done by the radiology team had me hooked. I left my new graduate program to stay on full time, and I focused on working as a scrub/scout nurse for the interventional labs staffed by the radiology teams. This work sparked a deep interest, and I’ve since moved into a role where I now coordinate and educate in, what I believe to be, one of the most exciting areas of healthcare: endovascular neurointervention (ENI).
Outside of work, you’ll find me trying to create something with my amateur graphic design skills, swimming in any available nearby body of water, or spending time with my friends and family. I’m grateful to have a very supportive husband — which has been crucial during the many on-call shifts over the years — and a 7-year-old daughter who spends most mornings asking if she can join me at work to help “fix people’s brains”.
How did you end up in Endovascular Neurointervention (ENI) Nursing?
I was first introduced to ENI through radiology as a scrub scout nurse working in the lab, learning and performing a range of highly specialised, complex procedures, often after being called in at 2am. This gave me hands-on insight into the technical and emotional intensity of this field. Over three years, I developed a deep respect for the work and the type of patients supported by ENI.
When the Clinical Nurse Specialist position came up, I jumped at it. It has allowed me to transition from procedural work to a more holistic and strategic role; coordinating care, supporting patients through their pre-operative workup and recovery, and seeing more than just the acute event. It’s something I didn’t get to see when my role ended at the theatre door.
What is endovascular neurointervention nursing?
ENI is a minimally invasive speciality providing diagnostic and treatment interventions for neurovascular conditions. Think cath lab, but for the brain. The diversity of conditions we treat means that no two days look the same, and that’s one of the things I love most about the role.
As a Clinical Nurse Specialist in ENI, I’m involved in the full spectrum of patient care, from the initial referral to the long-term follow-up. One day, I could be coordinating an emergency helicopter retrieval for a rural stroke patient requiring endovascular clot retrieval (ECR) or rounding on a patient following the emergency coiling of their ruptured aneurysm (aSAH). The following day, I could be seeing a patient in clinic, reviewing their ultrasound and CT scans and scheduling them for carotid stenting, or I could be meeting with the neurosurgical team, planning a patients middle meningeal artery (MMA) embolisation for treatment of subdural hematoma (SDH).
A significant part of my role also includes education and research. This is one of my favourite parts of the job – the two go hand in hand, one informs the other, and both ultimately improve patient outcomes.
Can you share an experience that stands out to you and how it impacted your approach to patient care?
Anyone working in neurology, stroke, neurosurgery — or any form of brain care — will attest to how challenging and unforgiving brain injuries can be. Even with the best possible medical care and interventions, outcomes can be unpredictable, and recovery is often slow and complex. But when it works, the impact is immediate and profound.
One case that’s always stayed with me was a patient who presented to the emergency department with sudden onset hemiplegia and severe dysarthria. Thanks to the seamless coordination between the ED, stroke, and radiology teams, he was assessed, diagnosed, and brought to our lab in under 50 minutes. He underwent an awake ECR for a large vessel occlusion, and during the procedure, after a tiny, pea-sized clot was removed, he suddenly spoke, and with clear speech said: “Oh, I can feel my arm again.”
That moment was incredible and the fact that he tolerated the procedure awake was a testament to the reassuring communication and calm demeanour of the both the procedural and the anaesthetic team. Their ability to make the patient feel safe and informed in such a high-stress situation made all the difference.
That case reminds me how vital calm, clear communication is, not just for outcomes, but for helping patients feel safe. Taking a moment to explain what’s happening can be the difference between a terrifying experience and one that the patient feels part of.
What do you find to be the most rewarding aspect of endovascular neurointervention nursing?
The most rewarding part of working in ENI is helping patients overcome life-threatening conditions, often in the face of huge emotional barriers.
This was really solidified to me in a case that happened during my first few months of working as a Clinical Nurse Specialist. A young woman was referred to us after a screening CT scan detected a large, complex basilar artery aneurysm. Her mother had died from an aneurysmal subarachnoid haemorrhage, and as a mother of two young children herself, the patient understandably carried deep fear, trauma and anxiety.
Our team supported her through every step: from diagnostic angiogram, pre-operative clinic appointments, unscheduled phone consults, answering her questions, and providing her with reassurance – to the day of her technically complex flow-diverting stent treatment. Her procedure was a complete success, without any complications. I was able to support her post-operatively on the ward and meet her family; we still have the thank-you cards from her children in the office.
It’s been two years since her initial treatment, and she’s living a full and normal life. Our daughters are similar in age, and we often chat about them during her follow-up appointments. Being able to guide her through that journey, support her through fear, and watch her step fully back into her life — it’s a privilege to play a role in that.
Given the complexity of the cases you handle, how do you foster effective teamwork and communication within your unit and the wider team?
Fostering effective teamwork in ENI means building strong, trust-based relationships not just within our immediate team but across multiple departments and hospitals. Our core team is small — three doctors, three nurses, and one secretary — yet we care for patients across three health districts. We rely not only on one another, but also on our close working relationships with radiology, neurosurgery, neurology, anaesthetics, same-day, recovery, general practitioners, and rehabilitation teams — to name a few.
Establishing and maintaining strong communication pathways across all these services is vital. Our team, and my former mentor in particular, worked incredibly hard to develop effective workflows. Maintaining them and continually looking for opportunities to improve them is one of the most important aspects of my role. I make a point of being visible, approachable, and available so that staff feel comfortable reaching out with questions or concerns. Whether it’s through scheduled MDT meetings, an MS Teams channel or over coffee in the hospital cafe, I support whatever platform works best for the team to share information efficiently. Ultimately, ENI is a highly collaborative speciality, and our ability to deliver timely, safe, and effective care depends entirely on strong teamwork and communication.
What steps or strategies do you take to stay updated with the latest advancements and best practices in endovascular neurointervention?
ENI is still relatively new within medicine and nursing. The rate of innovation is rapid, and best practice is constantly evolving, so continuous learning is paramount.
I stay current by regularly reviewing relevant literature, attending conferences, and being an active member of organisations like the ACI Stroke Network and the Australasian Neuroscience Nurses’ Association. I participate in and host education sessions and work through case reviews to stay current across local trends and challenges.
Research is a particularly meaningful part of my role. I’ve recently presented at the Asia Pacific Stroke Conference on ECR retrieval times and am preparing to present at the upcoming Smart Strokes Conference. For me, continuous learning isn’t just about professional development — it’s about contributing to a culture of excellence, improving outcomes, and making our service the best it can be.
As an ENI Clinical Nurse Specialist, you likely play a role in educating and mentoring other nurses. How do you approach this aspect of your role?
As I mentioned earlier, education is one of my favourite parts of the role. I love supporting staff, mentoring students, and creating resources that make neurointervention more accessible (my graphic design skills come in handy here)! I’ve developed newsletters, hosted district-wide education days, and presented at international conferences. I’ve even tried developing a virtual reality training program. My ENI CNS colleague is equally as passionate about education and, together, we are always working on at least one quality improvement project, with another five or six projects written on our ‘ideas list’.
I believe there should be no limit to education, and with the scope of ENI so broad and the understanding of its role often limited, education is one of our greatest assets. I’m currently undertaking a master’s in clinical education, which has given me deeper insight into how people learn and how we can better embed learning in complex clinical environments. I use what I’ve learned to make education more engaging, sustainable, and meaningful — not just for nurses, but for everyone involved in the care of ENI patients.
What are your future goals and aspirations within the realm of endovascular neurointervention, and how do you see this field evolving in the coming years?
ENI is a small, highly specialised field, and nursing roles within it are even smaller. That presents both challenges and incredible opportunities. One of my aspirations would be to see nursing representation grow within the speciality, with dedicated pathways for leadership, education and clinical development.
In the coming years, I see ENI continuing to expand, driven by increasing demand for timely access and regional equity. Advancements in imaging, device technology, and extended treatment windows will likely make more patients eligible for intervention and enhance the quality of care delivered. As indications for ENI treatment continue to grow, I see real value in being part of the conversations that shape how our service — and the field more broadly — evolves in a thoughtful and inclusive way.
What advice/tips/resources would you give to a nurse wanting to work in this field?
For nurses interested in ENI, my biggest piece of advice is to keep an open mind — the learning curve can be steep, but it’s incredibly rewarding.
ENI is not a service offered at every hospital and that can make opportunities feel limited at first, but it also means there’s huge value in getting involved early and learning wherever you can. Ask to observe a procedure, reach out to someone in the field and ask the “silly questions”. You don’t need to be an expert in neuroanatomy — what matters most is your willingness to learn.
Be open, be calm, and stay curious. Neurointervention needs nurses who are passionate, adaptable, and ready to grow with a constantly evolving speciality.
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