1 COMMUNITY CHEMOTHERAPY NICOLA CALLAM HARROW PRIMARY CARE TRUST MACMILLAN COMMUNITY CHEMOTHERAPY CLINICAL NURSE SPECIALIST

2 INTRODUCTION TO MY ROLE MY PREVIOUS BACKGROUND WAS THAT OF WARD MANAGER IN ACUTE SURGERY I THEN WORKED AT A SPECIALIST CANCER HOSPITAL FOR A YEAR AND A HALF AS A STAFF NURSE AGAIN WHEN I COMMENCED MY CURRENT POST, I WAS NEW TO THE ROLE OF NURSE SPECIALIST HAVING A SENIOR NURSING POSITION IN THE FIELD OF ONCOLOGY WAS ALSO NEW TO ME

3 BACKGROUND EXPECTATIONS OF THE POST LOOKING AT WHAT WAS IN PLACE SAFETY ISSUES EDUCATION COMMUNICATION

4 BACKGROUND I WAS TOLD ABOUT THE JOB BY A COLLEAGUE I HAD WORKED WITH AT ANOTHER HOSPITAL (POST VACANT 1 YEAR) PREVIOUS POST HOLDER HAD A JOINT ROLE THEN IT WAS DIVIDED INTO TWO POSTS: - INTRAVENOUS CLINICAL NURSE SPECIALIST AND CHEMOTHERAPY CLINICAL NURSE SPECIALIST

5 HOW WAS THE NEED FOR THE SERVICE IDENTIFIED? CLOSURE OF A COMMUNITY HOSPITAL ALLOWED THE FUNDING OF THE POST DISTRICT NURSES WERE ASKED WHAT THEY WOULD LIKE FROM THE MONEY SUPPORT WITH INTRAVENOUS SERVICES AND CHEMOTHERAPY WAS ONE OF THE FOUR THINGS THEY IDENTIFIED

6 WHO DID YOU INVOLVE? I WAS NOT INVOLVED AT THIS STAGE, BUT THE MACMILLAN TEAM, HARROW PCT STAFF AND ACUTE STAFF ON THE CHEMOTHERAPY SUITE WERE CONSULTED FOR THEIR VIEWS

7 WHAT CHALLENGES / ISSUES DID YOU FACE? NEEDED TO EXPAND MY OWN KNOWLEDGE ON CHEMOTHERAPY RELATIVELY NEW TO ONCOLOGY WORKING IN AN UNFAMILIAR AREA NEW TO A NURSE SPECIALIST ROLE NEW TO THE COMMUNITY HAD A DIVIDE IN MY ROLE BETWEEN THE COMMUNITY AND THE ACUTE SECTOR WORKING UNDER THE REMIT OF TWO CANCER NETWORKS

8 WHAT CHALLENGES / ISSUES DID YOU FACE? NOT HAVING ANOTHER PERSON DOING THE SAME ROLE IN THE NHS PCT TEACHING AN ALREADY OVERWORKED TEAM OF DISTRICT NURSES NEW SKILLS MEETING ALL GP’S FUNDING FROM GP’S BARRIERS TO CHANGE

9 HOW DID YOU DEAL WITH THEM? WORKED ON A CHEMOTHERAPY UNIT 3 DAYS A WEEK HAD AN EXCELLENT INDUCTION PROGRAMME STARTED TALKING TO OTHER NURSES WITH CHEMOTHERAPY EXPERIENCE NETWORKING WITH ONCOLOGY/CHEMOTHERAPY CNS’S ATTENDING RELEVANT MEETINGS INVOLVED WITH NEW INITIATIVES

10 HOW DID YOU DEAL WITH THEM? INDUCTION PROGRAMME PROS AND CONS MY EXPECTATIONS OF THE JOB:- GIVING CHEMOTHERAPY AT HOME

11 CHANGES AND HOW IT HAS BENEFITED PATIENTS, STAFF AND CARERS PERSONAL DEVELOPMENT COMPLETED DIPLOMA IN CANCER CARE AND STARTING DEGREE IN OCTOBER COMPLETED N59 CARE OF THE PATIENT REQUIRING CHEMOTHERAPY LEO MANAGEMENT COURSE PICC STUDY DAY ADMINISTERING CHEMOTHERAPY ACCORDING TO PROTOCOLS GAINING KNOWLEDGE ALL OF THE TIME

12 CHANGES AND HOW IT HAS BENEFITED PATIENTS, STAFF AND CARERS COMMUNITY/PCT HAVE SPENT TIME WITH THE ONCOLOGY CNS FOR POOLE PCT I VISIT PATIENTS IN THEIR HOMES FOR SUPPORT ABOUT CHEMOTHERAPY SIDE EFFECTS OFFER A PHONE SERVICE TOO IF A PATIENT OR THEIR CARER HAS ANY WORRIES OR QUESTIONS WORK MON-FRI – 16.30

13 CHANGES AND HOW IT HAS BENEFITED PATIENTS, STAFF AND CARERS EDUCATION/TEACHING DOING TEACHING TO DRS AND COMMUNITY STAFF TO HEIGHTEN THEIR AWARENESS OF CHEMOTHERAPY N59 ASSESSOR TO NURSES ON THE CHEMOTHERAPY UNIT

14 THE FUTURE OF THE ROLE COMMUNICATION COMMUNITY TEACHING DEVELOPING A REFERAL CRITERIA TEACHING PACKAGE FOR PROBLEM SOLVING PATHWAYS FOR GENERAL SIDE EFFECTS OF CHEMOTHERAPY

15 THE FUTURE OF THE ROLE CONTINUAL DEVELOPMENT OF CLINICAL EXPERTISE PATIENT VISITS RE SIDE EFFECTS, ETC ADMINISTRATION OF CHEMOTHERAPY IN PATIENTS HOMES