Monday 21st December 2015
Mac Voice, the magazine for Macmillan professionals: Winter 2015
Cherith is the Royal College of Nursing’s Northern Ireland Nurse of the Year for 2015.
Tell us about your professional background.
I trained at the University of Ulster from 1991–1995. After that, my first job was in a plastic and maxillofacial unit based at the Ulster Hospital in Belfast. It was there I was first introduced to patients newly diagnosed with head and neck cancer who were having surgery as their main treatment. In 2000, I was appointed to my current role as a Macmillan clinical nurse specialist in head and neck cancer. I have also done intermittent research over the last 15 years.
What are the aims of your current role?
I work with newly diagnosed head and neck cancer patients and their families. As their key worker, I provide support and advice, and coordinate the patient’s pathway. It’s a very important role which includes providing psychological support and helping patients have as good a grasp as possible of what treatment will mean for them, along with the post-treatment impact.
Tell us about your Nurse of the Year award.
I was nominated for my involvement in a series of initiatives leading to improvements for head and neck cancer patients. It really feels a privilege and an honour as there are lots of nurses doing excellent roles and providing excellent care. I also want to share the award with my extremely supportive team.
What improvements did you make?
I realised there was very little evidence surrounding the key factors that contribute to post-treatment psycho-social difficulties for people with head and neck cancer. So I commenced a full-time three-year doctoral fellowship exploring this area. An important learning point was the huge vulnerability of patients post-discharge. A resulting initiative was to implement a telephone support aftercare service. Another recent project has been redesigning the surgical follow-up clinic as part of the Transforming Cancer Follow-Up (TCFU) initiative.
The redesign of the clinic included the introduction of an educational leaflet on the signs and symptoms of reoccurrence, electronic holistic needs assessments (eHNA) to assess patient needs and empowering patients to develop their confidence and skills for self-management. This enabled self-referral or rapid access back into the clinic when necessary. A nurse-led clinic was also established for the low-risk patients who were in year three of their cancer follow-up.
How have you used eHNAs?
Patients come to the follow-up clinic and, alongside a Macmillan volunteer with an iPad, complete a holistic needs assessment specific to head and neck cancer. In real time, the consultant and I have the findings and can focus the consultation around patient concerns rather than clinician concerns. We can also signpost patients to services that can help them.
People with head and neck cancer can often have low self-esteem. The eHNA provides them with the tools and the confidence to identify their key concerns and unmet needs, enabling the patient and their family to enter into a partnership with us. Since we have given people more control over what they need after treatment, referrals to our Macmillan information and support centre have increased.
Why do you think the aftercare you provide to head and neck patients is so crucial?
This is a very vulnerable patient group because it’s a very visual cancer and impacts on many very basic day-to-day functions such as speaking and eating. Psychological support promotes timely social reintegration for patients and an important part of aftercare is signposting patients to appropriate support services. Many of these patients come with smoking histories and a number with excessive alcohol intake as well. So a really big part of it is promoting health and well-being, especially post-treatment.
What are the challenges of your role?
Maintaining research activity while doing a busy clinical role. To further progress the ongoing research that informs clinical practice for patient benefit, there need to be more sustained clinical academic posts. There is currently no clear clinical academic pathway for nursing in Northern Ireland.
Another challenge is the same as for anyone working in oncology: the need for downtime. For me, that involves maintaining a work-life balance and taking walks on the beautiful beaches in Northern Ireland.
What are the rewards of your role?
The biggest reward for me is being that frontline member of staff working with cancer patients – making a positive difference to their quality of life. I also enjoy being able to merge patient-focused research for quality improvements into my day-to-day role. And finally, working as part of a team with colleagues who’ve got similar core values as myself – people who put patients at the heart of their practice.
Email Cherith Semple.