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COMMUNITY CHEMOTHERAPY. NICOLA CALLAM HARROW PRIMARY CARE TRUST MACMILLAN COMMUNITY CHEMOTHERAPY CLINICAL NURSE SPECIALIST . INTRODUCTION TO MY ROLE. MY PREVIOUS BACKGROUND WAS THAT OF WARD MANAGER IN ACUTE SURGERY

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COMMUNITY CHEMOTHERAPY

NICOLA CALLAM

HARROW PRIMARY CARE TRUST MACMILLAN COMMUNITY CHEMOTHERAPY CLINICAL NURSE SPECIALIST


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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


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BACKGROUND

  • EXPECTATIONS OF THE POST

  • LOOKING AT WHAT WAS IN PLACE

  • SAFETY ISSUES

  • EDUCATION

  • COMMUNICATION


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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


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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


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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


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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


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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


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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


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HOW DID YOU DEAL WITH THEM?

  • INDUCTION PROGRAMME PROS AND CONS

  • MY EXPECTATIONS OF THE JOB:-

  • GIVING CHEMOTHERAPY AT HOME


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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


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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 08.30 – 16.30


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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


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THE FUTURE OF THE ROLE

  • COMMUNICATION

  • COMMUNITY

  • TEACHING

  • DEVELOPING A REFERAL CRITERIA

  • TEACHING PACKAGE FOR PROBLEM SOLVING PATHWAYS FOR GENERAL SIDE EFFECTS OF CHEMOTHERAPY


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THE FUTURE OF THE ROLE

  • CONTINUAL DEVELOPMENT OF CLINICAL EXPERTISE

  • PATIENT VISITS RE SIDE EFFECTS, ETC

  • ADMINISTRATION OF CHEMOTHERAPY IN PATIENTS HOMES


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