I have a great passion for cancer care as a Uro-Oncology Clinical Nurse Specialist (CNS), which comes from my own experiences as a previous cancer patient. I had cervical cancer twice when I was a student nurse, requiring major surgery, and went on to develop a pelvic abscess several years later that caused small bowel obstruction, ureter obstruction and sepsis, requiring further surgery. As a result I have experienced multiple encounters with healthcare staff as both an inpatient and an outpatient over the years. Surgeries have left me with lymphoedema, nerve damage and infertility, as well as experience of other physical and psychosocial issues that come from a cancer diagnosis and its treatment.
It is my own experiences that have given me the drive to improve healthcare and patient care and, in particular, have given me a passion for cancer care that has led me to where I am in my career. I draw on the positive encounters I have had where I have seen true compassion, empathy and care that has gone above and beyond the level expected and feel influenced in my practice by these moments. I have also experienced negative aspects of care and strive to ensure that my patients do not experience these as I understand how distressing such poor experiences can be.
Improving the patient journey
I qualified as a nurse in 2011 and gained my first nursing role in Scarborough General Hospital. My career has mostly consisted of working in endoscopy environments and colorectal roles. I moved in to the field of urology as a Uro-Oncology CNS in April 2021, having gained an interest from when I used to assist with urology lists at Scarborough General Hospital. The uro-oncology role allowed me to train to undertake an advanced skill, carrying out trans-rectal ultrasound prostate biopsies as well as looking after cancer patients. It seemed like the perfect opportunity to look after those patients from pre-diagnosis through to post-treatment.
I have always had an interest in improvement work and had therefore completed an MSc in Advancing Healthcare Practice in 2015 with the Open University because the course offered an opportunity to study quality improvement, change management and leadership practice.
I applied for a place on Prostate Cancer UK's Clinical Champions Programme for 2022/23 and was lucky enough to secure one of 20 places after a competitive interview process. This is an 18-month leadership programme that aims to provide you with the knowledge and skills to deliver improvements in prostate cancer care, which I will graduate from in November. As part of this programme you are asked to undertake an improvement project that you will implement in your place of work. The programme involves training in change leadership, improvement science and system leadership. It also allows for networking with leaders in the field from all over the UK and my class consists of nurses, GPs, consultant urologists, consultant oncologists, radiotherapists and physiotherapists.
‘My project … was to learn to undertake transperineal prostate biopsies … I recognised this could help to reduce waiting times for patients but also deliver improvements in prostate cancer diagnosis because this style of biopsy allows for ease of access to tumours in more difficult-to-reach anterior areas in the prostate’
Enhancing prostate cancer care
My project idea for Prostate Cancer UK was to learn to undertake transperineal prostate biopsies and develop a nurse-led service because my Trust at that time, Greater Glasgow and Clyde, had one consultant operator doing these biopsies for my sector. I recognised this could help to reduce waiting times for patients but also deliver improvements in prostate cancer diagnosis because this style of biopsy allows for ease of access to tumours in more difficult-to-reach anterior areas in the prostate that can be missed on standard trans-rectal ultrasound biopsies and also reduces the rates of sepsis post-procedure.
I have been fortunate to be part of an improvement team consisting of consultant urologists on the programme who have invited me to train in the procedure at Imperial College and Bath Healthcare Trusts. This will allow me to do some intensive training over several weeks and take the skills back to my own Trust for further development. Healthcare trusts in London have managed to successfully phase out transrectal biopsies, recognising the benefit for their patients in doing so.
I have just completed a Postgraduate Diploma in Prostate Cancer Care that I have been undertaking for the past 2 years with Sheffield Hallam University. I wanted to improve my own knowledge in the field and the course has been an excellent source of knowledge, with modules in psychology of cancer care, excellence in prostate cancer care, survivorship in cancer care and researching for practice. These have greatly helped inform my practice and a lot of the course has tied in nicely with my leadership work with Prostate Cancer UK. I have now commenced a Clinical Doctorate Programme at the University of Stirling. Having been keenly interested in the piece of work that came out from Prostate Cancer UK this year on the North/South divide in prostate cancer diagnosis, I therefore aim to study health inequalities and how they have an impact on the prostate cancer experience for men.
Last year I applied for a place as a Trustee with the British Association of Urological Nurses (BAUN) and was appointed in November 2022. I applied for this place as I feel that healthcare improvement and high-quality services are so important and I was keen to undertake improvement work at a national level as well as local, and recognised that this would be an excellent way to do this. BAUN contributes to the future of urology nursing, providing education for urology nurses and promoting high standards in urology care and nursing. To be involved in assisting with this work is fantastic and I could not have imagined some of the opportunities that have been available to me through BAUN, it's really an exciting role that I would encourage anyone to apply for.
Earlier this year I was asked by the BJN and the British Journal of Community Nursing to write the foreword for a urology special supplement, considering the challenges faced by men who have incontinence issues caused by prostate cancer treatments (Mclaughlin, 2023). I thoroughly enjoyed doing this and it was an opportunity to highlight what men are going through after prostate surgery and to bring to the forefront a topic that has been hidden for too long.
Recognition and support
In the grand scheme of things what I am doing does not feel like a lot. I recognise colleagues every day who are going above and beyond, striving for improvement, delivering high-quality care, working long hours and doing extra wherever they can to assist patients in a difficult time in the NHS and who all deserve recognition. I am lucky enough to be a part of an excellent urology team who are supportive, encouraging and we work well together, which is vital.
I would not be doing what I am if it was not for my trainer and mentor Liz Norman, Uro-Oncology CNS at Inverclyde Royal Hospital, who has taught me everything I know so far. She is a colleague who is highly knowledgeable, compassionate and always goes the extra mile for patients every day. She has been a major influence in my practice these past 2 years and I owe so much to her and her patient style of teaching.
I have to thank the BJN for encouraging me to apply for this award. I was encouraged to submit an application and have confidence in myself. The BJN Awards event was a fantastic evening that recognised the hard work going on by nurses and nursing teams all over the UK who were clearly dedicated, passionate and innovative in their roles. I was shocked but delighted to hear that I was a finalist, and it was a real honour to be there and receive the Bronze Award. The Scottish Parliament (2023) acknowledged my receipt of the award with a congratulatory message within their Committee Motions in May 2023 which I am grateful for also. Thank you BJN!