I was delighted to be ‘highly commended’ at the British Journal of Nursing Awards at the Shakespeare Globe in London. I was humbled to be nominated by my lead cancer nurse and a colleague. This offers me the opportunity to tell you about my career and my work as a breast care nurse consultant.
I would like to share the values that have been with me from the outset, and the people and circumstances that shaped them as my career progressed. In 1984, after a negative experience in a care home for people with physical disabilities where I worked as a carer, I trained as an enrolled nurse. Due to lack of training and education, carers treated patients without respect, dignity or individuality.
I was determined to train as a nurse and to ensure patients were not treated without compassion. I was hands-on, always at the bedside, delivering basic nursing care. I was 18 years old and this was a great privilege. I was proud to care for vulnerable patients, treating them as I would a relative. The experiences of those early years shaped me into the next decade, as nursing changed and we saw the introduction of Project 2000 nurses.
My first qualified post was in an elderly care ward. Once again, I was faced with a leader (sister) who showed no care for this vulnerable patient group. I was shocked that many nursing staff followed her example. I thought that, if a bad leader could influence staff to behave badly, a good leader could have the opposite effect. Despite the challenges, I and a handful of staff nurses ensured we did everything to the best of our abilities to care for this client group. Moreover, I realised I had to improve my knowledge and skills to progress and become a leader who would act as a positive role model.
This start to my career shaped me into who I am today and how I care for my patients.
Before becoming a breast care nurse specialist I worked in theatres, orthopaedics and surgical wards. I knew I had the personal and professional qualities to undertake my current role, but my background was not in cancer. One of the breast surgeons knew I was interested in this area and asked me to apply. I had interviews on three occasions and sheer tenacity made it third time lucky. Before my appointment, I sought cancer work with Marie Curie Cancer Care and took a secondment in the palliative care ward.
I found it hard to believe that I had been appointed to the role and for the first few months I felt like I didn't deserve it. However, I soon embraced the opportunity; I was finally in a position not only to have hands-on clinical impact to improve outcomes, but I could also become involved more strategically, raising my profile to improve care and shape the cancer service. With each year my confidence grew and I received fantastic support from like-minded colleagues. I also had the opportunity to complete an advanced nursing practice course, consolidating my skills in advanced practice, allowing me to develop nurse-led services.
Nurse-led initiatives
I moved to Guernsey to do the job I love and to experience a whole new way of life by the sea and the cliffs. This work-life balance does prevent compassion fatigue and burnout. My breast consultant and I started at the same time 5 years ago and, together, we have developed a breast service to be proud of. First, I concentrated on developing nurse-led clinics, follow up, family history, symptomatic and results clinics. These improvements were supported by my manager and the consultant. (Guernsey's health service has no junior doctors, allowing nurses to have more autonomy.)
Another passion of mine is survivorship, the late effects of cancer treatment and health-related quality of life. In my first year in Guernsey, together with a fitness instructor, I started a breast cancer exercise class, offering physical and psychological support to women with breast cancer. I also worked closely with the clinical psychologist to deliver ‘Can move on’ support intervention. This was underpinned by a pilot study ensuring that patients were psychologically screened using validated screening tools.
Despite challenges, we continue to ensure the service is provided throughout the disease trajectory and beyond. This ‘Can move on’ intervention was recently audited, with the results suggesting that it improves outcomes.
New developments
More recently, in the final year of my master's, I became interested in pain education and yoga as an intervention at the end of cancer treatment. I am now undertaking a pilot/feasibility study to ‘evaluate the impact of a 6-week pain education and yoga intervention for women with primary breast cancer’.
Concurrently, I am the senior responsible officer for Health and Social Care's (HSC) Care Values Framework, which tackles issues such as compassion fatigue. This year, we will secure a licence for Schwartz Center Rounds and we have introduced foundation-level communications training. In addition, with funding from Macmillan, we have designed a 3D ‘engagement tree’ that allows staff to comment on compassion and the perceived barriers to delivering compassionate care.
I have come a long way since 1984—and my heart will always be in clinical nursing. The importance of leadership, compassion and empathy remain my core values.
This award has raised my profile, enabling me to influence future nurses and staff within my community. I hope I can inspire others to believe in themselves and recognise the strength within themselves to shape the future of nursing in an ever-evolving health service. My career shows that it is always possible to pick yourself up, dust yourself off and become a leading example of delivering care with compassion in nursing.