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COMMUNITY CHEMOTHERAPY

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

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  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 08.30 – 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

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