Valerie Tomlin is a children’s cancer nurse at Addenbrookes Hospital in Cambridge. She writes:
While every day on the unit is different - and all are unpredictable and varied - Monday morning starts with the ward round (an update of the patients on the ward from over the weekend) and a clinic handover to discuss the children attending clinic that day. The paediatric day unit (PDU) can see up to 30-40 children in a day, including children attending for treatments or scans, bloods/reviews, or long-term follow-up.
The rest of my morning is usually spent in the clinic seeing patients with the consultant, then following their care through the rest of the day - giving chemotherapy, discussing protocols and planning future appointments with them. Education is key – I spend a lot of time teaching parents how to give medication and chemotherapy at home and helping them to understand the protocols.
Four mornings a week, children attend for bone marrow aspirations or lumbar punctures under general anaesthetic which are carried out on the unit (up to six children a day). We have a small treatment room where the procedures are performed, rather than attending theatre, led by a paediatric anaesthetist, an operating department practitioner (ODP), registrar, and either myself or one of the other clinic nurses.
My first task of the afternoon is attending an MDT (multi-disciplinary team: Consultants, radiologists, pathologists etc.)meeting to discuss results and future care planning. Post-MDT I call the parents with the results and follow-up plans, then book/request all future scans for reassessments.
Addenbrookes as a Principal Treatment Centre (PTC) covers the whole of East Anglia, and we work with 11 shared care centres. Much of my afternoon involves liaising with these shared care centres and local community teams. It mostly consists of coordinating care at home, or supportive care at their local hospitals. The communication between centres is paramount in ensuring continuity of care, and also supporting our patients in transitioning from hospital to home.
Essentially, my role is to provide specialist support to the families, by coordinating their care and offering education and advice. I act as their advocate and keyworker throughout their treatment programme and into early follow-up. From the first moment I meet them on the ward, I aim to earn their trust and alleviate their initial fears. I’m their first point of contact during the patient pathway, so it’s important to build these relationships early on. Actually, my role is never-ending. At some point, I may even have time for a coffee – and there’s always cake on the ward!
Caring for children with cancer and their families can be challenging, but while it’s emotional, it’s also incredibly rewarding. These children - and their parents - are inspirational, and every day working with them is filled with fun and laughter.
