Role of the Clinical Nurse Specialist in Breast Cancer

Angela Oakley

Role of the CNS

• Experts our clinical field

• Never stop learning

• Advanced communication skills

• Ability to deal with emotionally difficult and challenging situations

• Quickly assimilate information and explain complex treatment options in understandable terms

Role of the CNS

• Widely acknowledged that the CNS plays a crucial role impacting of the quality of patient care

• What do we do?

• How do we do it?

Job Purpose

To provide

• high quality holistic care

• emotional support

• education and information

• signposting

• health promotion and well being

to patients with breast cancer and their families

Job Purpose

To act as a role model for nursing practice across the speciality and Trust, providing clinical nursing advice and education Act as a source of advice and knowledge for patients, carers and healthcare professionals within breast services and oncology To work within the MDT in the provision of optimal care throughout the patient pathway

National Cancer Action Team: Quality in Nursing Excellence in Cancer Care: The contribution of the Clinical Nurse Specialist, 2010

Key Contributions that CNS’s make to cancer care

Clinical Nurse Specialist

Excellent Decision making abilities

Empathy for patients and their families

Advanced communication and advocacy skills

Ability to assess patients’ holistic needs

In-depth knowledge of a tumour area

Advanced clinical / diagnostic skills

Acting as a key worker across the whole care pathway

Innovation, project management and change management

Leadership within the MDT and wider cancer team

Acting as a key worker across the whole care pathway

• Pre diagnosis

In fast track assessment clinic

In breast screening recall clinic

Acting as a key worker across the whole care pathway

• At diagnosis

NICE guidelines and ABS standards

Listen to patient

Reiterate and repeat

Summarise

Check

Acting as a key worker across the whole care pathway

• After diagnosis, before treatment starts

• Holistic needs assessment

• Discussion of treatment options

• Pre op information

Acting as a key worker across the whole care pathway

Post- op phone call

- Assessing adjustment

- Body image issues

- Advice and information

Acting as a key worker across the whole care pathway

• Post op MDT

• Patient advocate

• Results clinic

• Explain pathology report

• Explain rationale for adjuvant treatments

• Assessing adjustment

• Provide written information

Acting as a key worker across the whole care pathway

• Telephone support throughout adjuvant treatments

• Face to face meeting

• Further HNA

• Prosthesis fitting if required

Acting as a key worker across the whole care pathway

• End of treatment holistic needs assessment

• Meaningful conversation

• Care plan

• Moving forward health and well being event

Case Study

• Julie

• 44 yrs old

• Married

• 2 teenage daughters

• Works in supermarket