Debora Franchini

My name is Debbie and I work as Haematology Clinical Nurse Specialist at the Royal Hampshire County Hospital in Winchester.

My role is to support patients and their families from cancer diagnosis, trough treatment and beyond.

I act as key worker for the haematology patients in my caseload. This means that I am the link between patients and the wider multidisciplinary team. Part of my role includes referring and signposting patients to other local or national services, from which they can access psychological, spiritual, financial and social support if required.

When appropriate, I refer patients to different specialities or other health care professionals (e.g. physiotherapist, dietitians, OT, GP,…) to try and improve their quality of life or improve the side effects caused by their chemotherapies.

I have been working within haematology and cancer care for nearly five years now and wouldn’t change my job for the world. Being a clinical nurse specialist gives me the opportunity to make a difference for people affected by blood cancer.

As a CNS, I have the opportunity to support patients and their families in all aspects of their disease, treatment and care. The relationships I build my patients often span over a few years, which means I get to know them on a much more personal level than other professionals. Being able to build meaningful therapeutic relationships is very special and rewarding: it is what I love the most about my job.

I have recently become a representative for the UKONS Young and Early Career Cancer nurses MIG. I hope that my passion for cancer care will be able to inspire other young nurses to work and find their place within this rewarding specialty.

Emma Paul

The day in the life of an Acute Oncology CNS!

When we arrive at work, we ensure all the safety checks are done and take the phone off divert from the Out Of Hours team on the inpatient ward. The phone is a 24/7 line for patients who are unwell due to their cancer or cancer treatments.

We then have three safety huddles: CNS huddle (08:00), chemotherapy unit huddle (08:30) and a doctor huddle (09:00). This is to ensure everyone is aware of the plans for the day, jobs are allocated, and any expected difficulties are highlighted.

The rest of the morning usually consists of patient follow-ups and chasing blood or scan results which are kept in the diary. During this time if we have any calls from patients we would like to review, then we arrange for them to come to AOS for face-to-face review. We may also have face to face reviews scheduled in the diary from previous days or for patients who need review when on the unit having treatment. AOS receive referrals from CNS’, consultants, palliative care and other MDTs to call and see patients.

We also look after our cancer patients as inpatients. Every day we get a list of patients who have been admitted in the last 24 hours, if appropriate we add them to our inpatient list to see on the ward round. Usually, we have a consultant led ward round at least twice a week, on the other days it is SHO, or nurse led.

Part of a normal day is collecting data on both patients admitted with neutropenic sepsis and metastatic spinal cord compression to ensure our patients are receiving the right care on time.

We also carry out teaching and drop-in sessions for our OOH team to improve their competence and confidence in taking phone calls on the AOS line, as well education for our chemotherapy units, emergency departments and medical teams.

At the end of the day, we complete our safety checks and then hand/divert the AOS phone over to the OOH team on the inpatient ward. Ensuring all patients to be followed up and tasks for the next day are written clearly in the diary.

Clare Clayden-Lewis

My name is Clare and I am the Macmillan Lead Breast Clinical Nurse Specialist at Hampshire Hospitals NHS Foundation Trust.

I became a clinical nurse specialist as I wanted to extend and develop my skills to help support patients through their cancer pathway. I was adopted by Macmillan after my first year and the support they have provided has significantly helped to develop my career.

There continues to be significant new developments in the treatment of breast cancer and my role as a breast clinical nurse specialist is varied. No two days are the same and our duties range from providing telephone support, nurse led clinics and teaching to specialist skills such as lymphoedema, nipple tattooing and breast form fittings.

As a team we work very closely together, alongside members of the multi-disciplinary team. As a unit we are fortunate to be able to offer a wide range of oncoplastic techniques and advances in radiotherapy including intra operative radiotherapy.

I enjoy all aspects of my role, especially being there to support patients, their partners, their family and carers. It is a privilege to be a keyworker and getting to know patients, building a rapport and developing relationships. We help people when they may be at their most vulnerable, in order to make their pathway as straightforward as possible and aim to provide high quality care from diagnosis to patient led follow up.

It is fantastic to have a clinical nurse specialist day in order to raise the profile of clinical nurse specialists everywhere and celebrate the role and the work that we do.

Gemma Bryant

I work at Poole Hospital as the Acute Oncology Clinical Nurse Specialist, which encompasses Cancer of Unknown Primary. I have been in this role since October 2021, having previously worked as the Oncology Inpatient Ward Sister for 7 years. During my 7 years as a Ward Sister I was fortunate to have the opportunity to do a 9 month secondment to the Upper GI and CUP CNS role. It was during this time that I first found my love for the Cancer CNS role.

I feel it is a privilege to be able to support patients through their Cancer diagnosis and journey. As part of my role I meet patients at diagnosis, where a primary site of disease is not initially obvious. I then support the patient through subsequent investigations and procedures, being a primary contact for them at a time of uncertainty. It is rewarding to be able to provide a high level of support, both practically and emotionally to patients and their families. Occasionally, we are unable to find a primary cancer site and these patients remain under my care throughout their journey.

I am fortunate enough to have a very diverse role, which allows me to provide hands on patient care in our Oncology Assessment Unit, triage acutely unwell patients and use my assessment and prescribing qualifications. In addition to this, I provide education and training about Acute Oncology to the Oncology directorate and the wider Trust, including ED and AMU.

I love my job as every day is different, I feel I am able to make a positive difference and this is very rewarding. It is emotionally challenging and hard work but I am fortunate to work with an amazing team of Nurses, Doctors and Support Staff. Being a Nurse is part of who I am.

Susana Pires

Hi, my name is Susana and I’m a Haematology Specialist Nurse. I have started this role recently, although my background is Oncology/haematology – ward, chemotherapy, homecare, IV access and Lymphoma.

What I love about my job is that it is always so diverse, and I am able to use the competences I developed throughout the years to help my patients.

Part of my main role is to develop an exciting remote follow up system that has its focus on empowering patients to self-manage their haematology conditions, while still being under our care. We all know about the pressures the NHS is under and the haematology team in Portsmouth is really driven to develop innovative and sustainable ways to keep delivering the best care to patients and maintain a healthy work environment for staff.

At the moment a day in my life may mean I’m creating protocols and working on new pathways. The next day (or even in the same day) you will find me providing psychological support to patients and relatives, giving advice and education about their conditions and treatments, liaising with different teams, breaking bad news, etc.  Because I also love to be “hands on” and use my clinical skills, you will also find me administering chemotherapy, doing bloods tests, reviewing patients on the phone or face to face. It really depends on what the person needs, being flexible and compassionate is key.

I look forward to sharing with you the impact of these changes on the next CNS day.

Frankie Webb – What my CNS did for me

I was diagnosed with breast cancer in 2006. So many years ago. I have forgotten much of the emotion that everyone goes through.

But I will never forget the special person who guided and supported me and my husband.  My CNS.

Th first time I met her was when I was given my diagnosis.  After the Consultant left the room, she stayed with us to make sure we understood what was happening.  I knew from that first meeting that I would be safe and my husband also.

She was there at every meeting. When it came to chemotherapy, I was scared but needn’t have been. My husband came along to every session and the CNS was there to make sure we both were ok. She would chat to him if she though he needed it and sometimes send him off to get a cup of tea.

She gave me a card with her phone number and carried it with me everywhere.

No matter how busy she was we always felt she was there just for us!

This was now over 15 years ago and it is only this week that I have thrown away that phone number.

This is the reason I joined Cancer Services Partnership.  Not just to give a patient voice to cancer services at HHFT but also, where possible, to support these special people.  Hopefully I can give back something.

Thank you.  You will never be forgotten.

Rachel’s story

I first met Chrissy CNS at Hampshire HHFT a few days after my sudden diagnosis of Leukaemia back in May 2019.

From that moment she was always there for anything I needed importantly when she was having a well earned rest Eleanor CNS would be available too.

Chrissy provided lots of information, answering questions patiently and honestly. Checking in on me when I was an in-patient for many weeks and importantly supported my family too.

As treatment continued as an outpatient Chrissy with Eleanor were always there a constant source of help, information and reassurance, often going above and beyond always knowing what mattered to me.

Once treatment finished Chrissy has continued to be there via email and phone for anything related to my diagnosis and ongoing regular check ups. Just knowing someone like Chrissy who knew me well was out there has made such a difference, forever grateful.

Eileen Stonock (Rachel’s mum):

The importance and impact of the CNS’s role cannot be underestimated and indeed deserves this celebration.  I echo Rachel’s words above. As her mum I have witnessed and know the huge difference having Chrissy with Eleanor has made throughout her treatment and beyond. Just having someone who knew Rachel recognising what matters to her, as her mum is beyond reassuring. Thanks for being there for me too.