"My role is multi-functional and that’s why it’s so rewarding. We receive many anxious patients who come through the department, you’re part of their care while they have tests, you see them when they come for results, we meet them again on the wards, post-operatively and we may see them beyond that for follow ups. Patient care is non-stop, it’s seeing them and being there from the start to the end of their pathway."
I completed my training back in 1980 at the old Addenbrooke’s as an enrolled nurse. After getting married and having a family I came back to the Trust working twilight shifts and weekends before eventually getting a job on D7, which was a surgical ward. Whilst there an opportunity arose in the breast unit to undertake some research with breast patients, which then led onto the possibility of working in the outpatient department with breast cancer patients. I eventually became a full time breast care nurse, going on to train as a nurse practitioner. I completed my registered nurse training and went on to complete my Degree, followed by my Masters in Advanced Practice. I was the first nurse trustee of the Advanced Breast Surgeons (ABS). So I’ve grown within the role.
I’ve been in the Trust and in this team for a long time and it’s a reflection of how lovely the department is – I’ve never wanted to look elsewhere. I manage a team of cancer specialist nurses and a group of healthcare assistants. I work clinically – I see patients that are referred on a two week wait by their GP with a breast symptom. I examine patients and request any imaging they may need - an ultrasound or mammogram - which might lead to a biopsy and might diagnose breast cancer.
As a team, we run clinics every day of the week and can see up to 30 patients in each clinic, and also run assessment clinics where patients come after they have gone for a routine mammogram (for example in a Tesco car park), if they have an abnormal mammogram they are recalled to the breast unit for further assessment. In our roles we might meet patients before they have imaging and further diagnostic tests or it might be afterwards – our aim is to try and meet every patient that has a biopsy whether they have a possibility of breast cancer or not, so we’re there as a point of contact and they have that point of contact back to the unit.
"We want patients to know we’re a team, that we work together and feel ‘they know about me’ which is really important. Wherever possible we will try and give continuity of care so if you’ve seen someone you may want to see them at the results appointment too – it works well."Joanna Rowley
The most rewarding part of the job is feeling you’re making a difference. I think every patient that comes into the breast unit is fearing in the back of their mind that they have cancer, so to be able to assess and relay their worries and confirm it maybe isn’t breast cancer and is something else we can deal with, or with those who do have breast cancer it’s knowing they’ve done the right thing and are here now, we can look after them, get them the right treatment and support them.
I think to be a CNS or lead nurse you need to be a caring person and have a calm, cool head on your shoulders – there’s times things don’t quite go to plan, but being calm in certain situations reflects on patients and their trust in you. You need to be knowledgeable in your speciality so your patients are kept informed of best practice.
We want patients to feel they’re being cared for by a team who have their best interests at heart and to feel safe with that team – I know if it was me I would want to feel that someone is going to look after me, inform me and get me where I need to be.
"Cancer care has changed so much even in recent years."
When I started you may not have had a breast specific surgeon perform the operation and there were only six breast beds in a surgical ward. Today we have dedicated Consultant breast surgeons who use many different operating techniques, very much focusing on ensuring cancer is removed and the best cosmetic outcome is the result.
Ten to 15 years ago, you would have had a breast cancer diagnosis and had surgery and radiotherapy, but now it’s much more personalised and I know there is a lot of work happening in research to tailor treatments to individuals which is the way forward. Nearly every patient is offered some form of a trial throughout their treatment pathway at some stage.
I’ve been involved in the planning stages of the new breast unit within the new Cambridge Cancer Research Hospital – it’s very exciting and sounds like a great vision for the future. I think some of the ideas for the hospital are very forward thinking and I think for patients it’s going to be a centre of excellence in caring for women with breast cancer. And not just from a clinical point of view, but much more onus is now put on the holistic side of things, which is something I’m passionate about. I’ve been very active in recruiting a counsellor for the breast unit and she makes a huge difference to patients, who are offered six weekly counselling sessions as they finish their treatment/journey. I think that’s a big shift we’ve seen and I think it will carry on with the new hospital.