Acute oncology is every nurse’s business, writes Jennifer Trueland
ISTOCKPHOTO
Urgent response to cancer
care of patients who died within 30 days of receiving chemotherapy. ‘I was already thinking about how we manage unintended consequences and I knew we had to look at things differently,’ says Ms Jones, who was instrumental in developing the
’WHAT WE NEED TO DO IS MAKE EVERYONE ACUTE ONCOLOGY-AWARE’ – Philippa Jones
widely used UKONS 24-hour triage tool for oncology and haematology patients. In July 2014 she was appointed Macmillan associate acute oncology nurse adviser, the first-ever post of it kind. She will use her experience to review and develop acute oncology services that support patients who require urgent care, either due to their cancer or to the side effects of treatment. They will also give people easier access to specialist advice and can help them avoid unnecessary hospital admissions.
SUMMARY
One of the challenges for nurses looking after patients with cancer is knowing when a side effect from treatment can be considered ‘normal’, and when it needs further investigation. If, say, nausea and vomiting are a typical complication from a particular form of chemotherapy, at what stage might it require serious intervention? And if a patient turns up in the emergency department with such symptoms, what should the nursing team do? These were some of the questions that had preoccupied Philippa Jones before she took on a new role in acute oncology last year. An emergency department nurse with many years’ experience who ‘fell into oncology nursing and stayed’, she knew that too many cancer patients were dying because of complications or toxicities caused by the treatment they had received. Her suspicions were backed by the findings of the National Confidential Enquiry into Patient Outcomes and Death (www. ncepod.org.uk/2008sact.htm). This highlighted problems with the
Ms Jones set up the Midlands Acute Oncology Nurses Forum, which now has 100 members from all over the country. The forum shares good practice, such as calling patients to see how they are getting on after chemotherapy – something that could avoid an escalation of symptoms that might lead to hospital admission. The need for acute oncology nurse specialists is growing, says Ms Jones, but she adds that knowing how to respond to cancer patients is important for nurses across the health service. One example of spreading knowledge and responsibility is the oncology 24-hour triage service, set up by Ms Jones in Shropshire, to provide systematic support to cancer patients and carers. Although initially provided by the acute oncology team and oncology ward at Shrewsbury and Telford NHS Trust, it had difficulty in dealing with calls in a timely manner as the workload increased. The service was outsourced to the out-of-hours medical service Shropdoc, which uses UKONS to assess patients who are then reviewed by a GP or referred to the trust. ‘The population of cancer patients is growing,’ Ms Jones says. ‘Acute oncology nursing is the best secret around. We have to make everyone acute oncology-aware. That includes people in A&E, in primary care and elsewhere’ NS
Nurses increasingly encounter patients with cancer who experience potentially fatal side effects of cancer treatments. In her new role with Macmillan Cancer Support, Philippa Jones is developing acute oncology services across the UK that will support patients needing urgent care and help avoid hospital admissions. Author Jennifer Trueland is a freelance journalist
NURSING STANDARD 11other :: voluses 29 no 28 ::permission. 2015 23 Downloaded from RCNi.com by ${individualUser.displayName} on Jul 24, 2016. For personal usemarch only. No without Copyright © 2016 RCNi Ltd. All rights reserved.
ISTOCKPHOTO
Urgent response to cancer
care of patients who died within 30 days of receiving chemotherapy. ‘I was already thinking about how we manage unintended consequences and I knew we had to look at things differently,’ says Ms Jones, who was instrumental in developing the
’WHAT WE NEED TO DO IS MAKE EVERYONE ACUTE ONCOLOGY-AWARE’ – Philippa Jones
widely used UKONS 24-hour triage tool for oncology and haematology patients. In July 2014 she was appointed Macmillan associate acute oncology nurse adviser, the first-ever post of it kind. She will use her experience to review and develop acute oncology services that support patients who require urgent care, either due to their cancer or to the side effects of treatment. They will also give people easier access to specialist advice and can help them avoid unnecessary hospital admissions.
SUMMARY
One of the challenges for nurses looking after patients with cancer is knowing when a side effect from treatment can be considered ‘normal’, and when it needs further investigation. If, say, nausea and vomiting are a typical complication from a particular form of chemotherapy, at what stage might it require serious intervention? And if a patient turns up in the emergency department with such symptoms, what should the nursing team do? These were some of the questions that had preoccupied Philippa Jones before she took on a new role in acute oncology last year. An emergency department nurse with many years’ experience who ‘fell into oncology nursing and stayed’, she knew that too many cancer patients were dying because of complications or toxicities caused by the treatment they had received. Her suspicions were backed by the findings of the National Confidential Enquiry into Patient Outcomes and Death (www. ncepod.org.uk/2008sact.htm). This highlighted problems with the
Ms Jones set up the Midlands Acute Oncology Nurses Forum, which now has 100 members from all over the country. The forum shares good practice, such as calling patients to see how they are getting on after chemotherapy – something that could avoid an escalation of symptoms that might lead to hospital admission. The need for acute oncology nurse specialists is growing, says Ms Jones, but she adds that knowing how to respond to cancer patients is important for nurses across the health service. One example of spreading knowledge and responsibility is the oncology 24-hour triage service, set up by Ms Jones in Shropshire, to provide systematic support to cancer patients and carers. Although initially provided by the acute oncology team and oncology ward at Shrewsbury and Telford NHS Trust, it had difficulty in dealing with calls in a timely manner as the workload increased. The service was outsourced to the out-of-hours medical service Shropdoc, which uses UKONS to assess patients who are then reviewed by a GP or referred to the trust. ‘The population of cancer patients is growing,’ Ms Jones says. ‘Acute oncology nursing is the best secret around. We have to make everyone acute oncology-aware. That includes people in A&E, in primary care and elsewhere’ NS
Nurses increasingly encounter patients with cancer who experience potentially fatal side effects of cancer treatments. In her new role with Macmillan Cancer Support, Philippa Jones is developing acute oncology services across the UK that will support patients needing urgent care and help avoid hospital admissions. Author Jennifer Trueland is a freelance journalist
NURSING STANDARD 11other :: voluses 29 no 28 ::permission. 2015 23 Downloaded from RCNi.com by ${individualUser.displayName} on Jul 24, 2016. For personal usemarch only. No without Copyright © 2016 RCNi Ltd. All rights reserved.
