This nurse said that she had told patients she had taken a course: ‘They’ve (patients) been very interested and I had a lady just now that I
saw for a cancer care review and she said it was very useful having me here in the surgery because she said I can make an appointment
with you any time and chat to you but I can’t at the hospital…I think people often feel nurses have more time than GPs... and they
can come and discuss non-medical problems like psychological issues or problems about appearance.’ (PracticeNurse)
Practice nurses are delivering cancer care reviews, assessment and care planning as a result of understanding of the key concepts and developments in cancer care. Some nurses are doing combined chronic disease and cancer clinics, seeing patients annually and
following them up.
This nurse works with the secretary every month to identify patients who are due for their reviews and checks whether they have seen the doctor. Practice Nurses said that the GPs previously did all the
reviews but now if they feel the patients need more input and time they refer them to the nurse. Cancer care reviews generally took 20
or 30 minutes but one nurse said she would take as long as needed, which could be up to an hour.
One nurse talked about an opportunistic cancer care review she had carried out where ‘the patient talked through her fears and
everything and afterwards she said 'I feel so much better' and I didn’t really feel as if I’d done anything but that was equally something I picked up from the course. You know as nurses you want to advise and educate and you want to make things better, but
actually with your cancer care patients that’s just letting them talk.’ (Practice Nurse)
This practice nurse described a patient she had seen in a review. ‘I would say the other one that got a bit tearful, and I think she’d been bottling everything up, just seeing her going out of the room smiling whereas when she came in she was really wound up and really anxious and then seeing her going out and saying ‘I feel so much better now’. I think, because I had the time, the allocated time booked, you feel that you’re not going to rush, that you’re just going to sit and listen whereas if that time hadn’t of been allocated I might have really, I couldn’t really hurry her along but I wouldn’t have spoken to her in such depth had I not been allocated the time.’
Benefits taken from the Macmillan Outcomes Framework….
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