For 9.5 years I worked as a Clinical Nurse Specialist (CNS) in cancer care, working closely with multidisciplinary teams (MDT), planning services and delivering care that reflects the complex needs of this group of patients. Without this role and experience I wouldn’t have been able to build advanced clinical and diagnostic skills, alongside my non-medical prescribing and expertise in cancer care, allowing me to now work as an Advanced Nurse Practitioner in breast care.
As a CNS I was the key worker for a specific cancer site, e.g. breast, lung and brain, across the whole care pathway. Requiring an in-depth knowledge of a particular tumour site meant treating and managing patients’ health concerns, as well as promoting their health and wellbeing, it allowed me to develop the skillset for advanced nurse practice.
So what is a typical day for an advanced nurse practitioner?
After getting early morning admin done and/or attending a weekly breast unit meeting my patient work begins with a 2-week cancer wait clinic. Here I will see between 12-14 patients who have been referred by their GP for suspected breast cancer. The patients will undergo a triple assessment (physical examination, +/- mammogram if they are age 40 or over, +/- ultrasound) and if their imaging and examination is suspicious for a cancer they will then go on to have a biopsy and return to clinic 7-10 days later for the results. Throughout this process and any further treatment psychological support is so important, and I am there to provide this and answer any questions they might have before a breast care nurse is asked to provide further support. Empathy and advanced communication skills are vital for accurately assessing patients’ holistic needs and referral onto appropriate services in order to meet them.
Once the morning clinic has finished its time for lunch, checking emails or attending an Multi-Disciplinary Team meeting. This is followed by an afternoon clinic where I review 12 patients who have completed chemotherapy/radiotherapy treatment and assess for any signs of recurrence. The day can be varied as we may be telling patients that their disease is stable or we may be giving news they do not want to hear.
As a Cancer CNS, it has enabled me to develop a breadth of skills and work across a wide range of settings, contrary to the misconceptions about the role. I would not have been able to progress my career to become an Advanced Nurse Practitioner without this experience I would encourage colleagues to consider how you may wish to take your next step in your nursing career.
Further information
RCN Cancer and Breast Cancer Forum
RCN Library subject guide
RCN Standards for advanced level nursing practice
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