Day in the life – Diane Leach - Uro-oncology Clinical Nurse Specialist

We have another 'Day in the Life' story focusing on medical professionals across our region. Diane Leach is a ​Lead Uro-oncology Nurse Practitioner at Weston Park Hospital. As we look forward to National CNS Day on 26th April, it’s never too early to hear from the amazing people behind the titles.

 

What does a typical day look like to you?

 

At the beginning of the week, I look through all my clinic lists identifying new patient appointments, patients attending for scan results and patients who may have progressed on treatment and need further support.

 

Frequently I attend clinics for face-to-face appointments to provide effective, supportive and quality service for patients and their families. Patients are given a contact card so that they have continuity throughout their cancer care pathway. I act as a patient advocate and refer to other members of the multidisciplinary teams such as community palliative care, lymphoedema nurse specialists etc as required. 

 

I also signpost to other services that would be beneficial for example the Weston Park cancer support centre, the Cavendish centre or if they live outside of our region to their local support groups. I provide patient packs with relevant information leaflets where appropriate. I arrange scans, blood tests and prescribe medication if needed. A key role is providing emotional care and support to patients and their families whether that is at the start of their patient journey, coming to terms with a new diagnosis or the transition to a palliative care setting.

 

We have a direct telephone line where patients can leave messages for queries and advice that the team and I pick up throughout the day. Enquiries vary from clarification of treatment plans from their clinic appointments, how to get further medication when they are getting low on supplies, chasing up appointments, blood tests, scan results and what to do if they are feeling unwell or think they have mild side effects.

 

Discussions with patients can help prevent unscheduled admissions and assist with symptom control and care in the community setting. Being vigilant with patient monitoring and assessment can identify concerns early, preventing the escalation of adverse effects. I can arrange urgent appointments or after discussing blood results that are within normal limits, I can push back routine follow-up appointments to a later date. 

 

I also undertake a nurse-led radiotherapy telephone follow-up clinic which helps free up consultant clinic slots. I liaise with the patient's GP advising what further follow-ups and blood tests are required in the community. In this clinic, I assess patients for late effects from treatment given and refer them to other clinics for further assessment of symptom management as necessary.

 

What led you to work in this role? 

 

I have been at Weston Park as the Uro-oncology nurse for 5 years. Prior to that I worked as a stoma care nurse specialist at the Royal Hallamshire Hospital. My move to Weston Park was for career progression. It was a new post with the opportunity to undertake the MSc in Advanced Clinical Practice (ACP) where I found patient assessment and non-medical prescribing essential for working at an advanced level. I was also fortunate enough to be able to undertake the excellence in prostate care and treatment module which I have found invaluable for my role and the patients I care for. 

 

In what way do you work alongside other staff or teams within SYB?

 

I work closely with my immediate colleagues in the Uro-oncology team, other members of the multidisciplinary team (MDT) and have connections with staff from outside the region and in the patient’s local district hospitals. 

 

I am a member of the SYB Cancer Alliance clinical delivery group for urology where we review policies and look at how we can improve the quality of urology cancer services.

 

I am also an active member of the Urostomy Association where we have patient support groups/meetings locally.

 

How has your role changed in the last couple of years?

 

During the COVID-19 pandemic, a lot of the appointments were virtual with more telephone clinics. There was a lot of uncertainty and raised anxieties for patients regarding their treatments. It was especially hard for new patients and patients who found speaking on the telephone difficult. 

 

Although patients are now coming back for face-to-face appointments there are still some telephone appointments. We have found new ways of working that previously would not have seemed possible. There are advantages of telephone calls but as a specialist nurse, it is essential to make sure the patient and relative fully understand what was discussed during their consultation.

 

Over the last few years, I have also seen patient numbers increase with the introduction of new treatments resulting in patients living longer with their disease. 

 

What excites you most about your role? 

 

It is a very rewarding job that provides that nurse-patient relationship, improves patient experiences and outcomes and helps patients maintain a good quality of life. Through good communication, I can help to relieve patients and their family's anxieties and manage their expectations. I empower patients to take some control of their disease management and I also meet some inspiring patients.

 

Are there any personal or team achievements or highlights you’re most proud of? 

 

I am proud to have represented Sheffield Teaching Hospitals when presenting at national conferences and publishing articles in the British Journal of Nursing. I won a research award for work undertaken and stoma care nurse of the year award. I was also a finalist in the British Journal of Nursing awards. I am involved in writing national guidelines and patient information booklets.

 

In what way do patients or the public influence the work you do?

 

Listening to patients and relatives is very important. From patient feedback, I look at how we can improve the service with the resources we have available.

 

Looking ahead, what do you hope to achieve in the future within your role?

 

Currently, I am doing my MSc dissertation looking at service improvement and how I can demonstrate the value of our role to secure Uro-oncology funding for further resources.

 

At present, as a team, we are not able to be present at each key point of the patient's pathway and are unable to offer everyone a holistic needs assessment which is a national recommendation.

 

I also plan to start a local prostate cancer support group to inform patients about treatment options and new developments giving patients a feeling of control over their disease and giving them the opportunity to meet with fellow patients. It will also be a chance to discuss and promote a healthy lifestyle such as diet and exercise.