A day in the life of Louise Marley - Macmillan Head and Neck Clinical Nurse Specialist at the Royal Hallamshire Hospital

Check out what Louise Marley does in her role as Macmillan Head and Neck Clinical Nurse Specialist at the Royal Hallamshire Hospital

What does a typical day look like to you?

A typical day varies so very much as it is often dependent on patient and service need.

Initially the first task is returning any calls left by patients/carers/staff on our office answerphone. The level of intervention needed for calls can vary in complexity and time required. It isn’t an emergency line, but we do like to answer a call within the same day.

Running nurse-led clinics involves completing a holistic needs assessment for patients so that their care can be tailored to their individual personal needs. The assessment is performed pre and post treatment and allows time for the patient to ask questions and receive necessary support. Following this, we make any necessary referrals to other services such as benefit help. The appointments can take up to an hour, with additional admin time.

A personalised care plan is then written for the patient as a reflection of the consultation and is shared with them, their GP and hospital teams to aid a seamless service.

Education is also a huge part of my role; sharing good practice and empowering others to provide the excellent service that all Clinical Nurse Specialists (CNS) strive for each day.

In addition to this, I also see patients as needed in other clinics or when they are in-patients.

What led you to work in this role? 

I have worked in cancer nursing in various roles for decades and have been proud to be a CNS since 2003. As a ward nurse, I always aspired to be a CNS and so did a variety of roles to gain the necessary experience and knowledge whilst also studying to achieve the required academic qualifications.

In what way do you work alongside other staff or teams within South Yorkshire and Bassetlaw?

It’s essential that we work together with a wide variety of professionals to ensure effective and multi-disciplinary care. We communicate in a variety of ways - verbally, non-verbally or by letter. The team is multi-professional due to the complexity of our tumour group, this means we rely on each other for all our varied expertise and skill sets.

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

My role has changed over the last couple of years due to service demand and new initiatives such as the personalised care agenda. This means I have been involved in the education of a lot of staff across the trust, enabling them to incorporate this work into their daily care.

The impact of the pandemic is still felt in the NHS as we try to catch up, and cope with the extra demands that this, and other factors, place on care provision.

My clinics have flourished with numbers increasing constantly, as has our support group that runs alongside providing the wonderful peer support that we, as professionals, can never provide.

What excites you most about your role? 

To be able to help and support people with the aim always to make their very scary and life-changing diagnosis and treatment a little easier. To help make them feel that they aren’t alone and let the know that we are here by their side as they travel along their cancer pathway.

I have always strived to improve on the care I provide and have the necessary can-do attitude to adapt to change and service pressures.

My clinics excite me as you can make such a difference in that concentrated time with them and their carers, leading to less anxious and frightened patients and families. This then means patients are more likely to be more concordant with treatment and this in turn impacts the service overall.

I love running a support group and have done this for many years - it’s such a wonderful bunch of amazing members who develop new friendships as they grow in confidence with the support they get from one another.

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

Personally - My clinics are a huge achievement and have been used as areas of good practice in the trust. I also managed to pass my non-medial prescribers’ course last year which is notoriously hard, so that was a huge achievement.

Team – We are an amazing team of nurses who work so hard to support our patients and their carers, whilst also supporting the teams we work alongside. We are lucky as we work with a wonderful multi-professional team who strive to provide a high standard of care to a complex tumour group.

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

Our patients influence our care as we always react to their needs and change our service accordingly. We are privileged to care for a wonderful group of patients who make you feel very humble each day in the way they cope with the life-changing effects of treatment.

The public are often unaware of Head and Neck Cancer as it isn’t as well published as other cancers. For this reason, raising awareness of this and the main causes of this type of cancer and promoting a good healthy lifestyle is also a part of the job.

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

I have a new job starting soon which does move me away from patient contact. However, my new role involves enabling primary and acute teams to encompass the personalised care agenda into their daily work. In this way I feel I can use all my many years of experience and knowledge to enhance care on a much wider scale. I can also use the skills and my enthusiasm for this initiative including the work I have been doing in clinics to inspire others.

I will miss my role as a CNS as it is such a privileged and important role to patients and their carers as we act as the supporter and educator, but also the glue that ties everything together. To be able to make a difference to at least one person in the day is very rewarding and makes the role very fulfilling.

Great flexibility and autonomy are required in this dynamic role as new demands are placed on the services, but at the centre of everything is the patient and being their advocate.

Thank you for your time Louise, and good luck in your new role at Barnsley Hospital.