RCNi 'Excellence in Cancer Research' Nurse Award

These research nurses have established and developed a phase 1 oncology trials clinic at Southampton General Hospital, delivering a portfolio of complex academic and commercial trials while showing empathy and compassion to patients with limited options and life expectancy. The clinic offers patients hour-long appointments to discuss the complex information relating to participation in a phase 1 oncology trial, reducing pressure on busy oncology clinics. The nurses support patients while they wait for treatment slots to become available and manage referrals sensitively. They deliver treatments, including novel agent first-in-human treatments and capture data.

Karen Parsons conducted a pilot project integrating holistic needs assessments (HNAs) into the role of cancer research nurses when they become the key workers for prostate cancer patients participating in clinical trials. The HNA includes assessment of physical, practical, family/relationship, emotional, spiritual/religious concerns and lifestyle or information needs. The process includes continence and erectile dysfunction assessment, and development of appropriate care plans and referral. As well as ensuring seamless patient care, a care plan is devised with the patient agreeing the best way to manage concerns or appropriate referrals are made. Positive feedback indicates high levels of satisfaction with information, contact, treatment and support.

Advanced nurse practitioner Lorraine Turner led, designed and managed an audit to assess the holistic needs of the rapidly increasing number of patients referred to the experimental cancer medicine team. The audit highlighted patients who had a significantly high level of concern at referral, increasing to 79% at the end of trial, with concerns relating to current illness, treatment, physical concerns, not being able to do things, and the future. Symptoms causing significant distress at referral included pain, shortness of breath, bowel problems and lethargy. Approximately half were referred to palliative/supportive care services following assessment. Only 14% were already in contact with supportive care services.

This nursing team has demonstrated how to successfully run cancer trials in the era of personalised medicine. While its expertise is in first-in-human safety studies, it has enthusiastically embraced the opportunity to adapt working practices to deliver a molecular profiling and treatment study. This has been highlighted by the success of recruitment to the National Lung Matrix Trial in north east England, and the team’s record for ensuring patients with a potentially treatable abnormality in their lung cancer are offered a chance at treatment. The team provides continuity of care for patients during the complicated process of entering and participating in the study.