Filipe Carvalho - Advanced Nurse Practitioner in colorectal surgery

I began working at The Royal Marsden 10 years ago when I moved to London. I trained in Portugal and worked in an oncology hospital near my home in Lisbon. I started as a staff nurse in Burdett Coutts Ward, then became a clinical site practitioner. I worked up to the position of Advanced Nurse Practitioner (ANP) in Colorectal Surgery a few years ago.

Working together

My day starts at 7.30am with the routine ward round. This involves managing my surgical patients, which includes carrying out assessments, making clinical decisions and formulating management plans. I look after all colorectal surgical inpatients, so I liaise with a variety of nursing staff and allied health professionals, such as dietitians, to ensure safe and high-quality care.

I work with the patients, their relatives and their community team to ensure they have a management plan in place to support them when they are discharged. Patients can contact me if they feel unwell or have any questions after surgery, and I can usually help. In more complex cases, patients come back in so I can assess them and perform blood tests or X-rays to diagnose any issues and provide ongoing care and treatment.

My patients are located all across the hospital, so I move around a lot. I also liaise with medical teams when patients require a surgical review, which means I can see 10 to 30 patients in an average day.

Lending support

As well as an ANP, I am the Lead Nurse for gastrostomy devices. This means I am the main contact for any patient with this type of feeding tube. For many years, patients with head and neck or oesophageal cancers would have a feeding tube inserted and be looked after by a large team of highly skilled health professionals – but no single person was responsible for co-ordinating the patients’ care after insertion.

I work closely with dietitians, interventional radiologists and clinical nurse specialists, so if the patient has a problem, I can support them. In addition, feeding tubes need to be changed routinely every three months, which I can do – but in the event that one becomes blocked, I can be called to either Chelsea or Sutton to deal with it.

I try to set aside some time for research to share knowledge and develop innovative ways of working and treating patients. I have been involved in a number of studies and written a chapter for The Royal Marsden Manual of Clinical Nursing Procedures. I also spend
time at The Royal Marsden School teaching advanced clinical assessment skills to nurses from all over the country, which I find extremely rewarding.

Although I have developed my skills and knowledge by completing courses such as my prescribing qualification, I feel blessed to have a job that still allows me to support patients every day. To be able to help patients get the most out of their lives at such a difficult time is a huge privilege.