CNS Katy Hardy with patient Jonathan Brown

It is almost 40 years since The Royal Marsden’s former Director of Nursing, Robert Tiffany, pioneered the role of the clinical nurse specialist (CNS) in the late 1970s – and the role continues to evolve to this day.

Eamonn Sullivan, Chief Nurse, says: “Today’s CNSs are the lifeblood of The Royal Marsden. Their diverse role spans emotional support through to advanced practice, running clinics, prescribing, and providing continuity for specialist teams and patients alike. Evidence has shown their positive impact on patient outcomes.”

Amanda Baxter recently retired after 23 years as a CNS specialising in urological and gastrointestinal (GI) cancers. She says: “I always had a passion for urology and GI because patients have to deal with so many life-changing side effects from treatment.

“As well as looking after the patient, I shared my expertise by training ward nurses. For example, when I started as a CNS, I was the only nurse at The Royal Marsden that was trained in stoma management, so I spent a great deal of time training nurses in the care of stomas so patients didn’t have to wait for me in order to receive the appropriate care.”

Amanda has known some patients since her early days as a CNS and believes that those long-lasting relationships have kept her going.

Our patients are living longer, so the role of the CNS has become even more vital

Amanda Baxter

She says: “It’s one thing to treat the patient’s cancer but another to support them and help them learn how to live with cancer and beyond. In the past 20 years, there have been advances with radiotherapy and innovative surgical techniques such as bladder reconstruction. Our patients are living longer, so the role of the CNS has become even more vital.”

Katy Hardy, CNS in colorectal oncology, has also seen the role change. She says: “I became a CNS four years ago, working as the patient’s advocate and key worker. New surgical techniques have transformed the patient pathway. My work is now also moving towards one-stop support groups for patients to learn about survivorship as more complex surgery presents new challenges.”

Sarah Irving, breast cancer CNS, explains: “More women are being diagnosed and surviving breast cancer than ever before, and the care pathway can be long and complex. The patient’s journey is about them and we are there to make sure they are as involved in their treatment as they want to be.

“As well as providing emotional and psychological support, we ensure that their voices are always heard. We are also a valuable resource for the other professionals involved, so that we can work as one big team to provide patients with the best possible level of care.

“We have been described as the ‘glue’ between patients and all the other professionals involved in their treatment. It’s so rewarding to help patients through their journey and support them as they come out the other side.”

It’s so rewarding to help patients through their journey and support them as they come out the other side

Sarah Irving, breast cancer CNS