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A day in the life: paediatric nursing

A Clinical Nurse Specialist at The Oak Centre for Children and Young People talks about her daily routine

Helen Pearson, Clinical Nurse Specialist in solid tumours at The Oak Centre for Children and Young People

My day can be quite unpredictable as it varies according to the needs of my patients. Generally, I start my morning at the day care handover meeting. This is a useful time to update the wider team on individual patient treatments and any current issues to help with the patient pathway and communication.

My role as CNS is to guide, support and coordinate patients and parents through the treatment pathway, so I try to see them on as many hospital visits as possible but ensure I am at key consultations such as diagnosis, scan results and alterations in treatments.

Throughout the day, in between seeing patients, I spend a lot of time replying to the many phone calls and emails I receive. The majority of parents will call or email asking for symptom management advice or discussions regarding their ongoing treatment. I am able to make clinical judgements and decisions based on these conversations and act appropriately, whether this be to advise a medical review at their shared care hospital or provide supportive medication advice.

The Royal Marsden has a shared care working agreement with 16 hospitals in the South region so our patients can receive non-specialist treatment closer to their homes. I liaise closely with our shared care hospitals and children's community teams to ensure our patients are receiving the necessary supportive care during treatment.

The connection with the family is by far the best part of my job. The CNS role provides continuity of care and a point of contact in which families feel secure

Within the multidisciplinary team I refer patients for appropriate support. This includes dietitians, physiotherapy, psychologists and occupational therapists. I plan and organise scans and investigations as required during the patient's treatment protocol and where possible try to coordinate these on the same day to reduce hospital visits.

Three days a week I am in outpatient clinics. I think being in the diagnosis consultation is key for me building a relationship with the family. The connection with the family is by far the best part of my job. The CNS role provides continuity of care and a point of contact in which families feel secure. This is essential to the patient's pathway of care to help them adjust to managing in a stressful unexpected situation.

Caring for patients aged between one and 24 requires an adaptive approach to accommodate their individual needs. As a CNS I take into account the holistic needs of each family; for me it's not just about the patient's physical health but also having enough information to plan treatment around their lives. Schooling and holidays are an important part of family life and we try to accommodate treatment around this when it is clinically safe to do so.