The crucial role of a Clinical Nurse Specialist (CNS)

Claire Deering, Brachytherapy Clinical Nurse Specialist at the Prostate Brachytherapy Centre, Royal Surrey County Hospital NHS Foundation Trust, gives us an insight into her role and the support she provides patients undergoing LDR-Brachytherapy treatment.

What is the difference between a Urology Nurse Specialist and a Prostate Nurse Specialist?

According to research commissioned by Prostate Cancer UK, the specialist cancer nursing community is pivotal to patient experience. The National Cancer Patient Experience Survey (NCPES) in England has demonstrated that patients with cancer who have access to a Clinical Nurse Specialist (CNS) generally report better experiences of care and understanding of the disease. They are less likely to feel isolated and more likely to feel they have their information needs met and are in control of their own decisions. However there is a wide geographic variation in the provision of specialist nursing for men with prostate cancer.

As Clinical Nurse Specialists, within the treatment of prostate cancer, the roles of Urology Nurse Specialist and Prostate Nurse Specialist remain linked. However, there has been an evolution within the role of the prostate cancer nurse specialist, which has led to the formation of sub specialist nurses. For example, working in a tertiary referral specialist centre, I am lucky enough to work within a nurse specialist team that is now made up of a Prostatectomy CNS, a Diagnostic CNS, a Community Outreach Prostate CNS and Metastatic Prostate Cancer CNS.

This sub specialising has enabled my job as a brachytherapy nurse specialist to evolve into an interesting and immersive role. It combines elements of the role of Prostate Nurse Specialist and Urology Nurse Specialist. The role of the Urology Nurse Specialist remains a vital and much more all-encompassing field in which you need expertise in a wider range of clinical scenarios.

Raising Awareness

A big part of my role is assessing patients for their suitability for brachytherapy as a treatment option and so I am lucky to spend time with them and hopefully inform them so they can be confident in the decision making process.

On a practical level, this usually means talking them through all the treatment options that are available to them and helping them to discount those options that perhaps they are less keen on. It also means providing information so patients can understand why a certain treatment option that perhaps they have their heart set on might not be in their best interest as an individual.

It’s important for the nursing community to take an active role in raising awareness of all the treatment options available within the general community. This could include more roadshow type events – perhaps at GP practices if they were in agreement, attending men’s health forum groups, speaking at support groups, meeting with primary care professionals etc. An online community where professionals can communicate via forums as proposed by BXTAccelyon is fantastic, particularly for treatment centres that might not be able to provide all the treatment options available to patients. This may be a starting point to overcome the accessibility and availability limitations currently in place.

Having the opportunity to speak to others within a secure online community would definitely help me to know I was doing everything I could to provide accurate and relevant information to improve the experience for prostate cancer patients across the UK.

A message to nurses and patients

Firstly, there are developments within the treatment of prostate cancer that are extremely innovative and exciting. Men do recover from prostate cancer and often with very few symptoms or side effects including in the area of erectile dysfunction.

Secondly, it really is important for patients and carers alike to explore all the treatment options to find that which is right for each individual. Research indicates that the majority of patients don’t seek advice from more than one specialist; they might not even be aware of all the options in making their treatment decision.

Finally, life really does continue, as does quality of life after treatment.