Claire Taylor

Assessing and managing chemotherapy-induced peripheral neuropathy

Assessing and managing chemotherapy-induced peripheral neuropathy

CIPN is a common side effect of certain cytotoxic regimens characterised by sensory symptoms

Essential toolkit: colorectal cancer

Keep your learning up to date with our series of monthly toolkits to help support nurses in delivering recovery cancer care.

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Claire Taylor: Helping people to live better with and beyond bowel cancer

About half of those treated for rectal cancer will have debilitating bowel symptoms. Offering simple advice and signposting them to where they can get help can significantly improve their quality of life, says Macmillan nurse consultant Claire Taylor.

Pelvic exenteration for rectal cancers

Nursing care for patients undergoing pelvic exenteration for rectal cancers

Pelvic exenteration is an established surgical procedure aimed at removing primary locally advanced pelvic cancers or recurrent pelvic cancers. Exenteration is major surgery, involving considerable risk of morbidity and prolonged recovery. Patient suitability should be considered carefully and all potential complications discussed pre-operatively so that patients can make an informed choice about treatment. This article focuses on pelvic exenteration for patients with rectal or anal cancer. The surgery involves removal of the rectum and possibly also the bladder, and therefore stoma formation. In addition to physical challenges, such as pain and fatigue, patients face emotional issues such as altered body image. Nursing care is therefore crucial and, ideally, should be provided by a specialist service to ensure that all members of the multidisciplinary team are able to contribute to patient-centred care. This article explores the elements of nursing care after surgery and in the longer term, including pain management, mobility, nutrition, fatigue, stoma care, continence and support with psychological issues such as sexuality. The management of potential post-operative complications, such as unplanned return to surgery, is also discussed.

Stratified follow up: supporting patients to self-manage

Changing the way people are supported after cancer treatment is a national priority to ensure they are helped to live well with and beyond the disease. At present, follow-up care is medically led, does not meet all people’s needs and has insufficient capacity to cope with increasing numbers of survivors. Implementing stratified follow up can improve after-care as it offers a personalised approach, promotes supported self-management and allocates more resources to those in greatest need. This article proposes that, before implementation of stratified follow up, time is taken to embed the recovery package in mainstream after-care, thereby offering greater opportunities for support after cancer treatment. Practical considerations are discussed, informed by experience of running a pilot pathway for colorectal cancer survivors. To achieve this service redesign, a cultural shift is required by managers and commissioners to enable the necessary resource allocation.

Boundaries in advanced nursing practice: the benefits of group supervision

Aim The aim of this study was to identify the effects of a clinical supervision group on the practice of biofeedback therapists. Method Qualitative methods, including in-depth interviews, semi-structured interviews and non-participant observation were used to gather data to explore the experience and perceived impact of clinical supervision. Results Group supervision provided a safe environment for practitioners to share experiences and test ideas about their practice. It increased their ability to set boundaries with clients and realise the limits of their practice. Conclusion Clinical supervision in a group was found to enhance effectiveness, and professional and personal development.

Patient satisfaction with information on late effects

A patient survey was conducted to determine satisfaction with information provision during pelvic radiotherapy and identify any unmet information needs. A questionnaire was designed that incorporated questions from the European Organisation for Research and Treatment of Cancer Quality of Life Group information questionnaire. Eligible patients were identified from a database of those who had received treatment at the cancer centre over an 18-month period. Eighty three patients were sent the questionnaire and 58 (70%) responded. Nearly half would have liked more information and none wanted less. More than two thirds of respondents stated they had received written information, which in half of cases was offered by a nurse. Information on potential late effects of radiotherapy was well received, with most indicating a preference to be offered it before treatment. Continuing review of an individual’s information prescription throughout the cancer pathway is recommended.

Reviewing nursing support in cancer care

Supportive care has come to the forefront of political attention, a fact symbolised by last month’s release of the National Institute of Clinical Excellence (NICE) Supportive and Palliative Care Guidelines to improve care for adults with cancer. The full scope of this guidance for service delivery is intended to improve cancer patients’ experience of care – one of the central aims of The NHS Cancer Plan (Department of Health, 2000). A review of our own role in offering support, and our position in ensuring that the appropriate recommended supportive services are available, is, therefore, timely.