Nicola James

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Nicola James

How my patient experience has enabled me to empathise with those in my care

My own diagnosis made me re-evaluate what I thought I knew about survivorship


Why euthanasia has stunted palliative care's development in the animal world

Should the veterinary profession’s justification for euthanasia ever apply to human beings?

Book review: Aromatherapy, Massage and Relaxation in Cancer Care

Nurse consultatnt Nicola James reviews Aromatherapy, Massage and Relaxation in Cancer Care by Ann Carter and Peter A. Mackereth.

i am here

Book Review: I Am Here

Nicola James reviews this memoir about encounters with people on an oncology ward in Melbourne.

I Am Here book cover

Book review: I Am Here

Nurse consultant Nicola James reviews I Am Here by Johannes Klabbers

Confused pathway

Without a clear path, senior nurses are lost

Financial uncertainty and a lack of defined career pathways mean specialist staff get stuck in one place, says Nicola James.

The success of a nurse-led, one-stop suspected prostate cancer clinic

Until recently, the prostate biopsy, and accompanying trans-rectal ultrasound, has been the domain of senior doctors. However, there is no reason why a senior, appropriately trained nurse could not undertake this part of the diagnostic pathway. This article describes the development of a one-stop, nurse-led prostate cancer clinic. It shows how the entire diagnostic pathway for men with suspected prostate cancer can be nurse-led in a safe and competent manner. Continuous robust audit of the patient experience and of safety issues relating to the biopsy itself describe a service that is welcomed by patients, that has dramatically improved their experience, has significantly improved waiting times and is as safe as a medically-led service.

Managing cancer of unknown primary: Are we getting it wrong?

Cancer of unknown primary features among the ten most common cancer diagnoses. Patients are often very ill at presentation and currently, management of their condition focuses heavily on finding the primary site, possibly at the expense of other needs. This article considers the debate surrounding the search for the primary site, reports on 14 case histories and discusses the need for a more co-ordinated and evidence based approach to the care of this patient group.

Extending outpatients’ hours

An evening clinic for urological follow-up appointments was led by a nurse consultant at Chesterfield Royal Hospital NHS Foundation Trust in order to: meet national waiting time targets; improve the quality of service delivered; address the problem of lack of clinical space during the day, and provide patients with a choice of appointments. A questionnaire was sent by post to a random selection of patients who had attended the hospital’s evening clinic. The intention was to determine their views on appointments outside the traditional hours of 9am to 5pm. A total of 90 per cent thought that evening clinic appointments should be more widely available. The results show that consideration should be given to a more widespread approach to moving away from office hours in terms of outpatient activity.

The role of the uro-oncology CNS

To meet the new cancer related targets, address the void left by junior doctors and to improve patient care, a uro-oncology clinical nurse specialist (CNS) was added to the urology team of Chesterfield Royal Hospital with the specific aim of developing nurse-led prostate cancer follow-up. This article chronicles the development of this role, and considers the difference that having a CNS in post makes to the patient’s experience of cancer.

Establishing a prostate cancer support group

Whilst in the UK, there has been no shortage of breast cancer support groups for women, there are comparatively few support groups for men with prostate cancer, often regarded as a similar disease in terms of trajectory. This article considers this inequality, and looks at the need for, and the experience of, setting up a prostate cancer support group facilitated by clinical nurse specialists.

The importance of clinical trials in cancer care

If the treatment of cancer is to advance, it is essential that research and...