Nurse teams: using every member’s skills to improve patient care

The One Step at a Time initiative, developed as a result of a nurse’s own experience of cancer, offers support with accessible information written for patients by patients

  • Nurse Emma Harnett spearheaded the project after feeling unprepared when she herself was diagnosed with cancer
  • Underpinning it is a drive to improve the experience of those affected by cancer and support communication with their significant others
  • The initiative won the Team of the Year category at the RCN Nursing Awards 2022
Initiative founder members (from left) Emma Harnett, Shahid Sardar and Ann Nutt Picture: Tim George

Just a week after getting a new job as primary care nurse facilitator at charity Macmillan Cancer Support, Emma Harnett was herself diagnosed with cancer.

Despite years of experience as a practice nurse – and her new role improving and shaping cancer services – she felt completely unprepared. Although she had exemplary care, the sense of not really understanding what was going on – or the implications – persisted and if anything, became even stronger when she completed treatment.

The right support at the right time

It was this experience that inspired One Step at a Time, an initiative that supports cancer patients by providing accessible information – and which has won the RCN Nursing Awards Team of the Year category, sponsored by LV=.

‘It was a harrowing time,’ says Ms Harnett. ‘Exactly seven days after I got the job I was diagnosed with cancer, and found myself accessing Macmillan services and going through that journey.

‘The treatment and aftercare I had was brilliant, but once you go through treatment there’s a seeming lack of support. There actually is a lot of support out there to help you pick up the pieces, but once you’ve finished cancer treatment, and you’ve been so well supported every step of the way, you feel that it drops off a cliff.’

‘What prompted me to start this movement is really the need to keep information simple, in language that everyone can understand’

Emma Harnett, founder of One Step at a Time, which won the RCN Nursing Awards Team of the Year category

The project got off the ground after Ms Harnett had a meeting with Ann Nutt, patient panel chair at Princess Alexandra Hospital in Essex. This started a conversation about what patients actually need to make the process easier for them, and that included revolutionising the type of information available. The other key member of the team from the beginning was hospital patient engagement lead Shahid Sardar.

Cancer information for patients, by patients, with expert input

One Step at a Time (OSAAT) is essentially cancer information for patients, by patients and professionally produced, Ms Harnett explains, with involvement from patients and clinicians. ‘I have that unique position of being a nurse and a Macmillan professional, but also have the lived experience,’ she says.

‘On diagnosis you’re given a huge folder of information, and that’s somewhat bewildering and overwhelming. I’m a nurse and do understand the clinical side, but not everybody does. What prompted me to start this movement is really the need to keep information simple, in language that everyone can understand.’

The three started out making a short video based on Ms Harnett’s experience of cancer, and then launched the OSAAT brand in October 2020. Word soon spread, and Ms Harnett’s colleagues at West Essex Clinical Commissioning Group (CCG) were keen to join in, along with patients and colleagues from the Princess Alexandra.

Videos, pocket guides and leaflets: using the team’s skills

Although it has been a challenge – they have to fit OSAAT in around their day jobs – there has been a willingness to work together. The team plays to individuals’ strengths, Ms Harnett says, whether that is the marketing expertise of CCG cancer campaign manager Iolanda Cuomo, or the lived experience of patients.

‘Together we can bring clinical, personal and professional viewpoints and work collaboratively,’ says Ms Harnett.

Patient information explains the journey through cancer care, including the healthcare professionals involved and possible treatment options Picture: Tim George

Non-clinical ‘pocket guides’ were next, plus other videos based on the experience of patients and carers, and in the past two years the project has gathered momentum.

Now patents are offered leaflets at diagnosis, OSAAT is part of the integrated care system patient engagement strategy and has been promoted during education initiatives and other events locally, and more widely. The team is also tackling health inequalities by, for example, producing information in languages other than English.

‘The value of information to support decision-making and care and treatment planning is so important and cannot be overestimated’

Sue Tranka, RCN Nursing Awards judge and chief nursing officer for Wales

‘We’re proud of this work and have been honoured to use our experience of cancer in a positive way to help other patients,’ Ms Harnett adds. ‘Despite the challenges of the pandemic, we’ve amplified the patient voice.’

How to build a winning team in healthcare

Tips for successful team working from Emma Harnett:

  • Share your vision Working as a team means coming together with a shared vision and a shared passion – and having the right people at the table
  • Focus on patients, and listen to them One Step at a Time is about amplifying the patient voice, which means patients have to be at the centre of what we do. We as clinicians shouldn’t be saying how it should be, we should be listening and taking patients with us
  • Collaborate and capitalise on talent Be truly collaborative – and that means valuing everyone’s skills and experiences
  • Look beyond your own organisation Work in conjunction with the voluntary sector – there are lots of great resources out there, and it’s also good to network and share experience and ideas

Building resources to improve the experience for others

The awards judges were particularly impressed with the efforts made by the team to provide relevant and accessible information. Chief nursing officer for Wales Sue Tranka said: ‘The One Step at a Time team’s information and guide for people diagnosed with cancer is underpinned by a drive to improve the experience of those affected by cancer while also supporting communication with significant others.

‘The value of information to support decision-making and care and treatment planning is so important and its value cannot be overestimated.’

The team worked with patients to develop the resources Picture: Tim George

LV= managing director Heather Smith said: ‘The One Step At A Time Team, led by Ms Harnett, are worthy winners of this award. To go through a life-changing cancer diagnosis and use this to help improve the journey for others is remarkable.

‘The team has created a wealth of fantastic resources and information for people going through the same experience and their fantastic contribution is why they thoroughly deserve to win.’

The Team of the Year award is sponsored by LV=