RCNi Nurse Awards 2018: Exemplifying the advanced skills required to deliver groundbreaking work
Lead research nurse Foteini Rozakeas has picked up the Excellence in Cancer Research Award
at the RCNi Nurse Awards 2018 for her pioneering lead in an advanced cancer study
The lead nurse in a pioneering research trial has been recognised for her compassion and expertise in recruiting patients to a sensitive study.
Foteini Rozakeas, who works for University College London Hospitals NHS Foundation Trust, was announced the winner of the Excellence in Cancer Research award, sponsored by Cancer Research UK, at the RCNi Nurse Awards earlier this month.
Ms Rozakeas is the lead research nurse in the pioneering PEACE (Posthumous Evaluation of Advanced Cancer Environment) Study.
‘It is an honour and a privilege to win this RCNi Nurse Award for the team. It will help raise awareness of the PEACE study on a national level, because this is pioneering research that has never been done before, with the potential to have significant clinical implications for personalised treatment for cancer patients,’ says Ms Rozakeas.
‘PEACE is the UK's first national study of blood and tissue samples from patients who have died from cancer, which means we will have information about cancer that we have never had before.
‘Patients and their families often say “we would like to give something back to the NHS as a thank you.”’
‘The PEACE team is offering this opportunity by allowing patients to choose to donate their body to cancer research.’
Watch: RCNi Nurse Awards 2018 Excellence in Cancer Research winner Foteini Rozakeas describes her project
Sensitive and dignified
Ms Rozakeas is responsible for screening, recruiting and registering patients to the study to achieve a minimum target of 10-15 tissue harvests per year in a sensitive, respectful and dignified way.
She is also responsible for coordinating with the 12 supporting recruiting sites and affiliated settings, such as hospices and coroners. She works to increase referrals from internal and external consultants and regularly gives presentations to raise awareness of the study.
She also liaises with the PEACE multidisciplinary team to coordinate the tissue harvests in a timely manner 24-72 hours after death.
Coordinating this extensive team brings its own challenges.
‘There are logistical challenges because the team is so complex,’ says Ms Rozakeas.
‘It involves a multitude of disciplines for example the pathology department, the mortuary, palliative care nurses and also nurses coming together to respect and honour the patient’s dying wish for a good cause – to save lives.’
The PEACE study
PEACE is a multicentre observational cohort prospective study collecting tissue donation from different tumour sites for up to 500 patients after their death.
Patients have to be a minimum of 18 years, diagnosed with metastatic cancer and primary brain tumours, and have given informed consent to enter the study.
PEACE aims to understand how cancers grow and spread and identify gene abnormalities in different types of cancer.
The study hopes to identify markers in tumours that can predict whether a patient will respond to a particular anti-cancer therapy and explain why some patients become resistant to drug therapy.
The study also hopes to determine whether a single tissue sample is representative of the entire tumour, or whether multiple samples are required and determine genetic abnormalities that allow the spread of cancer tumours by comparing tissue samples from primary and secondary tumours in the same patient.
Cancer Research UK lead research nurse Anne Croudass was on the RCNi Nurse Awards judging panel.
She says: ‘Foteini was a worthy winner in a strong category.
'Her role exemplifies the advanced skills, expertise, and empathy required by clinical research nurses to deliver groundbreaking research such as the PEACE study.’
Janyne Asfeth, member of the RCN forum for cancer and breast care, sits on the European Oncology Nursing Association advisory council.
She adds: ‘Foteini is a compassionate nurse able to manage very difficult conversations about death and dying in the context of clinical research with patients, families and other healthcare professionals.
‘This complex multicentre study requires a high level of communication and co-ordination across sites and professional groups and she manages this with great expertise.’
Unique consent process
Once she receives a referral, consultations on consent are conducted in a sensitive way and take up to two hours. Written informed consent requires three signatures – the patient, a witness and Ms Rozakeas. The patient must demonstrate the mental capacity to make an informed decision at the time.
The consent process is unique so she visits external sites at their first opportunity to recruit to demonstrate the family consultation. ‘It is a good opportunity to share learning,’ she says.
‘There are a magnitude of sensitivities. Timing can be tricky, but patients are usually given an information sheet when they move towards their supported care.
‘I am the nurse advocate,’ says Ms Rozakeas.
‘I respect the patient’s and relatives’ religious, cultural and spiritual beliefs. I offer them emotional and psychological support at difficult times.’
Sometimes patients’ wishes conflict with their relatives or loved ones.
‘One of first patients I recruited was so open to the research and gave consent, with her cousin acting as witness.
'After she died, I approached the family to organise the harvest and they were completely against it. They were not aware their daughter had signed up. In that situation, I respected the parents as I felt that was the best outcome.’
It was the sensitive way she deals with these complexities that earned her the award.
The study is relatively new and Ms Rozakeas believes her practice will improve. ‘As nurses, we are always reflecting on our practice.’
Ms Rozakeas is hoping difficult conversations workshops as will become mandatory to change the culture around death and dying.
‘Winning this award raises the PEACE study’s profile. It will also open up new opportunities for other diseases.’
Cancer Research programme
Cancer Research UK’s new Excellence in Research programme supports clinical research nurses working on cancer trials.
The programme is designed to provide and signpost to continuing professional development, cancer-specific education and networking opportunities.
Clinical research nurses who wish to grow their knowledge, skills and expertise in delivering cancer trials, and connect and share best practice with their peers, can sign up here.
A related feature on the programme can be read here: The valuable contribution of clinical research nurses