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Translating cancer nursing into practice

The new UKONS president Richard Henry talks to Anne Horner about planning for a surge in older people with cancer and finding time to care in busy workplaces

The new UKONS president Richard Henry talks to Anne Horner about planning for a surge in older people with cancer and finding time to care in busy workplaces.


Richard Henry discusses what can be done to ensure caring for cancer is a long-term solution

Richard Henry, the new president of the UK Oncology Nursing Society (UKONS), is a busy man highly aware that caring cannot be rushed.

As a teaching fellow at Queen’s University Belfast’s School of Nursing and Midwifery, he lectures on cancer nursing. ‘We look at how cancer nursing translates into practice, looking at communication, maintaining people’s dignity and establishing interpersonal relationships that are dependent on trust and empathy’ he says.

Changing the game

‘You can talk about that in the classroom, but to get people to do that in practice…especially in busy areas where the organisation of the ward area and the clinic is such that they are very task-orientated,’ he explains, before adding: ‘We see bright, young, enthusiastic students coming in who want to change the world.

'They want to do so much, and yet three years later out trudges the person. Maybe we burn up their enthusiasm.’

Common signs

In the week of our interview Health Education England (HEE) said it was aiming to halve the rate of students dropping out. But why do so many leave? Mr Henry believes there is a common theme: ‘You hear the same thing: we are busy. There is something about the culture.’

‘But we can make a difference to workplace culture. The old adage is always right – keep your workforce happy, help them to believe they are making a decisive contribution. That’s what good managers should do, but many of the managers are under the cosh. They have a difficult job,’ he adds.

Development

Throughout the interview he is keen to sound equally measured. He describes UKONS’ role as supporting and developing the cancer workforce and looking at the issues which are important to them.

As president of UKONS, he leads an organisation that aims to promote excellent nursing care through supporting nurse development, as well as to influence and advise on cancer policy and clinical practice. It now has 5,500 members and ‘over the past four to five years our membership started to shoot up’, he adds.

‘We look at every issue on its merits, presenting both sides of the argument. The idea is to prompt debate. We want to foster professionals who can think for themselves,’ he says.

Being UKONS president is ‘a great honour,’ he says. ‘We have got a growing community of cancer nurses. I’ve been involved with them most of my working life, so it is a great opportunity to give something back into a profession that has been so good to me.’

'This is a geat opportunity to give something back'

Keen to see the development of a coherent cancer workforce strategy, he was disappointed when HEE said last October that cancer workforce figures would not be released.

‘Your immediate gut reaction is to think “Oh gosh, what are they hiding?” There’s an absolute need for a coherent workforce strategy as it arguably doesn’t exist,’ he says.

‘Any strategy should take account of current amazing technological and treatment-based developments, while acknowledging the deficits of the past. [And] without a steer how can we be sure we can deliver? I’m not just pointing a finger at the Department of Health. Lots of people should discuss what we want and how we are going to get it. At UKONS we would absolutely want to be involved in those discussions’ he adds.

Greater defecit 

A further frustration is around the numbers of cancer clinical nurse specialists (CNS). Macmillan Cancer Support’s 2014 census of specialist adult cancer nurses in England revealed a rise in numbers of patients assigned a CNS from 84% in 2010 to 89% in 2014, meaning one in ten people with cancer did not have CNS support, even though the CNS is known to make a huge difference to patient experience.

Locally the situation is much worse, he says. ‘In Northern Ireland we’ve had a significant CNS deficit for quite a long time. In 2011 we had 56, three years later there was just one more nurse.

‘A lot of the attention is on the CNS, but at UKONS we need to engage the nurses working in general wards – primary care nurses, practice nurses, we see them as integral parts of the cancer nursing family. We want to bring them up to speed on what UKONS does and what it is about,’ he explains.

Progress has to happen

He becomes impassioned as he talks of a failure to plan for the expected growth in numbers of older people with cancer.

‘More people who have had cancer are going to survive into extreme old age with multiple other diseases. Many are socially isolated, living in poor standard housing or in poverty. It will put tremendous pressure on cancer services.

‘Many – Macmillan, for example – have highlighted the issue, yet no obvious progress has been made on a mass scale. We are not addressing these people’s needs coherently and consistently.’


RICHARD HENRY’S NURSING JOURNEY

How it started In 1983, at the age of 27, he quit being an English and history teacher to become a nurse.

What, when and where Becomes an oncology nurse in 1986 at Northern Ireland Radiotherapy Centre, then at Belvoir Park Hospital in Belfast.

Why? ‘My mother said “you should go and do nursing”. I hadn’t a clue what she was talking about.’

Nurse educator He has worked in cancer nurse education for more than a decade and is teaching fellow in the School of Nursing and Midwifery at Queen’s University Belfast.

Dislikes How stories of celebrities with cancer are often presented. He says: ‘There is the kind of celebrity circuit with lurid headlines: “I’m not going to let this beat me”. Cancer still gets characterised as a fight to the death.’

Likes Presenter Steve Hewlett’s cancer diary on BBC Radio 4. ‘He’s very realistic. It’s about his hopes, down periods and his fears.’

Hobbies Painting, gardening and modern opera. ‘When I go to London I always try to get to see something at the Royal Opera House, but it’s quite expensive.’

Published research The role of the cancer specialist nurse (2015) Nursing in Practice, 87, 24.11.2015, 32-34.

The future 2016-2018 UKONS president.

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