The more for less agenda doesn’t cut it
You can’t fault a cancer nurse’s work ethic, but rising workloads are having a significant impact on our ability to fully support patients.
You can’t fault a cancer nurse’s work ethic, but rising workloads are having a significant impact on our ability to fully support patients
As an advanced nurse practitioner specialising in ovarian cancer, I have been an adviser on Target Ovarian Cancer’s ground-breaking Pathfinder study into the lives of people living and working with ovarian cancer in the UK, which included a survey of gynae-oncology nurse specialists.
Pathfinder’s results were published recently and I was pleased to see that 90% of nurses say all women with a diagnosis of ovarian cancer at their hospital are assigned a specialist nurse. In my working life and as president of the National Forum of Gynaecological Oncology Nurses, I’ve seen nursing provision increase.
Despite this, nurses are becoming increasingly stretched in their day-to-day roles. Only 46% of the nurses responding to Pathfinder said they felt their cancer centre had enough nurses to care for all the women being treated there. This shows that pressure on nurses’ time is increasing too – a majority (63%) of nurses say they are able to meet all the medical needs of women, such as symptom control, but this leaves one third of my peers feeling stretched.
of cancer nurses feel stretched
Women with a diagnosis of ovarian cancer also report unmet needs. Of those experiencing nausea, 69% say they received help and of those needing help with pain management, just 55% received it.
While we would all hope to see additional investment in the vital work we do, we must work as creatively as we can with the resources we have, working with colleagues across our multidisciplinary teams to provide the best possible care for women with ovarian cancer.
You can’t fault a cancer nurse’s work ethic. We’re pushing up against some great, yet challenging advances: in ovarian cancer, recent developments and clinical trials mean there are more lines of chemotherapy and different combinations of drugs.
The range of treatments for ovarian cancer is still too limited, and yet new treatments can put added strain on our workload. Patients now come in for more treatments – olaparib, bevacizumab – and those treatments can bring more toxicities and support needs.
'You can't fault a cancer nurse's work ethic'
Women may also be referred for end of life care, and in Pathfinder, 54% of nurses say they are always able to refer women. Having a team you can call on is so important and I work alongside a really supportive palliative care team.
In gynaecological cancers, working across teams can bring improvements in broader needs like mental health, where 80% of women with ovarian cancer report problems. Treatment can have a huge impact on sex and intimacy, but just 12% of women say anyone involved in their treatment has talked to them about this.
Recurrence is common and 51% of women say they need support coping with the fear their cancer might come back. Yet 63% of nurses say they don’t always have time to do this.
If broader and more holistic support is there, including mental health services, we can help women through difficult times.
Making the difference
There are time pressures on us, but I know that even five minutes with a patient can make the biggest difference in the world. Through Pathfinder, Target Ovarian Cancer is calling on the government to make sure we have the right level of nurses to support all women with ovarian cancer and more support for us.
The charity already has a commitment from the Minister for Community Health and Care to work with it to deliver recommendations set out in the report.
About the author
Natalie Percival is advanced nurse practitioner and president of the National Forum of Gynaecological Oncology Nurses