More support for prostate cancer nurse specialists needed

Most of the time, I feel like I have the best job in the world. But I still have a clock on my phone counting down to my retirement date. I tried to leave nursing once but came back after realising that no other job could give me the satisfaction of making such a difference to peoples’ lives. It is like an addiction, with intense highs and lows, often in the same day.

It is easy to list what I do. Men with prostate cancer are referred to me right from diagnosis, and I am there to support and counsel them through their illness and treatment. I prescribe treatment, request imaging and tests, monitor their progress in nurse-led clinics, refer them to other specialities, perform physical examinations, break bad news and monitor them every step of the way. On top of this, I also run patient education seminars, write leaflets and co-run a support group.

What is less easy to define is the impact of my role. I am passionate about nursing, but in my 20 years as a nurse in an ever-evolving NHS, I have seen first-hand how nurses’ worth is not always appreciated. As we have taken on more and more roles within the patient pathway, somehow the unique nursing role has become less valued.

Excellent nursing is often a hidden thing. It may take place in private and can be an intimate exchange, and it doesn’t always show up in spreadsheets about activity. But it is a skill, it is what patients remember and value, and it is vital.

A recent report from Prostate Cancer UK on the specialist nursing workforce reflected many of the challenges I currently face. The report revealed that prostate cancer specialist nurses are taking on too many roles, resulting in unmanageable caseloads. They are also working unpaid hours and leaving aspects of care undone, one of the most common being a relatively new initiative: the holistic needs assessment.

Implementing this assessment meaningfully requires resources, but with many nurse specialists reporting little or no administrative support, this is nigh on impossible. This week I have assessed, diagnosed and treated. I have supported men coming to terms with a diagnosis or terminal condition, and I have held the hand of a crying man as he told me his deepest fears.

But I have also spent many hours printing invitations and stuffing envelopes to invite men to a health and wellbeing event, as well as printing and faxing referrals and making appointments. If we truly value the nursing role, we have to provide the support to allow specialist nurses to do their jobs.

The Prostate Cancer UK report also revealed a prostate cancer nursing workforce which could become extinct within the next ten years. We are largely an aging workforce ready for retirement, but there are no clear plans to train and develop nurses to take our place, and there are very few opportunities for progression.

As dedicated urology wards disappear, we need to think quickly about development posts and succession planning. Prostate cancer is set to become the most common cancer overall in the UK by 2030, but at this rate there will be no specialist nursing workforce around to support those living with the condition. Urgent action is needed.

The report from Prostate Cancer UK was long-awaited and welcome, but revealed few surprises for those of us working in the field. I love my job, but like any job it has its frustrations, and I am pleased that these frustrations have finally been evidenced and acknowledged. I hope that we can now talk about them in a constructive way, and with the right support we can tackle them head on to improve patient care.

About the author

Louisa Fleure is a clinical nurse specialist at a London trust for men with advanced prostate cancer