Wednesday, 6 August 2014

Oncology experiences

The longest placement of our course is for twelve weeks, towards the end of our third year.  We can ask to be placed in a particular specialism, and the university and the hospitals it partners with try to accommodate our requests.  I asked for oncology, and was given it.

It was a tough placement.  So much is expected of us by this stage in our course.  Our mentors are assessing whether or not they are happy for us to join the register of nurses, and we are acutely aware that in a few weeks or months (if our mentors are satisfied with our abilities) we will be newly qualified and practising independently.  We are trying to learn as much as possible while we still can, but also prove that we already know how to be safe and work as a graduate nurse.  We have seen so much by this stage of our course (after a Saturday night shift in A&E I truly thought I'd seen everything) - but of course we haven't seen or experienced a fraction of what there is to see.  People's bodies and minds still shock and surprise me.  This placement was when I properly understood that I will never stop learning.

And then there is oncology itself.  Cancer is a very complex disease that evolves and changes over time.  It can be cured and managed better than ever before - but not always.  It affects everybody differently, and touches a person's family, friends and lifestyle too.  

In my first week on the ward, one of the Macmillan Nurse Specialists said that I must make sure to spend a morning with her in one of the outpatient clinics before the end of the placement.  "You will get a very one-sided view of cancer by working on a ward," she told me.  It wasn't until the penultimate week of my placement that I got a chance to take her up on her invitation and join her in the outpatient clinic.  On the ward I cared for people who were very sick - either because their disease had progressed and they were close to end of life, or because the treatment they were receiving was making them extremely unwell, even though it may have been killing the cancer.  However, in the clinic I met a much greater number of patients who were either living a completely full life with cancer and whose symptoms were completely under control, or whose cancer had been cured or removed - by the often harrowing treatment we gave on the ward - and who had been in remission for many years.  Many of these people were the beneficiaries of the enormous amount of reasearch and experimentation that goes into oncology in this country.  It was helpful to be reminded that the very unwell people I was nursing on the ward, were just a small proportion of the number of people affected by the disease.

I had so much to think about and a great deal to say while I was on placement on this ward, but was unable to express it - partly due to confidentiality, but also because there was just so much to process in my mind.  I took even more photos than usual on my commutes, and tried to spend the time on the train really focusing on my nursing skills, and reflecting on my new life as a nurse.  I didn't get enough sleep because the shift pattern on this ward was unusually relentless, and I didn't run for the same reason.  To be able to give of yourself - as you need to do when you are a nurse, and in many other professions - you need to be able to look after yourself too.  I ended the placement with a new determination to make more time for running, sleeping, reading magazines and baking cakes - all those good things which recharge my batteries and keep me content. 

12:30pm - last week at Bart's so last week of St Paul's pictures. This one is for @runnergmcc who thinks I haven't taken enough! #stpauls  #london #work #studentnurse

6:55 - St Paul's looking particularly majestic this morning #stpauls #london #morning

6:45am - playing peepo with St Paul's #london #morning #stpauls #work

6:50am - looking up #stpauls #london

12:10 - came in early to do some shopping before work, and found myself admiring this view of St Paul's from the back as I came up the escalators from New Change #stpauls #london #sky

6:50am - the top of the dome, above the top of the trees #stpauls #sky #london #morning

6:45 - coming up from underground #london #tube #morning #work

Although I'm not going to be working in oncology when I qualify, I wonder if it might be something I return to at some point in my career.  As well as being the toughest placement I've done, it was also one of the most satisfying.  I had days where I came out of work on such a high because I knew I'd left patients feeling better at the end of the shift because of something I'd done.  And quite simply, that's what it's all about.

6:45am - steps like piano keys at St Paul's station #tube #london #work #commute


  1. ...and make sure you continue to care for your own needs. Us ladies tend to give, give and give - particularly to others. All the best there x

  2. Thank you for sharing this - so interesting to have a perspective from a nurse's point of view. You seem to have a great balance of work, fun, sewing, and time to blog about it all - I'm sure it takes a lot of effort to keep it in balance, but I love reading about it.

  3. I'm full of admiration for you Nancy. You've not chosen an easy profession but you you seem to do it with such an enthusiasm. I only hope that if ever I need nursing it is by someone just like you.

  4. I'm really glad you enjoyed your last placement even if it meant that some of the other things fell by the wayside. It's really easy to forget to look after yourself. I talk a lot about that with my own students (mostly medics but some other healthcare professions too) and then have to be mindful of not neglecting myself. I hope you really enjoy your time off and then moving into your new job. Exciting times - i'm looking forward to hearing about it.

  5. Oh, I do love your blog very much.


Even though I often do not have the time to reply to everybody, I really appreciate all your comments so much - thank you for taking the time to read my blog and share your thoughts on what I've written.