Back to the floor – Melanoma clinic

Melanoma Group I had an invite from Ruth Board, Consultant Oncologist, to visit her team and patients in the melanoma clinic held in the Rosemere Cancer Centre.

For those of you who don't know, over 3,400 patients receive radiotherapy there comprising 53,000 treatment attendances, just short of 14,000 patients attend as outpatients and over 8,500 patients have chemotherapy in the unit. That's a lot of people going through a relatively small centre!

They have oodles of high-tech, super expensive equipment, 7 linear accelerators and deliver lots of specialist therapies with more acronyms than you can shake a stick at - IMRT, VMAT, IGRT (after trying to remember all that I've added my own acronym....NMHH otherwise known as Now My Head Hurts!)

On the day I was there it was to see the outpatient clinic at work. Normally I do a full shift but on this occasion I was only able to spend a couple of hours before I was tracked down by my PA Karen (believe me, you don't mess around when she's called you back to the office!) As those of you who read my blogs will know I usually like to be part of the team and do real work but this time I was content to be an observer.

When Ruth first invited me to the clinic she explained what melanoma is and how young some of her patients are. I felt a bit anxious to be honest, I certainly didn't want to become emotional and I was concerned that I might be overwhelmed by some of our patients’ stories.

I arrived at the Rosemere Cancer Centre to be introduced to all the staff ranging from HCAs, specialist nurses, medical students and registrars. The first thing that struck me was how light-hearted the staff were, lots of jokes and banter, very friendly as you would expect, not at all gloomy or sombre but the biggest surprise was that many of the patients were the same.

Ruth checked with every patient first to see if they would mind me being present during the consultation and only then was I allowed to enter the room. Some patients had relatives with them and others came alone - I did check with everyone if they would mind if I wrote about what I learned so what you read has got their permission. Before we went in to see the patients Ruth spoke to the specialist nurse to make sure everything was up to date and everyone was clear about results and next steps. It’s so very important in this environment that staff are aligned and the patient has the same information from anyone they choose to ask.

I sat in a consultation with a gentleman who had brought his wife with him. Ruth explained to them that the trial drug he was on was no longer working and she would need to change his medication. I was really impressed by how she did it because it was just like chatting to a friend. The language was easy to understand and very interactive inviting questions or comment.......and then she left the room to give the specialist nurse a chance to make sure the patient fully understood. The patient's wife waited until Ruth had left the room and then broke down. It was very emotional but the specialist nurse was incredible - I know they have training but this stuff comes from the heart; and they have heart in bucketfuls! That lovely couple left the room smiling.

I met fantastic patients who said some amazing things about the staff at Rosemere - it puts a bit of a counterbalance against the negative things we read in the press and hear about in the media. We need to do much more to get those voices heard because we have much to be proud of in both our hospitals.

The next patient and her partner were regulars at the clinic and I could hear Ruth asking them for permission for me to join them, first of all there was silence, then rustling and scuffling followed by raucous laughter ............when I went into the room it was to discover that they had found their iPads, googled me and boy did they take the proverbial! This young couple were a privilege to be with; they clearly knew the prognosis, extremely clued up on medication, side-effects and treatments, asked very relevant questions and questioned what they heard and had a determination to enjoy their lives together. There's a strong genuine camaraderie between doctor, nurse, patient and partner - they know each other very well so they approach each visit with a measure of informality and have fun together.  It felt like family.

In an effort to be more helpful I was dispatched to get coffee/tea for everyone from the volunteers tea bar - Ruth paid and despite what she says I definitely gave her the change back!  So there I am transporting 9 drinks back on a tray and sloshing them everywhere in front of a waiting room full of people when a patient smiled (pityingly I thought) and said in a loud stage voice 'wouldn’t she do better if she had a pair of sensible shoes on'! Don't you just love the things patients say!

So what are the things that staff or patients said that I'm going to have a look at?

Patients said they sometimes had to wait a long time for pharmacy to be dispensed so I'll ask Gareth Price Chief Pharmacist to take a look and see how we can help them in the busiest clinics.
The clinicians couldn’t access pictures on the computer system if there were too many people trying to access it at the same time - I'll speak to the IT team to find out if we can improve access.
Staff noted there are no facilities to make drinks or quiet areas to sit down together for a break - I can't promise anything here but I will commit to me and Miles Timperley, our Director of Facilities and Services, having a walk about with the managers to see if we can improve staff environment.
And finally ……..get some proper shoes!

So to Ruth, Maggie, Rachel, Richard, Joan, Claire and Carolyn and all your patients - thanks for having me. It gave me great insight into your team and how you pull together. You should be very proud.

Karen Partington

Tweet: Back to the floor blog - Melanoma clinic