A day in the life of a breast care nurse

Breast care nurses can support women in many ways through their breast cancer journey. They can coordinate care, help with managing side effects, translate difficult medical terminology, explain treatment options, and advocate on behalf of an individual woman to make sure her voice is heard.

The Beacon spoke with Monique, a breast care nurse at Royal Melbourne Hospital, and Lauren, one of the women she looks after, to learn more about a day in the life of a breast care nurse.

4.45 am: I like starting my day with an hour-long walk. I know how important exercise is, and it’s something I talk a lot about with the women I support. My walk is my time to focus on me: it is important to look after myself when so much of my day involves caring for others.

Morning: every day is different, but most mornings I do rounds with the breast surgeons. I talk with the women who had their breast surgery the previous day, assess their needs, help them prepare for discharge with things such as drain care and lymphoedema prevention, and discuss the next steps.

Women having chemotherapy start arriving at the oncology clinic. I make sure they know I am here for them. This can be a struggle, as chemotherapy is on a different site, but the women just have to ask for me if there is anything they need and I can pop over and see them.

Some days I attend an interdisciplinary team meeting or run the breast clinic. This allows me to support, advocate for and educate newly diagnosed women.

Another big part of my mornings is coordinating care. Yesterday I sorted out an urgent dental appointment to treat a dental abscess for a woman scheduled for chemo today. I try to make things run as smoothly as possible for the women.

Lunch: I respond to emails while I eat.

Afternoon: I have one-on-one appointments. If a woman is getting ready for surgery, I check she has a good understanding of her surgery and discuss her pre- and post-op care. I make sure she has a My Journey Kit and, if she’s having a mastectomy, I fit her for a My Care Kit bra. I ask some questions to find out what her needs might be. For instance, questions around sexuality and body image, or how the family is going to manage at home. It is important that she knows I am here to have these conversations.

In our one-on-one chat, we might discuss breast reconstruction and go through some pictures of how other women look after their surgery. I sometimes put a woman considering reconstruction in touch with another woman so she can ask questions or suggest she come along to a breast reconstruction awareness (BRA) session so she can meet others who have been through it.

Sometimes I do a survivorship care appointment for a woman at the end of her treatment. We discuss any concerns and develop a care plan so she knows what to expect in terms of her follow-up care.

After the appointments are finished, there is always paperwork to catch up on. My pager will be going and queries from outpatients will need answers. I try to catch up with other inpatients as well as seeing our post-op patients. I triage new referrals. If it’s a Tuesday, I’ll attend another breast clinic, and if it’s a Friday I’ll run my nurse-led nipple tattoo clinic. Helping women with this step at the end of the journey is a positive way to end the week.

5.00 pm: I visit the women in hospital I haven’t had time to see today. My thoughts turn to tomorrow – I try to forward plan, but our priorities are changing all the time.

Evening: On a good day, I’ll leave at six, sometimes it’s closer to seven.
The most important thing for women to know is that they can ask me anything. Whatever they need I will do my best to be there for them, but I do struggle with the knowledge that as hard as we try we cannot always be everything to everyone.

 

Lauren’s experience

Lauren

I was diagnosed with breast cancer in October last year at the age of 30. I’m now in the middle of my chemotherapy treatment and have surgery coming up at the end of June.

A typical treatment day for me starts a lot like a day at work – I take some medication to help with chemo side effects and then catch the bus into Peter Mac for my chemo treatment.

Because I am relatively well right now, Monique my breast care nurse doesn’t pop into every treatment, but it is a real comfort to know she is only a phone call away. Monique’s an intermediary between me and the medical world. She translates the medical jargon and explains my choices to me. I’ve often checked with Monique when I’ve been confused. She is there for me if I have a strange reaction to a treatment and am wondering if I need to freak out or if it’s nothing to worry about!

Monique is a master in making my appointments flow smoothly. When I was diagnosed I tried to take control of the practical things, but there are so many different appointments to coordinate. I have some fatigue and memory issues, so Monique’s help is important to me.

Monique sees who I am as a person and is a great support through the emotional impact of diagnosis and treatment.

She helps connect me to any additional services I need. She is a consistent face and voice through a tumultuous time. I can’t fully express how grateful I feel for how much support she provides.

Issue 79
Winter 2017