Bethan Lloyd Owen: How I came to be the independent sector’s only consultant nurse in breast care.

I qualified as an enrolled nurse over 20 years ago. At first I worked in a general surgical ward and soon realised there wasn’t enough expert information given to women with breast cancer.

I remember being asked by one of the staff nurses to arrange a lady’s discharge. She was in her early 40s and had had a mastectomy. The breast prostheses were kept in a box in the linen cupboard – they looked like shoulder pads gone wrong.

Someone on the ward handed me the box and I was told to leave it with this very upset patient so that she could put something in her bra “so no one would know what she had had done”.

I felt helpless. I knew this lady was going home devastated.

It had to get better

I contacted all the suppliers to request prosthesis samples and build up a range. Soon I started receiving calls from other nurses, doctors and consultants asking me to see their patients on other wards and in outpatients.

It was from here that one of the first NHS one-stop fast-track breast clinics in Birmingham started. For the first time patients referred to us had triple assessment, if required, all in the same day.

As a result our breast cancer patients were given their diagnosis and started treatment weeks earlier than previously. Those who didn’t have cancer were put out of their misery at their first hospital appointment.

Recognition

I was awarded Outstanding Achievements within Nursing at the Nurse of the Year Awards for this. After converting to RGN and gaining ENB, Dip, A11-998-237 I was promoted to CNS in Breast Care. The breast surgeons I worked with in the NHS had arranged for me to support their patients with breast cancer at our local private hospital.

So there was a lot of work to be done to ensure the standards of breast cancer care were on a par with our NHS service. The opportunity to set up two other services, predominantly with the same consultants who shared my philosophy of care, was very exciting. One of the new things to learn was supporting patients with health care insurance issues.

Going private

In 2000 I was offered a full-time position with BUPA (now Spire), dealing with breast care in two hospitals. I gained my BSc in 2001 and started by setting up nurse-led clinics to support patients with a family history of benign and malignant breast disease, treating approximately 120 newly-diagnosed breast cancer patients a year.

I clinically examine patients and request imaging, but don’t carry out biopsies. I give patients results after the MDT. In 2002 a second CNS in breast care joined the team and I set up my second patient support group which is available for both NHS and private sector patients.

I receive telephone calls regularly from patients, doctors, nurses and other health care professionals asking for advice via a 24/7 telephone service. All patients are supported through diagnosis, surgery and adjuvant therapies by my colleagues and myself.

Reaching out

During follow-up I co-ordinate referrals to other members of the team to ensure prompt intervention. I am part of a team, but I am also the only professional who is constantly involved in every patient’s care, being the link between them and all other health professionals.

I am also the clinical lead for Spire for the Breast Cancer Service, being part of the team responsible for standard setting and clinical pathways of care that meet with the national cancer plan.

I lecture student nurses and doctors, primary health care teams and women’s groups. I have also established an annual breast awareness session for fifth year girls at two local schools and advise Breast Cancer Care on their patient information leaflets.

Fundraising is a big part of my role. Every two years I organise a Breast Cancer Ball in Birmingham which many of the medical team and patients attend. The money raised is used to give practical help such as payment towards a wig, child care or housework.

My job is unique and I would find it impossible to describe a typical working day. Juggling my local, national and managerial commitments means no two days are the same.

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